Gynecomastia
Definition
Gynecomastia is a common disease of the male breast where there is a benign glandular enlargement of that breast at some time in the male's life. It usually consists of the appearance of a flat pad of glandular tissue beneath a nipple which becomes tender at the same time. The development may be unilateral or bilateral. There is rarely a continued growth of the breast tissue; ordinarily the process is of brief duration and stops short of the production of permanent enlargement of the breast.
Causes
A great number of patients who suffer from this disease have a disturbance in the proper ratio of androgen and estrogen levels. The normal ratio of the two hormones in plasma is approximately 100:1. "The etiology of gynecomastia in patients with a known documented cause appears to be related to increased estrogen stimulation, decreased testosterone levels, or some alteration of the estrogens and androgen so that the androgen-estrogen ratio is decreased"(Williams 373). From this information it was discovered that there is also a lower ratio of weaker adrenal androgens (delta 4-androstenedione and dehydroepiandrosterone) found in youths with this disease. It was once believed that there was an imbalance in the ratios of testosterone to estrogen or estradiol, but this is now know to be untrue.
There are three areas the can be attributed to the cause of gynecomastia: physiologic, pathologic and pharmacologic. "Enlargement of the male breast can be a normal physiologic phenomenon at certain stages of life or the result of several pathologic states."(Isselbacher, 2037)
In the case of physiologic gynecomastia the disease can occur in a newborn baby, at puberty or at any time in a man's life. In the newborn, transient enlargement of the breast is due to the action of maternal and/or placental estrogens. The enlargement usually disappears within a few weeks. Adolescent gynecomastia is common during puberty with the onset at the median age of 14. It is often asymmetrical and frequently tender.
It regresses so that by the age of 20 only a small number of men have palpable vestiges of gynecomastia in one or both the breasts. Gynecomastia of aging also occurs in otherwise healthy men. Forty percent or more of aged men have gynecomastia. One explanation is the increase in age in the conversion of androgens to estrogens in extra-
glandular tissues. Drug therapy and abnormal liver functioning can also be causes of gynecomastia in older men.
In this essay, the author
- Explains that 85% of male breast masses are due to gynecomastia.
- Explains that gynecomastia is a benign glandular enlargement of the male breast. the development may be unilateral or bilateral.
- Explains that when the primary cause can be identified and corrected, breast enlargement diminishes until it disappears. androgen replacement therapy may produce dramatic improvement in men with testicular insufficiency.
- Explains that 85% of male breast masses are due to gynecomastia.
- Explains that gynecomastia is a benign glandular enlargement of the male breast. the development may be unilateral or bilateral.
- Explains that when the primary cause can be identified and corrected, breast enlargement diminishes until it disappears. androgen replacement therapy may produce dramatic improvement in men with testicular insufficiency.
- Explains the physiologic, pathologic, and pharmacologic causes of gynecomastia.
- Explains that there are very few signs and symptoms associated with gynecomastia, although the most common time of onset is during puberty.
- Explains that only half or less of gynecomastia patients have a satisfactory diagnosis due to insufficient diagnostic techniques, causes that are still undefined and/or difficult to diagnose.
- Explains that the treatment for gynecomastia is related to how the patient was affected by the disease.
- Explains that the wilford hall usaf medical center tested a male who had developed right side gynecomastia at the age of twenty-four and had abnormally high ratios of estradiol, estrogen and aldosterone.
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