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Gynecomastia
Discussion in 'All Categories' started by VIkas - Feb 13th, 2012 1:09 pm.
VIkas
VIkas
I am 22 years old 70kg weight. I think i am suffering from gynecomastia since the age of 16. and my left portion of chest is slightly bigger then the right. Which medicine will be good me : - Tamoxifen or danazol or both.
re: Gynecomastia by Dr M.K. Gupta - Feb 18th, 2012 10:40 pm
#1
Dr M.K. Gupta
Dr M.K. Gupta
Dear Vikash

Generally, no treatment methods are required for physiologic gynecomastia. Pubertal gynecomastia resolves spontaneously within several weeks to three years in approximately 90% of patients. Breasts more than 4 cm in diameter may not completely regress.

Identifying and managing an underlying primary disorder often alleviates breast enlargement. If hypogonadism (primary or secondary) may be the reason for gynecomastia, parenteral or transdermal testosterone replacement treatments are instituted. However, testosterone does have the potential to exacerbate gynecomastia through the aromatization of the exogenous hormone into estradiol.

For patients with idiopathic gynecomastia or with residual gynecomastia after treatment of the main cause, medical or surgical treatment might be considered. A major factor that should influence the first selection of therapy for gynecomastia is the condition
re: Gynecomastia by Dr M.K. Gupta - Feb 18th, 2012 10:42 pm
#2
Dr M.K. Gupta
Dr M.K. Gupta
Generally, no treatment methods are required for physiologic gynecomastia. Pubertal gynecomastia resolves spontaneously within several weeks to three years in approximately 90% of patients. Breasts more than 4 cm in diameter may not completely regress.

Identifying and managing an underlying primary disorder often alleviates breast enlargement. If hypogonadism (primary or secondary) may be the reason for gynecomastia, parenteral or transdermal testosterone replacement treatments are instituted. However, testosterone does have the potential to exacerbate gynecomastia through the aromatization of the exogenous hormone into estradiol.

For patients with idiopathic gynecomastia or with residual gynecomastia after treatment of the main cause, medical or surgical treatment might be considered. A major factor that should influence the first selection of therapy for gynecomastia is the condition duration. It's unlikely that any medical therapy can lead to significant regression in the late fibrotic stage (a amount of 12mo or longer) of gynecomastia. Consequently, medical therapies, if used, ought to be tried at the start of the condition course.

With the administration of clomiphene, an antiestrogen, approximately 50% of patients achieve partial reduction in breast size, and approximately 20% of patients note complete resolution. Negative effects, while rare, include visual problems, rash, and nausea. Tamoxifen, an estrogen antagonist, is effective for recent-onset and tender gynecomastia.[15] Up to 80% of patients report partial to complete resolution. Nausea and epigastric discomfort are the main negative effects.

Other drugs used, albeit less often, include danazol. Danazol, an artificial derivative of testosterone, inhibits pituitary secretion of LH and follicle-stimulating hormone (FSH), which decreases estrogen synthesis in the testicles.

Reduction mammoplasty is recognized as for patients with macromastia or long-standing gynecomastia or in persons in whom medical therapy has failed. It is also considered for cosmetic reasons (and for accompanying psychosocial reasons).

More extensive cosmetic surgery may be required in patients with marked gynecomastia or who have developed excessive sagging from the breast growth due to weight reduction. If surgery is essential for patients with pseudogynecomastia, liposuction might be warranted.

A Chinese study indicated that endoscopic subcutaneous mastectomy, without skin excision, happens to be an effective treatment for gynecomastia. Inside a report on the procedure's use within 65 patients (125 breasts) with gynecomastia, grade IIB or III, the authors stated that only a few operative complications occurred, including 2 cases of partial nipple necrosis and 1 case of subcutaneous hydrops. They also reported that postsurgical chest contour was satisfactory in most patients which no recurrences were seen throughout the 3- to 36-month follow-up period. Complications of surgery include sloughing of tissue as a result of compromised circulation, contour irregularity, hematoma or seroma formation, and permanent numbness within the nipple-areolar area.
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