{ "schemaVersion": 2, "eyebrow": "Endocrinology", "title": "Gynecomastia", "summary": "Evaluate gynecomastia by separating typical pubertal or drug-related disease from hypogonadism, systemic illness, hormone-secreting tumors, and male breast cancer. Focus testing on atypical, progressive, or unexplained presentations; withdraw reversible exposures and reserve surgery for persistent, consequential disease.", "seoDescription": "Physician approach to gynecomastia: targeted evaluation, hormone and imaging triggers, reversible causes, observation, and surgical referral.", "clinicalQuestion": "How should clinicians evaluate gynecomastia, identify secondary causes, and select observation, cause-directed treatment, or surgery?", "specialty": "Endocrinology", "audience": "U.S. physicians and medical trainees", "tags": [ "gynecomastia evaluation", "male breast mass", "pubertal gynecomastia", "male hypogonadism", "anabolic steroid gynecomastia", "male breast cancer" ], "keyTakeaways": [ "Typical pubertal gynecomastia usually requires reassurance and follow-up rather than routine endocrine testing; 85% to 90% regress within 6 months to 2 years. [19][22]", "A focused medication, supplement, anabolic-androgenic steroid, recreational substance, systemic-disease, breast, and testicular assessment determines whether laboratory testing is needed. [7][20][21]", "For unexplained, recent-onset, progressive, painful, or otherwise atypical gynecomastia, obtain testosterone, LH, FSH, estradiol, beta-hCG, prolactin, thyroid testing, renal function, and liver tests; add DHEA-S when an adrenal tumor is a concern. [20][21]", "Do not order imaging routinely; use testicular ultrasonography, breast imaging with biopsy, adrenal imaging, or pituitary MRI only when examination or laboratory findings direct the anatomic search. [12][20]", "Stop or replace an implicated medication or exposure when feasible; long-standing gynecomastia is less likely to regress because glandular tissue becomes fibrotic. [19][20]", "Consider surgery for persistent gynecomastia with substantial pain, psychosocial burden, cosmetic concern, or suspected malignancy; defer elective adolescent surgery until pubertal completion to reduce regrowth risk. [19]" ], "sections": [ { "id": "triage-and-phenotype", "eyebrow": "Initial assessment", "heading": "Which gynecomastia presentations need urgent exclusion of malignancy or endocrine disease?", "intro": "Begin with phenotype and tempo before ordering a broad endocrine panel.", "paragraphs": [ "Document onset, progression, laterality, tenderness, nipple discharge, sexual function, change in virilization, weight change, hyperthyroid symptoms, and recent recovery from malnutrition or serious illness. Review prescription and nonprescription agents, supplements and herbal products, cosmetic exposures, cannabis and other recreational substances, and anabolic-androgenic steroid use. Also ask about renal disease, liver disease, thyroid disease, infertility, and family or syndromic features suggesting Klinefelter syndrome. [7][12][20][21]", "Examine whether enlargement is palpable subareolar glandular tissue versus predominantly adiposity, then assess regional lymph nodes, skin and nipple findings, thyroid, abdomen for hepatomegaly or mass, body hair and other virilization, and both testes for volume asymmetry, atrophy, or a discrete mass. A breast mass suspicious for malignancy requires mammography and biopsy rather than empiric hormonal therapy. [12][20]", "Recent, prominent, painful, progressive, or otherwise unexplained enlargement warrants directed evaluation because it can signal drug exposure, gonadal failure, altered estrogen production, renal or hepatic disease, thyrotoxicosis, or a tumor. Conversely, an adolescent with otherwise typical pubertal development, a reassuring breast and testicular examination, and no concerning history generally does not need routine hormonal testing. [7][21][22]" ], "bullets": [ "Escalate promptly for a suspicious breast lesion or regional adenopathy: obtain mammography and tissue diagnosis. [12][20]", "Escalate for a palpable testicular lesion, testicular atrophy, or biochemical evidence of hCG/estradiol excess or gonadotropin abnormality: obtain testicular ultrasonography. [10][20]", "Do not assume unilateral enlargement is malignant; unilateral and bilateral gynecomastia both occur, but physical findings determine whether breast cancer evaluation is necessary. [24]" ], "subsections": [], "table": { "caption": "Phenotype-based initial branch points in gynecomastia evaluation. [7][12][20][21][22]", "columns": [ "Clinical pattern", "Immediate next action", "What the result changes" ], "rows": [ [ "Typical pubertal presentation with normal examination and no concerning exposure or systemic features", "Reassure and observe; avoid routine endocrine testing. [7][22]", "Most cases regress during follow-up; investigate only if course or examination becomes atypical. [19]" ], [ "Recent, progressive, painful, prominent, or unexplained enlargement", "Obtain directed hormonal and systemic laboratory evaluation. [20][21]", "Identifies hypogonadism, thyroid, renal, hepatic, adrenal, or tumor-associated pathways requiring cause-directed management. [20]" ], [ "Suspicious breast examination", "Mammography and biopsy. [12][20]", "Establishes or excludes breast malignancy before nonoperative management." ], [ "Testicular mass, atrophy, or abnormal hCG, estradiol, or gonadotropins", "Testicular ultrasonography. [10][20]", "Directs evaluation for testicular pathology or altered gonadal function." ] ] } }, { "id": "targeted-testing", "eyebrow": "Diagnostic workup", "heading": "Which laboratory tests are indicated, and how should results direct imaging?", "intro": "Test selectively when history or examination does not identify a benign physiologic or exposure-related explanation.", "paragraphs": [ "For recent-onset or unexplained gynecomastia, measure serum total and free or bioavailable testosterone, LH, FSH, estradiol, beta-hCG, prolactin, thyroid-stimulating hormone with free thyroxine, serum creatinine, and liver enzymes. Add DHEA-S or urinary 17-ketosteroids when a feminizing adrenal tumor is in the differential. These tests distinguish androgen deficiency, altered gonadotropin signaling, hCG- or estradiol-associated tumor physiology, hyperprolactinemia, thyrotoxicosis, and renal or hepatic contributors. [20][21]", "Interpret hormone results as a pattern rather than in isolation. Low testosterone with altered LH and FSH supports evaluation for hypogonadism; elevated beta-hCG or estradiol, or depressed LH in an otherwise unexplained presentation, should prompt testicular ultrasonography. If testicular ultrasonography is normal despite these abnormalities, proceed to chest radiography and abdominal CT to search for an extratesticular or adrenal source. [10][12]", "Reserve pituitary MRI for a laboratory or clinical pattern that localizes to the sella, rather than using it as routine imaging. Similarly, adrenal CT should follow clinical or biochemical concern for an adrenal mass. Routine imaging without examination or laboratory triggers is not recommended. [20]" ], "bullets": [ "Order karyotype testing when the examination or clinical context raises concern for Klinefelter syndrome. [10]", "If infertility is a major concern in a patient with suspected hypogonadism, include seminal fluid analysis in the reproductive assessment. [12]", "In adolescents, routine endocrine panels have low yield: endocrine investigations provided no new clinical information in 99.4% of cases in one 197-patient series. [22]" ], "subsections": [], "table": { "caption": "Targeted tests and downstream actions for unexplained or atypical gynecomastia. [10][12][20][21]", "columns": [ "Test or finding", "Etiologic branch", "Next action" ], "rows": [ [ "Total/free testosterone with LH and FSH", "Androgen deficiency or abnormal gonadotropin signaling. [12][20]", "Evaluate the hypogonadal pattern and its cause; assess fertility when relevant. [12]" ], [ "Beta-hCG or estradiol elevation; depressed LH", "Possible testicular or extratesticular hormone-secreting process. [10][12]", "Perform testicular ultrasonography; if normal, obtain chest radiography and abdominal CT. [10]" ], [ "TSH and free thyroxine abnormality", "Thyroid hormone excess or other thyroid dysfunction. [20][21]", "Treat or further evaluate thyroid disease as the reversible contributor. [20]" ], [ "Elevated creatinine or liver enzymes", "Renal or hepatic disease. [20][21]", "Evaluate and manage underlying systemic disease. [20]" ], [ "DHEA-S or urinary 17-ketosteroid abnormality when adrenal tumor suspected", "Feminizing adrenal tumor pathway. [20]", "Proceed to adrenal imaging directed by the clinical and biochemical presentation. [20]" ], [ "Suspicious breast mass", "Male breast cancer pathway. [12][20]", "Mammography and biopsy. [12][20]" ] ] } }, { "id": "cause-directed-management", "eyebrow": "Management", "heading": "How should treatment be matched to the etiologic branch and duration?", "intro": "Remove reversible drivers first; observation is appropriate when symptoms and malignancy risk are low.", "paragraphs": [ "When a medication, supplement, estrogen-containing exposure, recreational substance, or anabolic-androgenic steroid is implicated, discontinue, replace, or stop the exposure when clinically feasible and reassess the breast examination and symptoms. Drug-induced gynecomastia may regress after withdrawal, but prolonged disease is less likely to resolve completely after fibrotic change develops. [7][16][19][20]", "Treat identified systemic and endocrine causes rather than treating breast enlargement in isolation. Relevant branches include hypogonadism, thyrotoxicosis, renal or hepatic dysfunction, hyperprolactinemia, and testicular, adrenal, or other malignancy-associated hormone production. The diagnostic pattern should determine the referral and definitive therapy rather than a uniform antiestrogen strategy. [12][20][21]", "For asymptomatic, long-standing adult gynecomastia without concerning findings, reassurance is appropriate. For new-onset disease, follow-up is reasonable because spontaneous regression occurs in adolescents and adults, whereas persistence beyond 1 year is associated with a low likelihood of complete regression. [19]", "Do not combine anastrozole with tamoxifen: coadministration lowers anastrozole concentration and provided no efficacy benefit over tamoxifen in breast cancer trial data. Anastrozole has not demonstrated efficacy for pubertal gynecomastia and is not an established treatment for that indication. [1][2][3][4]" ], "bullets": [ "Document pain, tenderness, psychosocial impact, duration, and objective breast findings at reassessment; these determine whether continued observation remains acceptable or procedural treatment should be discussed. [7][19]", "Avoid treating typical pubertal gynecomastia with surgery or hormones during the first 1 to 2 years. [6]", "Counsel patients using anabolic-androgenic steroids that acne and gynecomastia are frequent adverse effects and that withdrawal effects can create cyclical dependency. [16]" ], "subsections": [ { "heading": "Adolescent gynecomastia", "paragraphs": [ "For physiologic pubertal gynecomastia, reassure, assess psychological distress, and follow clinically. Approximately 85% to 90% of pubertal cases regress between 6 months and 2 years; persistence after age 17 is uncommon. The reported median duration in one longitudinal cohort was 1.9 years. [7][14][19]", "Order hormonal testing in adolescents when gynecomastia is excessive, prolonged, occurs outside midpuberty, or is accompanied by concerning examination findings or exposures. The suggested targeted evaluation includes testosterone, estradiol, hCG, LH, FSH, TSH, and DHEAS; additional studies may include prolactin, free thyroxine, inhibin B, and anti-Müllerian hormone when the clinical differential requires them. [14]" ], "bullets": [ "Assess testicular examination carefully; a testicular mass, atrophy, or incomplete/abnormal pubertal development shifts management from observation to endocrine or tumor-directed evaluation. [7][14][20]", "Address distress directly: psychological discomfort is common, and its severity may support referral for persistent disease even when the endocrine evaluation is unrevealing. [7][22]" ] } ], "table": { "caption": "Management by duration, impact, and cause. [6][7][16][19][20]", "columns": [ "Situation", "Management", "Escalation trigger" ], "rows": [ [ "Typical pubertal gynecomastia within 1 to 2 years", "Reassurance, psychosocial assessment, and clinical follow-up; avoid hormones or surgery during this interval. [6][7]", "Persistence, progression, atypical timing, concerning examination, or significant distress. [7][14]" ], [ "Identifiable drug, supplement, or anabolic steroid exposure", "Stop, replace, or discontinue the implicated exposure when feasible. [7][16][20]", "Persistent enlargement or pain after exposure removal, or abnormal examination/laboratory findings. [19][20]" ], [ "Systemic/endocrine disorder or hormone-secreting tumor pattern", "Treat the underlying disorder and complete directed imaging or specialty evaluation. [10][12][20]", "Abnormal beta-hCG, estradiol, gonadotropins, testicular examination, or suspicious breast findings. [10][20]" ], [ "Persistent disease for more than 12 months with substantial symptoms or psychosocial burden", "Discuss surgical management after cause evaluation. [19]", "Suspected malignancy requires diagnostic tissue evaluation rather than elective cosmetic surgery. [19][20]" ] ] } }, { "id": "surgical-selection", "eyebrow": "Procedural care", "heading": "When should gynecomastia surgery be considered?", "intro": "Surgery is a definitive option after etiologic evaluation and when persistence or consequences outweigh operative tradeoffs.", "paragraphs": [ "Consider surgical treatment for long-standing gynecomastia, generally beyond 12 months, when there is considerable pain, psychological stress, cosmetic concern, or concern for malignancy. Subcutaneous mastectomy is the most commonly used operative technique for glandular tissue; technique selection depends on the relative fat, parenchyma, skin laxity, and severity of enlargement. [19]", "In adolescents, defer elective surgery until the testes have reached adult size because breast tissue can regrow if surgery occurs before pubertal completion. Surgery may nevertheless be necessary for a suspicious lesion, in which case diagnostic priorities supersede cosmetic timing. [19]", "Liposuction may be used with mammoplasty in men with gynecomastia when body contour and adipose contribution warrant it. In body-contouring data, reported overall liposuction complication rates were 2.4%, including 0.7% for liposuction alone and 3.5% when combined with other procedures; complications include ecchymosis, edema, infection, seroma, hematoma, and venous thromboembolism. These estimates are not specific to gynecomastia operations. [23]" ], "bullets": [ "Before referral, document duration, glandular versus adipose distribution, skin excess, tenderness, psychological impact, prior exposure withdrawal, and completed evaluation for suspicious breast or testicular findings. [19][20]", "Do not use elective surgery as a substitute for evaluation when malignancy is suspected; obtain mammography and biopsy. [12][20]" ], "subsections": [], "table": { "caption": "Surgical decision points in gynecomastia. [19][23]", "columns": [ "Candidate feature", "Procedural implication", "Key tradeoff" ], "rows": [ [ "Persistent glandular gynecomastia with pain, distress, or cosmetic burden", "Subcutaneous mastectomy is commonly used. [19]", "Long-standing fibrotic tissue is less likely to regress spontaneously, supporting definitive treatment when symptoms are consequential. [19]" ], [ "Significant adipose component requiring contouring", "Liposuction may be used in conjunction with mammoplasty. [23]", "Risks include infection, seroma, hematoma, and venous thromboembolism. [23]" ], [ "Adolescent without completed puberty", "Usually defer elective surgery until adult testicular size. [19]", "Earlier surgery can be followed by regrowth of breast tissue. [19]" ], [ "Suspicion for breast malignancy", "Diagnostic mammography and biopsy take precedence. [12][20]", "Cosmetic operative planning should wait for tissue diagnosis." ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use anastrozole tablets safely and effectively. See full prescribing information for anastrozole tablets. Initial U.S. Approval", "detail": "dailymed.nlm.nih.gov", "url": "https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=c7666def-a855-4ca3-a322-603a88a44101&type=display", "authors": "dailymed.nlm.nih.gov", "host": "dailymed.nlm.nih.gov" }, { "number": 2, "title": "highlights of prescribing information - DailyMed", "detail": "dailymed.nlm.nih.gov", "url": "https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=acbfaaa9-503c-4691-9828-76a7146ed6de", "authors": "dailymed.nlm.nih.gov", "host": "dailymed.nlm.nih.gov" }, { "number": 3, "title": "[PDF] Arimidex (anastrozole) tablet label - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020541s026lbl.Pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov" }, { "number": 4, "title": "[PDF] 20541Orig1s023 - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/review/2018/20541Orig1s023.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov" }, { "number": 5, "title": "[PDF] Anastrozole Clinical Pediatric Review - 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PubMed", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pubmed/12704923", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov" }, { "number": 22, "title": "Most Teens with Gynecomastia Don't Need Hormone Lab Tests | ASPS", "detail": "www.plasticsurgery.org", "url": "https://www.plasticsurgery.org/news/press-releases/most-teens-with-gynecomastia-dont-need-hormone-lab-tests", "authors": "www.plasticsurgery.org", "host": "www.plasticsurgery.org" }, { "number": 23, "title": "Liposuction: Concepts, safety, and techniques in body-contouring surgery | Cleveland Clinic Journal of medicine", "detail": "www.ccjm.org", "url": "https://www.ccjm.org/content/87/6/367", "authors": "www.ccjm.org", "host": "www.ccjm.org" }, { "number": 24, "title": "Clinical and Etiological Aspects of Gynecomastia in Adult Males: A Multicenter Study - PMC", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996435", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov" } ], "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use anastrozole tablets safely and effectively. See full prescribing information for anastrozole tablets. Initial U.S. Approval", "detail": "dailymed.nlm.nih.gov", "url": "https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=c7666def-a855-4ca3-a322-603a88a44101&type=display", "authors": "dailymed.nlm.nih.gov", "host": "dailymed.nlm.nih.gov", "snippet": "back pain, insomnia, headache, peripheral edema and lymphedema, regardless of causality. ( 6.1) In the advanced breast cancer studies, the most common (occurring with an incidence of >10%) side effects occurring in women taking anastrozole tablets included: hot flashes, nausea, asthenia, pain, head", "score": 0.23575042 }, { "number": 2, "title": "highlights of prescribing information - DailyMed", "detail": "dailymed.nlm.nih.gov", "url": "https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=acbfaaa9-503c-4691-9828-76a7146ed6de", "authors": "dailymed.nlm.nih.gov", "host": "dailymed.nlm.nih.gov", "snippet": "The efficacy of ARIMIDEX in the treatment of pubertal gynecomastia in ... Patients in the 0005 trial had responded better to prior tamoxifen treatment.", "score": 0.22164577 }, { "number": 3, "title": "[PDF] Arimidex (anastrozole) tablet label - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020541s026lbl.Pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "hot flashes, nausea, asthenia, pain, headache, back pain, bone pain, increased cough, dyspnea, pharyngitis and peripheral edema. (6.1) To report SUSPECTED ADVERSE REACTIONS, contact AstraZeneca Pharmaceuticals LP at 1-800-236-9933 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch -------------------D", "score": 0.21770357 }, { "number": 4, "title": "[PDF] 20541Orig1s023 - accessdata.fda.gov", "detail": "www.accessdata.fda.gov", "url": "https://www.accessdata.fda.gov/drugsatfda_docs/review/2018/20541Orig1s023.pdf", "authors": "www.accessdata.fda.gov", "host": "www.accessdata.fda.gov", "snippet": "angioedema, urticaria and anaphylaxis have been reported in patients receiving ARIMIDEX. [see Contraindications (4.2)] 7 DRUG INTERACTIONS 7.1 Tamoxifen Co-administration of anastrozole and tamoxifen in breast cancer patients reduced anastrozole plasma concentration by 27%. However, the coadministra", "score": 0.17728357 }, { "number": 5, "title": "[PDF] Anastrozole Clinical Pediatric Review - FDA", "detail": "www.fda.gov", "url": "https://www.fda.gov/media/75520/download", "authors": "www.fda.gov", "host": "www.fda.gov", "snippet": "in children. Others (e.g. ovarian cyst, fractures due to underlying fibrous dysplasia) represent known complications of McCune-Albright syndrome. The small size of the dataset and the absence of a control group make causality assignment difficult. 7.1.5.5.2 Pubertal gynecomastia indication 7.1.5.5.2", "score": 0.16931002 }, { "number": 6, "title": "Gynecomastia in Adolescent Boys - JAMA Network", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jama/fullarticle/332010", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "We recommend that adolescent gynecomastia should not be treated either surgically or with hormones, within 1 or 2 years.", "score": 0.5183761 }, { "number": 7, "title": "Gynecomastia in adolescents : Current Opinion in Pediatrics", "detail": "journals.lww.com", "url": "https://journals.lww.com/co-pediatrics/fulltext/2008/08000/gynecomastia_in_adolescents.3.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Crossmark: Check for updates\n\n# Gynecomastia in adolescents\n\n## Purpose of review\n\nGynecomastia is a common finding in adolescent men. The primary care provider should feel equipped to thoroughly evaluate this condition and to differentiate physiologic from pathologic breast enlargement. The present", "score": 0.7163977 }, { "number": 8, "title": "Routine Endocrinologic Evaluation Is Unnecessary... - Ovid", "detail": "journals.lww.com", "url": "https://journals.lww.com/00003094-202463110-00001", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "EAA clinical practice guidelines—gynecomastia evaluation and management. Access to Surgical Treatment of Adolescent Gynecomastia Readers", "score": 0.67243975 }, { "number": 9, "title": "Gynecomastia : Indian Journal of Endocrinology and Metabolism", "detail": "journals.lww.com", "url": "https://journals.lww.com/indjem/fulltext/2014/18020/gynecomastia__clinical_evaluation_and_management.4.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "is increasing. In addition, increased use of anabolic steroids and environmental contamination with xenoestrogens or estrogen-like substances may stimulate glandular proliferation in male breast tissue. In mild cases, simple reassurance coupled with advice on diet and exercise may be sufficient. How", "score": 0.5221784 }, { "number": 10, "title": "Multidisciplinary Team Care: Adolescent Breast", "detail": "journals.lww.com", "url": "https://journals.lww.com/00078609-202505000-00008", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Depending on the institution, pediatric surgeons may be equipped to treat gynecomastia or may be the frontline for evaluation of a breast condition, ultimately", "score": 0.42105237 }, { "number": 11, "title": "Gynecomastia - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/gynecomastia", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Laboratory evaluation should be guided by the history and physical examination findings. Thyroid, renal, and hepatic function tests should be obtained, as should serum levels of testosterone, prolactin, follicle-stimulating hormone, and luteinizing hormone.17,19,20 Although not a common cause of gyn", "score": 0.78512776 }, { "number": 12, "title": "1 Testosterone - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/neuroscience/1-testosterone", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "A careful history, including medication history, and physical examination usually identify potential predisposing conditions or medications causing gynecomastia that in older men may be mulifactorial.160-162 Clinical evaluation should focus on evidence of androgen deficiency; assessment of prescript", "score": 0.6826801 }, { "number": 13, "title": "Hyperestrogenism - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/neuroscience/hyperestrogenism", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "A careful history, including medication history, and physical examination usually identify potential predisposing conditions or medications causing gynecomastia that in older men may be mulifactorial.160-162 Clinical evaluation should focus on evidence of androgen deficiency; assessment of prescript", "score": 0.6721816 }, { "number": 14, "title": "11-Ketotestosterone - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/neuroscience/11-ketotestosterone", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Sertoli cell tumors have been found in association with both PJS and the Carney Complex (CNC). CNC is often associated with mutations in the protein kinase, c-AMP dependent, regulatory, type 1, alpha _(PRKAR1A)_ gene, which encodes the regulatory subunit type 1 of protein kinase A.369 Among boys, ad", "score": 0.6721816 }, { "number": 15, "title": "Persistent Gynecomastia due to Short-term Low-dose Finasteride for ...", "detail": "academic.oup.com", "url": "https://academic.oup.com/jcemcr/article/2/5/luae050/7657109", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "Finasteride was discontinued after 2 months, and gynecomastia was unchanged 5 months after drug withdrawal. The gynecomastia regressed but did", "score": 0.21608633 }, { "number": 16, "title": "Androgen Misuse and Abuse | Endocrine Reviews - Oxford Academic", "detail": "academic.oup.com", "url": "https://academic.oup.com/edrv/article/42/4/457/6117781", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "Acne and gynecomastia are frequent side effects of androgen abuse. androgen abuse creates a cyclical form of drug dependency due to androgen withdrawal effects", "score": 0.18603624 }, { "number": 17, "title": "Effects of Gynecomastia Surgery on Readiness and Return to Duty ...", "detail": "academic.oup.com", "url": "https://academic.oup.com/milmed/article-pdf/189/7-8/e1637/58417516/usad452.pdf", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "Simple mastectomies are routinely performed in the military health care system as gynecomastia can cause significant pain and discomfort when wearing body armor", "score": 0.15583521 }, { "number": 18, "title": "Male hypogonadism: recommendations from the Fifth International ...", "detail": "academic.oup.com", "url": "https://academic.oup.com/smr/article/13/4/548/8242145", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "In men's health, tamoxifen has been used off label to treat anabolic–androgenic steroid (AAS)–induced gynecomastia or breast tenderness.201,202", "score": 0.42892754 }, { "number": 19, "title": "Gynecomastia: Clinical evaluation and management", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3987263", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "## often spontaneously regresses in both adolescent and adults and so in most patients only follow-up is necessary. In pubertal males; 85-90% of cases regress between 6m and 2 years and continuation after the age of 17 is rare. In adults, asymptomatic males with long-standing breast enlargement do ", "score": 0.7014069 }, { "number": 20, "title": "[PDF] Gynecomastia - Cleveland Clinic Journal of Medicine", "detail": "www.ccjm.org", "url": "https://www.ccjm.org/content/ccjom/71/6/511.full.pdf", "authors": "www.ccjm.org", "host": "www.ccjm.org", "snippet": "Laboratory screening should include measurements of: • Thyroid function • Liver enzymes • Serum creatinine • Serum total and free or bioavailable testosterone, estradiol, LH, follicle-stimu-lating hormone (FSH), and prolactin • Serum beta-hCG • Serum DHEA-sulfate or urinary 17-keto-steroids (may be ", "score": 0.7872945 }, { "number": 21, "title": "[Disordered hormone regulation in gynecomastia] - PubMed", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pubmed/12704923", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Title: [Disordered hormone regulation in gynecomastia] - PubMed\nAn official website of the United States government. **The .gov means it’s official.**. Federal government websites often end in .gov or .mil. sharing sensitive information, make sure you’re on a federal. The **https://** ensures that y", "score": 0.68874115 }, { "number": 22, "title": "Most Teens with Gynecomastia Don't Need Hormone Lab Tests | ASPS", "detail": "www.plasticsurgery.org", "url": "https://www.plasticsurgery.org/news/press-releases/most-teens-with-gynecomastia-dont-need-hormone-lab-tests", "authors": "www.plasticsurgery.org", "host": "www.plasticsurgery.org", "snippet": "Most patients underwent laboratory testing to measure levels of hormones, such as testosterone and estradiol (a form of estrogen). Importantly, these tests had abnormal results in just three patients: a rate of 1.7 percent. Dr. Arneja and colleagues write, \"Endocrinological investigations did not yi", "score": 0.55912215 }, { "number": 23, "title": "Liposuction: Concepts, safety, and techniques in body-contouring surgery | Cleveland Clinic Journal of medicine", "detail": "www.ccjm.org", "url": "https://www.ccjm.org/content/87/6/367", "authors": "www.ccjm.org", "host": "www.ccjm.org", "snippet": "Lipomas and angiolipomas, with minimal to no scarring\n Lipedema, in which subcutaneous fat deposition in the lower limbs can interfere with daily activities such as walking; in these patients, liposuction can improve mobility27\n Lymphedema, particularly if it is refractory to traditional conservativ", "score": 0.10306976 }, { "number": 24, "title": "Clinical and Etiological Aspects of Gynecomastia in Adult Males: A Multicenter Study - PMC", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996435", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "### Methods\n\nMedical records of 237 men aged 18-85 years with gynecomastia were evaluated.\n\n### Results\n\nHighest prevalence of gynecomastia was observed between 21 and 30 years (n = 74; 31.2%). The most common presenting complaints were aesthetic concerns (62.8%) and breast pain (51.2%). 25.3% of th", "score": 0.79561085 } ], "publishedAt": "2026-09-16T00:19:17.480889+00:00", "updatedAt": "2026-09-16T00:19:17.480889+00:00", "readingMinutes": 6, "slug": "gynecomastia" }