Chronic gynecomastia is a disorder of the endocrine system. It leads to an increase in the size of the male breast tissues. Disturbances or disorders of the endocrine system lead to an increase in the level of estrogens and androgens. These are considered to be a reason behind chronic gynecomastia. The disease might also occur if the ratio of estrogen and androgen are appropriate but the ratio has changed. Diagnosis is based on the symptoms of the disease. If medical treatment has persisted beyond two years then it can be taken as ineffective. Excess tissues are surgically removed.
Signs, Symptoms and Causes
A subcutaneous chest tissue can be palpated/detected under the aerola of the nipple as compared to soft fatty tissues such as in pseudogynecomastia. Estrogen is the reason for growth in the male breast tissues. In a quarter of cases, causes of gynecomastia are unknown. Main cause of gyecomatia is change in the ratio of estrogen and androgen or endocrine disorders.
Some diseases in men like kidney failure or liver disease may lead to growth of breast in men. HIV medication, chemotherapy, ulcer medication, antifungals, antibiotics and hormone treatment may also lead to gynecomastia. Adolescents also suffer from gynecomastia between the ages of 10 and 12 but it generally goes away after 18 months. Around 10-25 percent of the cases are the result of use of medications.
Diagnosis and Treatment
To diagnose, a thorough examination by a doctor is required. A review of the medical history of the patient is done to find out the causes. Some laboratory tests to diagnose gynecomastia are carried out to rule out chronic diseases. Imaging is done to find out if it is gynecomastia or pseudogynecomastia. If breast cancer is suspected, mammography is carried out to rule out the possibility.
Mild cases of gynecomastia are treated by making lifestyle changes. Proper diet and exercise are recommended. Medical treatment yields best results if started within two years of male breast enlargement. In case of chronic gynecomastia, surgical removal is required. Surgical approaches to treat gynecomastia include liposuction and mastectomy. Radiation therapy is also used to treat some cases of gynecomastia. The efficacy of this treatment is limited once gynecomastia has started. Once gynecomastia sets in, this treatment is not very effective. Compression jackets are one way to hide the enlargement. It is temporary and noninvasive. It can be worn under any clothing to hide the fatty breast tissues.