The Relationship between Psychopathology, Self-esteem, Body Perception and Serum Sex Steroids in Pubertal Gynecomastia

Arslan, Semiha Comertoglu; Esın, İbrahim Selçuk; Çayır, Atilla; Orbak, Zerrin; Dursun, Onur Burak

doi:10.9758/cpn.2021.19.3.498

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…During adolescence, having and maintaining a body perception that is physically and sexually pleasing is important for positive identity development. The association between PG and internalization disorders, negative body perception, and self-esteem has been demonstrated in various studies [10][11][12]. A previous study in our clinic showed that tamoxifen treatment led to positive improvements in body perception beginning from the first month of treatment [13].…”

Section: Discussionmentioning

confidence: 87%

Tamoxifen Treatment for Pubertal Gynecomastia: When to Start and How Long to Continue

Sabancı¹,

Kızılkan²,

Akgül³

et al. 2023

Breast Care

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Introduction: Pubertal gynecomastia is a common clinical condition among male adolescents and in most cases it regresses spontaneously. However, tamoxifen treatment is recommended in selected cases. We aimed to evaluate the indications, safety and efficacy of tamoxifen treatment in adolescents with pubertal gynecomastia. Methods: The data of 83 adolescents with pubertal gynecomastia who were treated with tamoxifen between 2006 and 2018 were evaluated retrospectively. The clinical and laboratory data, initial complaint, tamoxifen treatment indication, duration and dose were recorded along with the treatment outcome. Results: The gynecomastia disc diameter’s monthly reduction rate was significantly higher in adolescents with an initial disc diameter ≥ 3 cm. The significant reduction of the disc started after the fourth month of tamoxifen treatment and continued to significantly reduce extending to the sixth month. Conclusion: Tamoxifen treatment in pubertal gynecomastia was found to be effective and safe. One of the current indications for tamoxifen treatment is having a disc size ≥4 cm and the recommended treatment duration is 4-6 months. However, this study suggests that treatment should be continued for at least 6 months to achieve the optimal effect. In addition, we recommend that the disc diameter threshold for starting tamoxifen needs to be ≥ 3 cm.

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Section: Discussionmentioning

confidence: 87%

Tamoxifen Treatment for Pubertal Gynecomastia: When to Start and How Long to Continue

Sabancı¹,

Kızılkan²,

Akgül³

et al. 2023

Breast Care

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“…They can lead to problems in interpersonal relations, social phobia or social isolation, and psychological disorders (e.g., depression, anxiety), and significant deterioration in social and academic processes. A correlation was found between the severity of the gynecomastia and the psychologic distress (2,(6)(7)(8)(9)(35)(36)(37). Mitigating psychological and social problems are the major reasons for medical intervention in PG.…”

Section: Discussionmentioning

confidence: 99%

“…The desired pharmaceutical therapy should be efficient and safe, fast acting, with low rate of side effects or complications. Such medical treatment can significantly shorten to alleviate the period of psychological distress and serve as an inexpensive and effective option ( 6 , 7 , 35 , 37 ).…”

Section: Discussionmentioning

confidence: 99%

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Gynecomastia: A systematic review of pharmacological treatments

Berger

Landau²,

Talisman³

2022

Front. Pediatr.

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BackgroundPubertal gynecomastia (PG), a benign condition with varied reported prevalence, typically appears at 13–14 years-old and is mostly idiopathic and self-limited. Psychologic impairments are common among adolescents with gynecomastia. Surgical intervention is reserved to severe cases and is offered towards the end of puberty. Pharmacological treatment is seldom given by clinicians mainly due to insufficient published data. We conducted this systematic literature review to assess the efficacy, safety, side effects, and complications of pharmacological treatments published.MethodsMEDLINE, Embase, and Cochrane CENTRAL were searched for the terms “gynecomastia”, “pubertal”, and “adolescent” in conjunction with medications from the Selective Estrogen Receptor Modulator (SERM), aromatase inhibitors (AI), and androgens groups in different combinations to optimize the search results. Exclusion criteria included: studies based on expert opinion, similar evidence-based medicine levels studies, and studies which discuss gynecomastia in adults. Selected articles were assessed by two authors. Data collected included: the level of evidence, population size, treatment regimen, follow-up, outcomes, complications, and side effects.ResultsOf 1,425 published studies found and examined meticulously by the authors, only 24 publications met all the study research goals. These were divided into 16 publications of patients treated with SERM, of whom four had AI and four androgens. In general, the data regarding pharmacologic therapy for PG is partial, with insufficient evidence-based research. Tamoxifen and SERM drugs have long been used as treatments for PG. Tamoxifen was the chosen drug of treatment in most of the reviewed studies and found to be effective, safe, and with minimal side effects.ConclusionsPharmacological treatment as a new standard of care has an advantage in relieving behavioral and psychological distress. Although high quality publications are lacking, pharmacological intervention with tamoxifen is appropriate in select patients. Conduction large-scale high-quality studies are warranted with various drugs.

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“…Nevertheless, the persistence of gynecomastia may cause significant psychological consequences in the affected adolescents, which include depression, anxiety, deterioration of self-esteem, and reduced quality of life [ 8 , 9 ]. Therefore, in boys with persistent gynecomastia causing significant psychosocial distress, surgical treatment could be considered.…”

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confidence: 99%

Pediatric endoscopic subcutaneous mastectomy (pesma) with liposuction in adolescents with gynecomastia

et al. 2022

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Background Surgical techniques for treatment of gynecomastia are increasingly less invasive. We described technical standardization of pediatric endoscopic subcutaneous mastectomy (PESMA) with liposuction. Methods All adolescents with primary gynecomastia, operated using PESMA with liposuction over the period June 2014–July 2021, were included. The video recording of procedures was analyzed to standardize the operative technique. After patient installation, 3 trocars were placed on the mid-axillary line. The technique included 5 steps: (1) subcutaneous injection of lipolysis solution and liposuction; (2) creation of working space using an inflated balloon; (3) gland dissection using 5-mm sealing device; (4) specimen extraction through the largest trocar orifice; and (5) placement of suction drainage tube. Results Twenty-four male adolescents, operated for Simon’s grade 2B and 3 gynecomastia using PESMA with liposuction over the study period, were included. Mean patient age was 16 years (range 15–18). Gynecomastia was bilateral in 19/24 (79.2%) and unilateral in 5/24 (20.8%). One (4.1%) conversion to open was reported. The mean operative time was 87 min (range 98–160) for unilateral and 160 min (range 140–250) for bilateral procedure. The mean length of stay was 2.2 days (range 1–4). Patients wore a thoracic belt for 15 up to 30 days postoperatively. Post-operative complications occurred in 5/24 (20.8%): 2- or 3 mm second-degree burns in 4 (16.7%) and subcutaneous seroma in 1 (4.1%). All complications were Clavien 2 grade and did not require further treatment. Aesthetic outcomes were very good in 21/24 (87.5%). Three (12.5%) boys had persistent minimal breast asymmetry but did never perceive it negatively. Conclusion PESMA combined with liposuction was feasible and safe for surgical treatment of gynecomastia in this selected cohort of patients. Although challenging, this procedure provided good aesthetic results, with no scars on the anterior thoracic wall. Standardization of the operative technique was a key point for successful outcome.

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The Relationship between Psychopathology, Self-esteem, Body Perception and Serum Sex Steroids in Pubertal Gynecomastia

Cited by 5 publications

References 31 publications

Tamoxifen Treatment for Pubertal Gynecomastia: When to Start and How Long to Continue

Tamoxifen Treatment for Pubertal Gynecomastia: When to Start and How Long to Continue

Gynecomastia: A systematic review of pharmacological treatments

Pediatric endoscopic subcutaneous mastectomy (pesma) with liposuction in adolescents with gynecomastia

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