Gynecomastia is an abnormal enlargement of one or both breasts in men, caused by an imbalance in the hormones estrogen and testosterone. It is a condition that can be easily and quickly ruled out, but if the diagnosis is confirmed, it is important to understand the causes, diagnosis and treatment of gynecomastia. The most common cause of gynecomastia is medications. A number of drugs have been reported to be associated with gynecomastia, such as antibiotics, antiulcer drugs, growth hormones and anti-AIDS antiviral drugs.
When advising a male patient on the use of a new medication that may cause gynecomastia, it is important to explain in detail the nature and importance of this problem. The diagnosis of gynecomastia should include an ultrasound of the breast and blood levels of beta-hCG, LH, follicle-stimulating hormone, estradiol, prolactin, testosterone, thyroid function (thyroid-stimulating hormone and thyroxine) and liver function tests. If the patient's blood test is not indicative of any specific endocrine or systemic disorder and the patient is not taking any medications related to gynecomastia, the cause is most likely idiopathic. Discontinuing the offending drug can lead to a regression of gynecomastia, but not always.
Weight loss may not completely reverse true gynecomastia since it is a glandular abnormality, even though breast enlargement may have been caused by the estrogen conversion pathway. In some cases, medical treatment may be necessary to reduce the size of the breasts. It is important to understand that gynecomastia can occur at any age and for various reasons. It is also important to understand that discontinuing the offending drug can lead to a regression of gynecomastia but not always.
In some cases, medical treatment may be necessary to reduce the size of the breasts.