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Encyclopedia > Gynecomastia
Gynecomastia
Classification and external resources
An obese teenage male with Gynecomastia.
ICD-10 N62.
ICD-9 611.1
DiseasesDB 19601
MedlinePlus 003165
eMedicine med/934 

Gynecomastia, or gynaecomastia, pronounced /ˌgaɪnəkoʊˈmæstiə/ is the development of abnormally large mammary glands in males resulting in breast enlargement, which can sometimes cause secretion of milk. The term comes from the Greek gyne (oblique stem gynaik-) meaning "woman" and mastos meaning "breast". The condition can occur physiologically in neonates, in adolescents, and in the elderly. In adolescent boys the condition is often a source of distress, but for the large majority of boys whose pubertal gynecomastia is not due to obesity, the breast development shrinks or disappears within a couple of years [1]. The causes of common gynecomastia remain uncertain, although it has generally been attributed to an imbalance of sex hormones or the tissue responsiveness to them; a root cause is rarely determined for individual cases. Breast prominence can result from hypertrophy of breast tissue, chest adipose tissue and skin, and is typically a combination. Breast prominence due solely to excessive adipose is often termed pseudogynecomastia[2] or sometimes lipomastia[3]. Image File history File linksMetadata Download high-resolution version (1800x1200, 333 KB) Male with very severe Gynecomastia. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // N00-N39 - Diseases of the genitourinary system: urinary system (N00-N08) Glomerular diseases Prefixes: .2 Diffuse membranous glomerulonephritis (N00) Acute nephritic syndrome (N01) Rapidly progressive nephritic syndrome (N02) Recurrent and persistent haematuria (N03) Chronic nephritic syndrome (N04) Nephrotic syndrome Lipoid nephrosis (N05) Unspecified nephritic syndrome (N06) Isolated proteinuria with specified... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Mammary glands are the organs that, in the female mammal, produce milk for the sustenance of the young. ... The word male has the following meanings: In biology, it refers to one half of a heterogamous reproduction system, where the female is the other half. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... The Adolescents were a punk band in the 1980s. ... Sex hormones are hormones that affect the reproductive system. ... Bodybuilder Markus Rühl has marked hypertrophy of skeletal muscle. ... Adipose tissue is one of the main types of connective tissue. ...

Contents

Causes

Physiologic gynecomastia occurs in neonates, at or before puberty and with aging. Many cases of gynecomastia are idiopathic, meaning they have no clear cause. Potential pathologic causes of gynecomastia are: medications including hormones, increased serum estrogen, decreased testosterone production, androgen receptor defects, chronic kidney disease, chronic liver disease, HIV,[4] and other chronic illness. Gynecomastia as a result of spinal cord injury and refeeding after starvation has been reported.[5] In 25% of cases, the cause of the gynecomastia is not known. Puberty refers to the process of physical changes by which a childs body becomes an adult body capable of reproduction. ... In biology, senescence is the combination of processes of deterioration which follow the period of development of an organism. ... Idiopathic means arising spontaneously or from an obscure or unknown cause. ... Estriol. ... Testosterone is a steroid hormone from the androgen group. ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ...


Medications cause 10-20% of cases of gynecomastia in post-adolescent adults. These include cimetidine, omeprazole, spironolactone, imatinib mesylate, finasteride and certain antipsychotics. Some act directly on the breast tissue, while others lead to increased secretion of prolactin from the pituitary by blocking the actions of dopamine (prolactin-inhibiting factor/PIF) on the lactotrope cell groups in the anterior pituitary. Androstenedione, used as a performance enhancing food supplement, can lead to breast enlargement by excess estrogen activity. Medications used in the treatment of prostate cancer, such as antiandrogens and GnRH analogs can also cause gynecomastia. Marijuana use is also thought by some to be a possible cause; however, published data is contradictory.[6] Cimetidine (INN) (IPA: ) is a histamine H2-receptor antagonist that inhibits the production of acid in the stomach. ... Omeprazole (INN) (IPA: ) is a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcer disease (PUD), gastroesophageal reflux disease (GORD/GERD) and Zollinger-Ellison syndrome. ... Spironolactone (marketed under the trade names Aldactone, Novo-Spiroton, Spiractin, Spirotone, or Berlactone) is a diuretic and is used as an antiandrogen. ... Imatinib is a drug used to treat certain types of cancer. ... Finasteride (marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Prosteride, Gefina, Finasterid IVAX) is an antiandrogen which acts by inhibiting type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone (DHT). ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ... Prolactin (PRL) is a peptide hormone primarily associated with lactation. ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... For other uses, see Dopamine (disambiguation). ... Lactotropes are cells in the anterior pituitary which produce prolactin. ... The anterior pituitary (also called the adenohypophysis, from Greek adeno, gland; hypo, under; physis, growth; hence, glandular undergrowth) comprises the anterior lobe of the pituitary gland and is part of the endocrine system. ... Androstenedione (also known as 4-androstenedione) is a 19-carbon steroid hormone produced in the adrenal glands and the gonads as an intermediate step in the biochemical pathway that produces the androgen testosterone and the estrogens estrone and estradiol. ... Estriol. ... HRPC redirects here. ... An antiandrogen, or androgen antagonist, is any of a group of hormone antagonist compounds that are capable of preventing or inhibiting the biologic effects of androgens, male sex hormones, on normally responsive tissues in the body (see androgen insensitivity syndrome). ... A gonadotropin-releasing hormone analog, also known as a GnRH analog, is a class of synthetic peptide drugs modeled on the human hypothalamic gonadotropin-releasing hormone (GnRH) and designed to mimic or antagonize the physiological effects of GnRH for therapeutic purposes. ... A Cannabis sativa plant The drug cannabis, also called marijuana, is produced from parts of the cannabis plant, primarily the cured flowers and gathered trichomes of the female plant. ...


Increased estrogen levels can also occur in certain testicular tumors, and in hyperthyroidism. Certain adrenal tumors cause elevated levels of androstenedione which is converted by the enzyme aromatase into estrone, a form of estrogen. Other tumors that secrete hCG can increase estrogen. A decrease in estrogen clearance can occur in liver disease, and this may be the mechanism of gynecomastia in liver cirrhosis. Obesity tends to increase estrogen levels.[7][8] Tumor (American English) or tumour (British English) originally means swelling, and is sometimes still used with that meaning. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Androstenedione (also known as 4-androstenedione) is a 19-carbon steroid hormone produced in the adrenal glands and the gonads as an intermediate step in the biochemical pathway that produces the androgen testosterone and the estrogens estrone and estradiol. ... Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Aromatase belongs to the group of cytochrome P450 enzymes (EC 1. ... Estrone (also oestrone) is an estrogenic hormone secreted by the ovary. ... Human chorionic gonadotropin (hCG) is a peptide hormone produced in pregnancy, that is made by the embryo soon after conception and later by the syncytiotrophoblast (part of the placenta). ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ...


Decreased testosterone production can occur in congenital or acquired testicular failure, for example in genetic disorders such as Klinefelter Syndrome. Diseases of the hypothalamus or pituitary can also lead to low testosterone. Abuse of anabolic androgenic steroids (AAS) has a similar effect. Mutations to androgen receptors, such as those found in Kennedy disease can also cause gynecomastia. Testosterone is a steroid hormone from the androgen group. ... A genetic disorder is a condition caused by abnormalities in genes or chromosomes. ... XXY karyotype Klinefelters syndrome is a condition caused by a chromosome abnormality in males (specifically, a nondisjunction); sufferers have a pair of X sex chromosomes instead of just one. ... The hypothalamus links the nervous system to the endocrine system via the pituitary gland (hypophysis). ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... Kennedys disease (KD) or X-linked spinal-bulbar muscular atrophy (SBMA) is a neuromuscular disease associated with mutations of the androgen receptor (AR). ...


Although stopping these medications can lead to regression of the gynecomastia, surgery is sometimes necessary to eliminate the condition.


Repeated topical application of products containing lavender and tea tree oils among other unidentified ingredients to three prepubescent males coincided with gynecomastia; it has been theorised that this could be due to their estrogenic and antiandrogenic activity. However, other circumstances around the study are not clear, and the sample size was insignificant so serious scientific conclusions cannot be drawn.[9] Lavender oil is an essential oil obtained by distillation from the flower spikes of certain species of lavender. ... Tea Tree Oil (Melaleuca Oil) Tea tree oil or melaleuca oil is a clear to very pale golden color essential oil with a fresh camphoraceous odour. ...


Diagnosis

The condition usually can be diagnosed by examination by a physician. Occasionally, imaging by X-rays or ultrasound is needed to confirm the diagnosis. Blood tests are required to see if there is any underlying disease causing the gynecomastia. This is a very painfull and non-loving affetive knot in your chest that will make you feel different. For other uses, see Doctor. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... For other uses, see Ultrasound (disambiguation). ... In general, diagnosis (plural diagnoses) has two distinct dictionary definitions. ...


Prognosis

Gynecomastia is not physically harmful, but in some cases can be an indicator of other more dangerous underlying conditions. Growing glandular tissue, typically from some form of hormonal stimulation, is often tender or painful. Furthermore, it can frequently present social and psychological difficulties for the sufferer.[10] Weight loss can alter the condition in cases where it is triggered by obesity, but losing weight will not reduce the glandular component and patients cannot target areas for weight loss. Massive weight loss can result in sagging tissues about the chest, chest ptosis, or drooping chest. A gland is an organ in an animals body that synthesizes a substance for release such as hormones, often into the bloodstream (endocrine gland) or into cavities inside the body or its outer surface (exocrine gland). ... Breast Ptosis, or sagging breasts is a medical term for the drooping or sagging of the breast. ...


Treatment

Treating the underlying cause of the gynecomastia may lead to improvement in the condition. Patients should talk with their doctor about revising any medications that are found to be causing gynecomastia; often, an alternative medication can be found that avoids gynecomastia side-effects, while still treating the primary condition for which the original medication was found not to be suitable due to causing gynecomastia side-effects (e.g., in place of taking spironolactone the alternative eplerenone can be used.) Selective estrogen receptor modulator medications, such as tamoxifen and clomiphene, or androgens or aromatase inhibitors such as Letrozole are medical treatment options, although they are not universally approved for the treatment of gynecomastia. Endocrinological attention may help during the first 2-3 years. After that window, however, the breast tissue tends to remain and harden, leaving surgery (either liposuction, gland excision, skin sculpture, reduction mammoplasty, or a combination of these surgical techniques) the only treatment option. Many American insurance companies deny coverage for surgery for gynecomastia treatment on the grounds that it is a cosmetic procedure. Radiation therapy is sometimes used to prevent gynecomastia in patients with prostate cancer prior to estrogen therapy. Compression garments can camouflage chest deformity and stabilize bouncing tissue bringing emotional relief to some. There are also those who choose to live with the condition. Selective estrogen receptor modulators (SERMs) is a class of medication that acts on the estrogen receptor. ... Tamoxifen is an orally active selective estrogen receptor modulator (SERM) which is used in the treatment of breast cancer and is currently the worlds largest selling drug for this indication. ... Categories: Stub | Selective estrogen receptor modulators ... Androgen is the generic term for any natural or synthetic compound, usually a steroid hormone, that stimulates or controls the development and maintenance of masculine characteristics in vertebrates by binding to androgen receptors. ... Aromatase inhibitors (AI) are a class of drugs used in the treatment of breast cancer in post- menopausal women. ... Letrozole (INN, trade name Femara®) is an oral non-steroidal aromatase inhibitor that has been introduced for the adjuvant treatment of hormonally-responsive breast cancer Estrogens are produced by the conversion of androgens through the activity of the aromatase enzyme. ... Liposuction, also known as lipoplasty (fat modeling), liposculpture or suction lipectomy (suction-assisted fat removal) is a cosmetic surgery operation that removes fat from many different sites on the human body. ... Breast reduction, or reduction mammoplasty, is a surgical procedure which involves the reduction in the size of breasts by excising fat, skin, and glandular tissue; it may also involve a procedure to counterract drooping of the breasts. ... Varian Clinac 2100C Linear Accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


References

  1. ^ Adolescent gynecomastia
  2. ^ Braunstein, GD (Feb 18 1993). "Gynecomastia". N Engl J Med 328 (7): 490-5. PMID 8421478. 
  3. ^ Allee, Mark R (2006-11-15). Gynecomastia. WebMD, Inc. (emedicine.com). Retrieved on 2007-05-20.
  4. ^ Peyriere, H; et al (Oct 22 1999). "Report of gynecomastia in five male patients during antiretroviral therapy for HIV infection". AIDS 13 (15): 2167-9. PMID 10546872. 
  5. ^ Heruti, RJ; et al (May 1997). "Gynecomastia following spinal cord disorder". Arch Phys Med Rehabil 78 (5): 534-7. PMID 9161376. 
  6. ^ Thompson D, Carter J. "Drug-induced gynecomastia". Pharmacotherapy 13 (1): 37-45. PMID 8094898. 
  7. ^ Glass, AR (Dec 1994). "Gynecomastia". Endocrinol Metab Clin North Am 23 (4): 825-37. PMID 7705322. 
  8. ^ Braunstein, GD (Jun 1999). "Aromatase and Gynecomastia". Endocr Relat Cancer 6 (2): 315-24. PMID 10731125. 
  9. ^ Henley D, Lipson N, Korach K, Bloch C (2007). "Prepubertal gynecomastia linked to lavender and tea tree oils". N Engl J Med 356 (5): 479-85. PMID 17267908. 
  10. ^ Wiesman, IM. et al.. Gynecomastia: An Outcome Analysis.

Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 319th day of the year (320th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 140th day of the year (141st in leap years) in the Gregorian calendar. ...

See also

The term male bra refers to brassieres that are worn by men. ...

External links to images

Hematospermia, or the presence of blood in semen, is most often a benign and idiopathic symptom, but can sometimes result from medical problems such as a urethral stricture, infection of the prostate, or a congenital bleeding disorder, and can occur transiently after surgical procedures such as a prostate biopsy. ... In males, retrograde ejaculation occurs when the fluid to be ejaculated, which would normally exit via the urethra, is redirected towards the urinary bladder. ... For other uses, see Breast (disambiguation). ... Chronic cystic mastitis, also called fibrocystic disease, Diffuse cystic mastopathy and Mammary dysplasia is a condition rather than a disease. ... Mastitis is the inflammation of the mammalian breast caused by the blocking of the milk ducts while the mother is lactating (see breastfeeding). ... Galactorrhea or galactorrhoea is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing. ... Mastalgia, mastodynia or mammalgia are names for a medical symptom that means - pain in the breast (from the Greek masto-, breast and algos, pain). ... Nipple discharge is the abnormal release of fluid from the nipples of the breasts. ... galactocele ...

  Results from FactBites:
 
gynecomastia.org (177 words)
It answers the most commonly asked questions about gynecomastia and then some.
Here is more information about the book and a direct link to Amazon.com.
gynecomastia, then please consider joining one of our mailing lists, or the discussion boards.
Gynecomastia- Health Encyclopedia and Reference (1043 words)
Gynecomastia is an abnormal enlargement of one or both breasts in men.
Gynecomastia is a common consequence of estrogen treatment in patients with prostate cancer.
Gynecomastia due to hyperthyroidism, acute hepatic disorders, or a recent onset of hypogonadism may remit in response to therapy for the underlying disorder.
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