Gynecomastia history and symptoms: Difference between revisions
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==== Age of onset ==== | ==== Age of onset ==== | ||
* Physiological gynecomastia has trimodal distribution occurring in neonatal, in pubertal age and in the elderly.<ref name="pmid18369226">{{cite journal| author=Niewoehner CB, Schorer AE| title=Gynaecomastia and breast cancer in men. | journal=BMJ | year= 2008 | volume= 336 | issue= 7646 | pages= 709-13 | pmid=18369226 | doi=10.1136/bmj.39511.493391.BE | pmc=2276281 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18369226 }} </ref><ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754 }} </ref> | * [[Physiological]] gynecomastia has trimodal distribution occurring in [[neonatal]], in [[pubertal]] age and in the elderly.<ref name="pmid18369226">{{cite journal| author=Niewoehner CB, Schorer AE| title=Gynaecomastia and breast cancer in men. | journal=BMJ | year= 2008 | volume= 336 | issue= 7646 | pages= 709-13 | pmid=18369226 | doi=10.1136/bmj.39511.493391.BE | pmc=2276281 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18369226 }} </ref><ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754 }} </ref> | ||
* Pathological gynecomastia can occur at any age secondary to any condition causing increased free estrogen to androgen ratio. | * [[Pathological]] gynecomastia can occur at any age secondary to any condition causing increased free [[estrogen]] to [[androgen]] ratio. | ||
==== Past Medical History ==== | ==== Past Medical History ==== | ||
* Gynecomastia is associated with a past medical history of cirrhosis, chronic renal disease, hyperthyroidism, orchitis, trauma to testis or use of medications (eg, prescription medications, over-the-counter medications, recreational drugs).<ref name="pmid25112235">{{cite journal| author=Narula HS, Carlson HE| title=Gynaecomastia--pathophysiology, diagnosis and treatment. | journal=Nat Rev Endocrinol | year= 2014 | volume= 10 | issue= 11 | pages= 684-98 | pmid=25112235 | doi=10.1038/nrendo.2014.139 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25112235 }} </ref><ref name="pmid25905330">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng JCM |title= |journal= |volume= |issue= |pages= |year= |pmid=25905330 |doi= |url=}}</ref> | * Gynecomastia is associated with a past medical history of [[cirrhosis]], [[chronic renal disease]], [[hyperthyroidism]], [[orchitis]], trauma to [[testis]] or use of medications (eg, [[Prescription drugs|prescription]] medications, over-the-counter medications, [[recreational drugs]]).<ref name="pmid25112235">{{cite journal| author=Narula HS, Carlson HE| title=Gynaecomastia--pathophysiology, diagnosis and treatment. | journal=Nat Rev Endocrinol | year= 2014 | volume= 10 | issue= 11 | pages= 684-98 | pmid=25112235 | doi=10.1038/nrendo.2014.139 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25112235 }} </ref><ref name="pmid25905330">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng JCM |title= |journal= |volume= |issue= |pages= |year= |pmid=25905330 |doi= |url=}}</ref> | ||
==== Social History ==== | ==== Social History ==== | ||
* Patients may have a history of use of illicit drugs or decrease in libido which might suggest hypogonadism.<ref name="pmid22790552">{{cite journal |vauthors=Barros AC, Sampaio Mde C |title=Gynecomastia: physiopathology, evaluation and treatment |journal=Sao Paulo Med J |volume=130 |issue=3 |pages=187–97 |year=2012 |pmid=22790552 |doi= |url=}}</ref> | * Patients may have a history of use of illicit drugs or decrease in [[libido]] which might suggest [[hypogonadism]].<ref name="pmid22790552">{{cite journal |vauthors=Barros AC, Sampaio Mde C |title=Gynecomastia: physiopathology, evaluation and treatment |journal=Sao Paulo Med J |volume=130 |issue=3 |pages=187–97 |year=2012 |pmid=22790552 |doi= |url=}}</ref> | ||
===Common Symptoms=== | ===Common Symptoms=== | ||
Common symptoms include:<ref name="pmid25905330">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng JCM |title= |journal= |volume= |issue= |pages= |year= |pmid=25905330 |doi= |url=}}</ref> | Common symptoms include:<ref name="pmid25905330">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng JCM |title= |journal= |volume= |issue= |pages= |year= |pmid=25905330 |doi= |url=}}</ref> | ||
* | *Asymptomatic | ||
*Breast pain | |||
*Breast enlargement | * Breast pain | ||
* Breast enlargement | |||
===Less Common Symptoms=== | ===Less Common Symptoms=== | ||
Less common symptoms of gynecomastia include:<ref name="pmid25905330">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng JCM |title= |journal= |volume= |issue= |pages= |year= |pmid=25905330 |doi= |url=}}</ref> | Less common symptoms of gynecomastia include:<ref name="pmid25905330">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng JCM |title= |journal= |volume= |issue= |pages= |year= |pmid=25905330 |doi= |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
The hallmark of gynecomastia is breast enlargement.The majority of patients with gynecomastia are asymptomatic. The most common symptom is pain. Less common symptoms depend on the underlying cause.
History and Symptoms
History
Age of onset
- Physiological gynecomastia has trimodal distribution occurring in neonatal, in pubertal age and in the elderly.[1][2]
- Pathological gynecomastia can occur at any age secondary to any condition causing increased free estrogen to androgen ratio.
Past Medical History
- Gynecomastia is associated with a past medical history of cirrhosis, chronic renal disease, hyperthyroidism, orchitis, trauma to testis or use of medications (eg, prescription medications, over-the-counter medications, recreational drugs).[3][4]
Social History
- Patients may have a history of use of illicit drugs or decrease in libido which might suggest hypogonadism.[5]
Common Symptoms
Common symptoms include:[4]
- Asymptomatic
- Breast pain
- Breast enlargement
Less Common Symptoms
Less common symptoms of gynecomastia include:[4]
- Symptoms of chronic liver disease (ascites, jaundice etc)
- Symptoms of chronic kidney disease (persistent nausea, oliguria, fluid retention, fatigue etc)
- Symptoms of hyperthyroidism (weight loss, tremors etc)
- Symptoms of depression (decreased sleep, appetite, concentration etc)
- Symptoms of hypogonadism (decreased libido etc)
References
- ↑ Niewoehner CB, Schorer AE (2008). "Gynaecomastia and breast cancer in men". BMJ. 336 (7646): 709–13. doi:10.1136/bmj.39511.493391.BE. PMC 2276281. PMID 18369226.
- ↑ Braunstein GD (2007). "Clinical practice. Gynecomastia". N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.
- ↑ Narula HS, Carlson HE (2014). "Gynaecomastia--pathophysiology, diagnosis and treatment". Nat Rev Endocrinol. 10 (11): 684–98. doi:10.1038/nrendo.2014.139. PMID 25112235.
- ↑ 4.0 4.1 4.2 De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Swerdloff RS, Ng J. PMID 25905330. Vancouver style error: initials (help); Missing or empty
|title=(help) - ↑ Barros AC, Sampaio Mde C (2012). "Gynecomastia: physiopathology, evaluation and treatment". Sao Paulo Med J. 130 (3): 187–97. PMID 22790552.