Citizendia

Gynecomastia
Classification and external resources
An obese teenage male with Gynecomastia.
ICD-10N62.
ICD-9611.1
DiseasesDB19601
MedlinePlus003165
eMedicinemed/934 

Gynecomastia, or gynaecomastia, pronounced /ˌgaɪnəkoʊˈmæstiə/ is the development of abnormally large mammary glands in males resulting in breast enlargement, which can sometimes cause secretion of milk. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings N00-N39 - Diseases of the Genitourinary system: urinary system (N00-N08 Glomerular diseases Prefixes. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Mammary glands are the organs that in Mammals produce Milk for the sustenance of the young Male (♂ refers to the sex of an organism or part of an organism which produces small mobile Gametes called spermatozoa. The term comes from the Greek gyne (oblique stem gynaik-) meaning "woman" and mastos meaning "breast". Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly The condition can occur physiologically in neonates (due to female hormones from the mother), in adolescents, and in the elderly. The Adolescents are a Hardcore punk band formed in 1980 in Fullerton, California. In adolescent boys the condition is often a source of distress, but for the large majority of boys whose pubertal gynecomastia is not due to obesity, the breast development shrinks or disappears within a couple of years [1]. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected The causes of common gynecomastia remain uncertain, although it has generally been attributed to an imbalance of sex hormones or the tissue responsiveness to them; a root cause is rarely determined for individual cases. Sex steroids, also known as gonadal steroids, are Steroid hormones that interact with Vertebrate Androgen or Estrogen receptors Breast prominence can result from hypertrophy of breast tissue, chest adipose tissue and skin, and is typically a combination. Hypertrophy is the increase of the size of an organ or in a select area of the tissue "Adipose" redirects here For the Doctor Who monster see " Partners in Crime " Breast prominence due solely to excessive adipose is often termed pseudogynecomastia[2] or sometimes lipomastia[3].

Gynecomastia should be distinguished from work hypertrophy of the pectoralis muscles caused by much exercise, e. Muscle hypertrophy is a scientific term for the growth and increase of the size of muscle cells g. swimming. Swimming is the movement by humans or animals through Water, usually without artificial assistance

Contents

Causes

Physiologic gynecomastia (also called Turcios Disease) occurs in neonates, at or before puberty and with aging. Senescence refers to the biological processes of a living Organism approaching an advanced age (i Many cases of gynecomastia are idiopathic, meaning they have no clear cause. Idiopathic is an Adjective used primarily in Medicine meaning arising spontaneously or from an obscure or unknown cause. Potential pathologic causes of gynecomastia are: medications including hormones, increased serum estrogen, decreased testosterone production, androgen receptor defects, chronic kidney disease, chronic liver disease, HIV treatment,[4] and other chronic illness. Estrogens (US otherwise oestrogens or œstrogens) are a group of Steroid compounds named for their importance in the Estrous cycle, Testosterone is a Steroid hormone from the Androgen group In mammals testosterone is primarily secreted in the testes of males and the Ovaries Androgen is the generic term for any natural or synthetic compound usually a Steroid Hormone, that stimulates or controls the development and maintenance of masculine Human immunodeficiency virus ( HIV) is a Lentivirus (a member of the Retrovirus family that can lead to acquired immunodeficiency syndrome Gynecomastia as a result of spinal cord injury and refeeding after starvation has been reported. [5] In 25% of cases, the cause of the gynecomastia is not known.

Medications cause 10-20% of cases of gynecomastia in post-adolescent adults. These include cimetidine, omeprazole, spironolactone, imatinib mesylate, finasteride and certain antipsychotics. Cimetidine ( INN) (sɨˈmɛtɨdiːn/ /saɪ- is a histamine H2-receptor antagonist that inhibits the production of acid in the Stomach. Omeprazole ( INN) (oʊˈmɛprəzoʊl is a Proton pump inhibitor used in the treatment of Dyspepsia, peptic ulcer disease (PUD Gastroesophageal Spironolactone (marketed under the trade names Aldactone, Novo-Spiroton, Spiractin, Spirotone, Verospiron or Berlactone Imatinib is a drug used to treat certain types of Cancer. It is currently marketed by Novartis as Gleevec ( USA) or Glivec Finasteride (marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Antipsychotics are a group of Psychoactive drugs commonly but not exclusively used to treat Psychosis, which is typified by Schizophrenia. Some act directly on the breast tissue, while others lead to increased secretion of prolactin from the pituitary by blocking the actions of dopamine (prolactin-inhibiting factor/PIF) on the lactotrope cell groups in the anterior pituitary. Prolactin ( PRL) or Luteotropic hormone ( LTH) is a Peptide hormone primarily associated with Lactation. The pituitary gland, or hypophysis, is an Endocrine gland about the size of a Pea. Dopamine is a Hormone and Neurotransmitter occurring in a wide variety of animals including both vertebrates and invertebrates Lactotrophs (also known as lactotrope mammatroph mammotroph epsilon acidophil prolactin cell and lactotropic cell are cells in the Anterior pituitary which produce The anterior pituitary (also called the adenohypophysis, from Greek adeno, "gland" hypo, "under" physis, "growth" Androstenedione, used as a performance enhancing food supplement, can lead to breast enlargement by excess estrogen activity. Androstenedione (also known as 4-androstenedione) is a 19- Carbon Steroid Hormone produced in the Adrenal glands and the Gonads Estrogens (US otherwise oestrogens or œstrogens) are a group of Steroid compounds named for their importance in the Estrous cycle, Medications used in the treatment of prostate cancer, such as antiandrogens and GnRH analogs can also cause gynecomastia. An antiandrogen, or androgen antagonist, is any of a group of Hormone Receptor antagonist compounds that are capable of preventing or inhibiting the biologic A gonadotropin-releasing hormone analogue, also known as a GnRH analogue, (sometimes analog) is a synthetic Peptide drug modeled after the Marijuana use is also thought by some to be a possible cause; however, published data is contradictory. Cannabis, also known as marijuana or marihuana, or ganja (from Hindi / Sanskrit: गांजा gānjā hemp) is a [6]

Increased estrogen levels can also occur in certain testicular tumors, and in hyperthyroidism. See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Hyperthyroidism is the term for overactive tissue within the Thyroid gland resulting in overproduction and thus an excess of circulating free thyroid hormones Thyroxine Certain adrenal tumors cause elevated levels of androstenedione which is converted by the enzyme aromatase into estrone, a form of estrogen. Androstenedione (also known as 4-androstenedione) is a 19- Carbon Steroid Hormone produced in the Adrenal glands and the Gonads Enzymes are Biomolecules that catalyze ( ie increase the rates of Chemical reactions Almost all enzymes are Proteins Estrone (also oestrone) is an Estrogenic Hormone secreted by the Ovary. Other tumors that secrete hCG can increase estrogen. Human chorionic gonadotropin ( hCG) is a Glycoprotein Hormone produced in Pregnancy that is made by the Embryo soon after conception A decrease in estrogen clearance can occur in liver disease, and this may be the mechanism of gynecomastia in liver cirrhosis. Cirrhosis is a consequence of chronic Liver Disease characterized by replacement of liver tissue by fibrous Scar tissue as well as regenerative Obesity tends to increase estrogen levels. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected [7][8]

Decreased testosterone production can occur in congenital or acquired testicular failure, for example in genetic disorders such as Klinefelter Syndrome. Testosterone is a Steroid hormone from the Androgen group In mammals testosterone is primarily secreted in the testes of males and the Ovaries A genetic disorder is a condition caused by abnormalities in Genes or Chromosomes While some diseases such as Cancer, are due to genetic abnormalities acquired Klinefelter's syndrome, 47XXY or XXY syndrome is a condition caused by a Chromosome Aneuploidy. Diseases of the hypothalamus or pituitary can also lead to low testosterone. The hypothalamus links the Nervous system to the Endocrine system via the Pituitary gland (hypophysis The pituitary gland, or hypophysis, is an Endocrine gland about the size of a Pea. Abuse of anabolic androgenic steroids (AAS) has a similar effect. Mutations to androgen receptors, such as those found in Kennedy disease can also cause gynecomastia. Kennedy's disease (KD or X-linked spinal and bulbar muscular atrophy (SBMA is a neuromuscular disease associated with mutation of the Androgen receptor (AR

Although stopping these medications can lead to regression of the gynecomastia, surgery is sometimes necessary to eliminate the condition.

Repeated topical application of products containing lavender and tea tree oils among other unidentified ingredients to three prepubescent males coincided with gynecomastia; it has been theorised that this could be due to their estrogenic and antiandrogenic activity. Lavender oil is an Essential oil obtained by Distillation from the flower spikes of certain species of Lavender. Tea tree oil is an extraction from the Melaleuca tree Tea tree oil or melaleuca oil is a clear to very pale golden color Essential oil However, other circumstances around the study are not clear, and the sample size was insignificant so serious scientific conclusions cannot be drawn. [9]

Diagnosis

The condition usually can be diagnosed by examination by a physician. A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health Occasionally, imaging by X-rays or ultrasound is needed to confirm the diagnosis. X-radiation (composed of X-rays) is a form of Electromagnetic radiation. Not to be confused with Supersonic. Ultrasound is cyclic Sound pressure with a Frequency greater than the upper Diagnosis is the identification by Process of elimination, of the nature of anything Blood tests are required to see if there is any underlying disease causing the gynecomastia.

Prognosis

Gynecomastia is not physically harmful, but in some cases can be an indicator of other more dangerous underlying conditions. Growing glandular tissue, typically from some form of hormonal stimulation, is often tender or painful. A gland is an organ in an animal's body that synthesizes a substance for release such as Hormones or Breast milk, often into the Bloodstream Furthermore, it can frequently present social and psychological difficulties for the sufferer. [10] Weight loss can alter the condition in cases where it is triggered by obesity, but losing weight will not reduce the glandular component and patients cannot target areas for weight loss. Massive weight loss can result in sagging tissues about the chest, chest ptosis, or drooping chest. Breast Ptosis, or sagging Breasts is a medical term for the drooping or sagging of the breast

Treatment

Treating the underlying cause of the gynecomastia may lead to improvement in the condition. Patients should talk with their doctor about revising any medications that are found to be causing gynecomastia; often, an alternative medication can be found that avoids gynecomastia side-effects, while still treating the primary condition for which the original medication was found not to be suitable due to causing gynecomastia side-effects (e. g. , in place of taking spironolactone the alternative eplerenone can be used. ) Selective estrogen receptor modulator medications, such as tamoxifen and clomiphene, or androgens or aromatase inhibitors such as Letrozole are medical treatment options, although they are not universally approved for the treatment of gynecomastia. Selective Estrogen Receptor Modulators ( SERMs) are a class of Medication that acts on the Estrogen receptor. Tamoxifen is an orally active Selective estrogen receptor modulator (SERM that is used in the treatment of Breast cancer and is currently the world's largest Clomifene ( INN) or clomiphene ( USAN and former BAN) or Clomid or Clomifert is a Selective estrogen receptor modulator (SERM Androgen is the generic term for any natural or synthetic compound usually a Steroid Hormone, that stimulates or controls the development and maintenance of masculine Aromatase inhibitors ( AI) are a class of drugs used in the treatment of Breast cancer and Ovarian cancer in postmenopausal women that Letrozole ( INN, trade name Femara) is an oral non-steroidal Aromatase inhibitor that has been introduced for the adjuvant treatment of hormonally-responsive Endocrinological attention may help during the first 2-3 years. After that window, however, the breast tissue tends to remain and harden, leaving surgery (either liposuction, gland excision, skin sculpture, reduction mammoplasty, or a combination of these surgical techniques) the only treatment option. Liposuction, also known as lipoplasty ("fat modeling" liposculpture or suction lipectomy ("suction-assisted fat removal" is Breast reduction or reduction mammoplasty is an Outpatient surgical procedure which involves the reduction in the size of Breasts by excising Many American insurance companies deny coverage for surgery for gynecomastia treatment on the grounds that it is a cosmetic procedure. Radiation therapy is sometimes used to prevent gynecomastia in patients with prostate cancer prior to estrogen therapy. Radiation therapy (or radiotherapy) is the medical use of Ionizing radiation as part of Cancer treatment to control Malignant Compression garments can camouflage chest deformity and stabilize bouncing tissue bringing emotional relief to some. Compression garments are pieces of clothing such as socks pantyhose sleeves etc that provide support that is especially useful for people who have to stand for long periods or people There are also those who choose to live with the condition.

References

  1. ^ Adolescent gynecomastia
  2. ^ Braunstein, GD (Feb 18 1993). "Gynecomastia". N Engl J Med 328 (7): 490–5. doi:10.1056/NEJM199302183280708. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 8421478.  
  3. ^ Allee, Mark R (2006-11-15). Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 655 - Battle of Winwaed: Penda of Mercia is defeated by Oswiu of Northumbria. Gynecomastia. WebMD, Inc. (emedicine. com). Retrieved on 2007-05-20. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 325 - The First Council of Nicaea &ndash the first Ecumenical Council of the Christian Church is held
  4. ^ Peyriere, H; et al (Oct 22 1999). "Report of gynecomastia in five male patients during antiretroviral therapy for HIV infection". AIDS 13 (15): 2167–9. doi:10.1097/00002030-199910220-00022. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 10546872.  
  5. ^ Heruti, RJ; et al (May 1997). "Gynecomastia following spinal cord disorder". Arch Phys Med Rehabil 78 (5): 534–7. doi:10.1016/S0003-9993(97)90171-4. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 9161376.  
  6. ^ Thompson D, Carter J. "Drug-induced gynecomastia". Pharmacotherapy 13 (1): 37–45. PMID 8094898.  
  7. ^ Glass, AR (Dec 1994). "Gynecomastia". Endocrinol Metab Clin North Am 23 (4): 825–37. PMID 7705322.  
  8. ^ Braunstein, GD (Jun 1999). "Aromatase and Gynecomastia". Endocr Relat Cancer 6 (2): 315–24. doi:10.1677/erc.0.0060315. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 10731125.  
  9. ^ Henley D, Lipson N, Korach K, Bloch C (2007). "Prepubertal gynecomastia linked to lavender and tea tree oils". N Engl J Med 356 (5): 479–85. doi:10.1056/NEJMoa064725. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17267908.  
  10. ^ Wiesman, IM. et al. . Gynecomastia: An Outcome Analysis.

See also

External links to images

Male bra (also compression bra or vest and Gynecomastia vest) refers to Brassieres that are worn by men The phenomenon of male Lactation in humans has become more common in recent years due to the use of Medications that stimulate a man's Mammary glands Though

Dictionary

gynecomastia

-noun

  1. (medicine) Excessive development of breasts in males, resembling the breast development in women.
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