What is gynecomastia
Gynecomastia (gynaecomastia:. Greek gyne, gynaikos woman + mastos
chest) - an increase of one or both breasts in men. Distinguish
true and false gynecomastia, or pseudogynecomastia. If true
gynecomastia, mammary gland hyperplasia resulting increased
equity of the milk ducts and connective tissue of the gland hypertrophy, and
pseudogynecomastia when - due to excess fat deposits in the subcutaneous
cellulose (typically in obesity).
One of the most
common form is true gynecomastia or pubertal
Youth gynecomastia that occurs during puberty when
normal sexual development. This form is characterized by gynecomastia
advent subareolyarnoy unilateral or bilateral swelling,
often quite painful. This swelling may disappear on
end of puberty, but in some cases it preserved and
adults. Cause Gynecomastia during puberty is not known, however,
It suggests that it is the result of a temporary imbalance between
synthesis of sex hormones (oestrogens, androgens), and gonadotropic
hormones and increase in blood concentration of prolactin and
estradiol. Most boys with pubertal gynaecomastia
breast enlargement is so small that no treatment
It requires only approximately 7-8% of patients over 3 years
Reserved large size breast that can injure
the psyche of a young man.
It is also noted in a number of diseases characterized by an imbalance
between the synthesis of estrogens, androgens, prolactin and gonadotropin
hormones (eg, when hermaphroditism, Klinefelter's syndrome, and others.).
Described familial forms of true gynecomastia, among which distinguish
gynecomastia, testicular atrophy is combined with, and is transmitted through the female
line, and testicular atrophy without gynecomastia, which is transmitted through the male
A special form of familial gynecomastia is
so called partial androgen insensitivity syndrome - gynecomastia, combined with
hypospadias. Gynecomastia when combined with hyperprolactinemia
oligospermia and sexual impotence. In this form of gynecomastia sometimes
find reshaping sella, note symptoms
tsentalnoy lesions of the nervous system.
often it occurs when hormonally active adrenal tumors and
testicular producing estrogens in prostate cancer.
Gynecomastia develops in cases involving
intoxication or metabolic processes in the body, while
dysproteinemia, protein starvation, diabetes mellitus, diffuse
toxic goiter, pulmonary tuberculosis, cardiovascular
failure, digitalis-treated (often in the recovery
period). In chronic liver disease is caused by gynecomastia
increasing the concentration of estrogen in the blood, the cause of which is
distortion steroid metabolism in the liver.
form is gynecomastia in alcoholic liver cirrhosis (syndrome
Silvestrini - Korda), this syndrome also includes hypogonadism and
sexual impotence. Gynecomastia can occur following treatment with drugs,
acting on the receptors of breast tissue to estrogen,
to increase their production or production of gonadotropins and prolactin:
estrogen, testosterone, Chorionic gonadotropin,
fenotiazidami. reserpine, veroshpironom. In patients with hypothyroidism,
Addison's disease gynecomastia associated with hormonal imbalance: in the first
case, it is a consequence of hyperprolactinaemia, in the second -
disorders of steroidogenesis in the adrenal glands.
is set based on the characteristic appearance of the patient,
anamnesis (treatment of sex hormone drugs,
veroshpironom etc.), biochemical studies.
Methods of treatment of gynecomastia
Conservative treatment. Conservative
outpatient treatment is carried out under the supervision of an endocrinologist. it depends
form of the disease. The need for treatment of adolescent gynecomastia,
the choice of method and timing of therapeutic measures are dictated
psychological condition of the patient. You can adhere to wait and see
tactics, as often 2-3 years at a junior gynecomastia
there is spontaneous regression of breast enlargement.
recent years, attempts were made to influence the pathogenetic
gynecomastia mechanisms with drugs suppressing the secretion of prolactin
(Parlodel or bromocriptine) or stimulate the release of
luteinizing hormone (clomiphene). Parlodel used in a dose of 2.5-5 mg daily for 1-6 months.
Surgical treatment. A high volume of mammary glands and no effect on the
conservative therapy, drug intolerance or inability to
to wait because of the unfavorable situation psychologically recommended
surgery (removal of the breast tissue through a periareolar
incision or liposaktsionnym method).