This article explains the relationship between low testosterone and the presence of gynecomastia. It also provides information on diagnosis and treatment options.
Most men believe that hormones are the purview of women. Every month they have their menstruation, and their hormones go up and suddenly they are very irritable.
What most men do not understand is that their bodies are also under the control of these hormones, though more subtly.
Sex hormones are what shape our body as we go through adolescence.
Females have estrogens, and males have testosterone and androgens. If the body is functioning normally, these hormones are kept in a balance which allows the body to look gender-appropriate. But what is the relationship between low testosterone and male breasts?
If the balance of these hormones is disrupted then the body begins to respond in ways that some people are not quite comfortable with. In women, this can mean becoming hairy or developing deeper voices. In men this could mean developing higher pitched voices, losing their armpit and pubic hair, or developing gynecomastia.
This article will define gynecomastia, what causes it and how it is diagnosed. It will also show the treatments available to treat a condition which causes a lot of mental anguish.
Medically, gynecomastia is defined as the enlargement of one or both breasts occurring in adult males. It is usually on both sides and appears similar to the breast enlargement that adolescent females experience. If diagnosed it must be differentiated from malignant masses found in the male breast.
The causes are usually an imbalance in the male hormones, also called androgens and feminizing hormones like estrogen, or the use of certain medications. If the enlargement occurs on one side only, or in part of the breast then a biopsy is recommended as this is probably a malignant mass.
The male breast just like the female breast is under the influence of hormones. Gynecomastia results when there is an imbalance between estrogens which stimulate breast tissue to grow and androgens which suppress these effects. These imbalances occur under normal and abnormal situations in the body.
In infancy and around puberty, an enlargement of the breasts in a male child is normal, or what is medically termed as physiologic gynecomastia. The enlargement is usually temporary, and symmetrical.
Males who are likely to be affected by this are newborns, those going through puberty, the very old, or any male who has elevated levels of estrogen in his system.
Elevated levels of estrogen occur in multiple disorders, the most important of which is liver cirrhosis. This is because the liver metabolizes estrogen, but when it is cirrhotic it is dysfunctional and thus it cannot metabolize estrogen effectively.
In newborns, gynecomastia is caused by the estrogens that linger from the placenta. These estrogens were produced by the mother and now affect the newborn male child.
In Puberty, gynecomastia is a result of greater amounts of a type of estrogen called estradiol, in comparison to testosterone.
For elderly males, gynecomastia occurs because the estrogen being produced by the adrenal glands next to the kidney increases.
This is because the adrenal glands are not producing a sufficient amount of the male hormones (androgens). Thus with elevated estrogens and diminished androgens, the breasts are stimulated to grow.
There are drugs such as alcohol, heroin or anabolic steroids like those used by weight lifters, which have been known to encourage the development of gynecomastia.
Occasionally gynecomastia occurs as part of a congenital disease known as Klinefelter syndrome, or if a male has a mass in his tests such as a Leydig cell tumor. Tumors in the liver, lungs and other body organs can produce hormones which encourage the breast tissue to multiply.
In gynecomastia, the breast tissue grows larger and becomes longer, this causes a change in the skin which also stretches to accommodate the increase in a size of the breast tissue.
When it occurs in adolescence, it tends to happen in one breast and is seen around the ages of 12 to 15 years. On the other hand, in the elderly, gynecomastia is usually seen in both breasts.
The signs and symptoms listed below are not specific for gynecomastia. Usually, they are considered together, in order to pinpoint the cause of a disease.
Some of the signs and symptoms are used to identify the underlying cause of the gynecomastia.
For a doctor to diagnose gynecomastia, a full and thorough physical examination must be carried out. This will not only identify the problem but give signs of what the underlying cause is.
The physical examination will proceed as follows:
Usually, in patients with physiologic gynecomastia, no tests are done after the physical examination. Also in adolescent males with gynecomastia, no more test are required.
A follow up after 6 months to observe the progression of the condition is recommended.
However, in certain patients, there are findings that usually prompt more testing. These include:
The list of tests that can be done:
The following are the protocols for treating gynecomastia:
There are also more natural ways to treat the problem such as nutrition, the use of herbal pills and exercises. Some pills are designed to treat low testosterone which in effect will eliminate enlarged male breasts.
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