Gynecomastia is a common disorder of the endocrine system in which there is a noncancerous increase in the size of male breast tissue.
Disturbances in the endocrine system that lead to an increase in the ratio of estrogens/androgens are thought to be responsible for the development of gynecomastia; but this may occur even if the levels of estrogens and androgens are both appropriate but the ratio is altered.
The classic feature of gynecomastia is male breast benign enlargement with soft, compressible, and mobile subcutaneous chest tissue palpated under the areola of the nipple in contrast to softer fatty tissue.
Gynecomastia can be caused by a deficiency of androgens or a relative or absolute excess of estrogens. If a drug is suspected, the offending agent should be stopped, if possible; however, most of the causes are not reversible and treatment is by reassurance.
Causes of gynecomastia
Diminished androgen
- orchidectomy
- decreased synthesis
- old age
- estrogens, progestogens, GnRH analogues
- decreased action: anti-androgens
Increased estrogen
- estrogen therapy
- estrogen secreting tumors
- gonadotrophin secreting tumors
- liver disease
Drugs (various mechanisms)
- cimetidine
- digoxin
- spironolactone
- simvastatin
- omeprazole
- antihypertensives
- ranitidine
- ketoconazole
- antidepressants (TCAs)
Adapted from Wikipedia, the free encyclopedia. Internet. October 25, 2016.