Gynecomastia in adolescents

Abstract

Gynecomastia is frequently encountered in the primary care setting. During adolescence, male breast enlargement is most often benign and rarely represents a pathologic mechanism. Careful attention should be paid to both the breast and testicular examination. A detailed history should include an inquiry regarding the use of illicit substances, anabolic-androgenic steroids, herbal products, and medications. The impact of gynecomastia on the adolescent's mental health should be assessed. A workup for pathologic causes is rarely required. Reassurance remains the standard of care for physiologic gynecomastia.

A clinical approach to gynecomastia

“…Androgens like dihydrotestosterone, danazol, clomiphene, and aromatase inhibitors such as testolactone and anastrozole may also be effective but has limited data and less commonly used (16).…”

A retrospective study of gynecomastia in male patients referred to Hatyai Hospital with breast lesions

“…Identified causes of gynecomastia are hypogonadism (25%), hyperprolactinemia (9%), chronic liver disease (4%), and drug induced (4%) [2]. Gynecomastia is thought to result from several mechanisms including increased androgen and leptin levels, human chorionic gonadotropin, and luteinizing hormone [3,4]. The majority of male patients with gynecomastia are asymptomatic and referred for persistently tender breasts, palpable lump, or disturbed body image [5].…”

Gynecomastia and Liposuction

“…Prevalence of asymptomatic gynecomastia is 60%-90% in neonates, 50%-60% in adolescents, and up to 70% in men age 50-69 years. [1][2][3] Trimodal distribution for asymptomatic gynecomastia is noted (neonatal, pubertal, and in elderly males). Prevalence of symptomatic gynecomastia is markedly lower.…”

“…[5] Previous studies have reported that in an average out-patient clinic you may see 10 to 20 new cases of gynecomastia per year, accounting for up to 80% of all male breast referrals. [2, www.intechopen.com 3,6,7] In a recent study the referrals for specialist evaluation for gynecomastia have increased 500% since 1990's making this pathology more prevalent. [8] …”