Gynecomastia: Clinical Evaluation and Management

Nelson Vergel

Founder, ExcelMale.com

As it is explained on the attached clinical nomograph, the diagnosis of the cause of a certain cases of gynecomastia (breast tissue growth in men) is complex and not necessarily explained by high estradiol blood levels.

Cakir B, Evranos B, Cuhaci N, Ersoy R, Polat S. Gynecomastia: Clinical evaluation and management. http://www.ijem.in/temp/IndianJEndoc…199_204101.pdf


Gynecomastia is the benign enlargement of male breast glandular tissue and is the most common breast condition in males. At least 30% of males will be affected during their life. Since it causes anxiety, psychosocial discomfort and fear of breast cancer, early diagnostic evaluation is important and patients usually seek medical attention.

Gynecomastia was reported to cause an imbalance between estrogen and androgen action or an increased estrogen to androgen ratio, due to increased estrogen production, decreased androgen production or both.

Evaluation of gynecomastia must include a detailed medical history, clinical examination, specific blood tests, imaging and tissue sampling. Individual treatment requirements can range from simple reassurance to medical treatment or even surgery.

The main aim of any intervention is to relieve the symptoms and exclude other etiological factors.
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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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