Gynecomastia - a one- or two-way benign breast enlargement in men. There are false and the true form of pathology. In the first case, gynecomastia is caused by fatty deposits in the overweight, the second - the growth of breast tissue.
Causes and symptoms of gynecomastia
True gynecomastia in men is caused by the following reasons:
- Violation of the ratio of estrogen and testosterone in the body. Such a condition is often seen in low-functioning of the sex glands, hormone-active tumors of the testes, pituitary gland, adrenal glands, lungs, pancreas and stomach, as well as Addison's disease, inflammation of the testicles and prostate cancer;
- Hyperprolactinemia - increased secretion of the hormone prolactin in hypothyroidism and pituitary tumors;
- Diseases associated with metabolic disturbances (obesity, diabetes, Graves' disease, and others.);
- Other diseases not endocrine nature (cirrhosis, cardiovascular or renal failure, chest trauma, HIV, etc..);
- Receiving a number of drugs that affect receptors glandular tissue, or enhance the production of prolactin estrogens have toxic effects on the testes, etc. Cause gynaecomastia in men anabolic steroids, metronidazole, corticosteroids, enalapril, verapamil, cimetidine, creams containing estrogens and many other means;
- Alcohol and drug use (marijuana, heroin).
The most characteristic symptom of gynecomastia - an increase in breast tissue and the appearance of it seals. Sometimes when touched there pain that periodically decrease and disappear completely.
Before removing gynecomastia, or its treatment, you must start a survey, which includes:
- Initial examination of the patient;
- Assessment of the degree of development of secondary sexual characteristics;
- Palpation of the testes, and mammary glands;
- Clarification of family and drug history;
- An analysis of existing conditions;
- Detection of alcohol or drug dependence.
If there are any signs of gynecomastia, an endocrinologist should be consulted, as well as a thorough hormonal examination. Methods of laboratory diagnostics determine blood levels of hormones such as testosterone, estradiol, thyrotropin, prolactin, hCG (human chorionic gonadotropin), FSH (follicle stimulating hormone) and LH (luteinizing hormone).
To detect breast cancer and determine the nature of gynecomastia (true or false) is used breast ultrasound.
Conservative treatment of gynecomastia
At the first stage of the disease (within four months after the start of the growth of glandular tissue) reduce the amount of breast conservative treatment methods possible. At the same time get rid of gynecomastia without surgery is simple enough. To this end, assigned hormone therapy, normalizing the balance of testosterone and estrogen, and as a result, reduces breast.
When conservative treatment of gynecomastia is used the following drugs:
- Antiestrogen agents (eg, tamoxifen). They are appointed in the case of excess estrogen in the male body. Antiestrogens inhibit this subclass of steroid hormones and do not allow them to influence the mammary gland. The use of such drugs, despite their efficiency is limited by numerous side-effects;
- Testosterone - a male sex hormone, which is prescribed for reducing its levels in the body. The positive effect of the drug is especially noticeable when hypogonadism, which is characterized by insufficient secretion of androgens or defeat underdevelopment sexual glands. However, the physiological teenage gynecomastia in men testosterone appointment is not always effective.
Surgical treatment of gynecomastia
When conservative therapy does not give the desired result or originally understood that the drug treatment does not work (for example, tumor lesions) performed surgery. When surgical removal is carried out excision of gynecomastia breast and the subsequent restoration of its physiological contour.
The indications for surgery are:
- A large amount of glandular tissue;
- Pronounced cosmetic defect;
- Age pathology over a year.
Operation with gynecomastia are the following types:
- Endoscopic mastectomy through an incision in the axillary region (a small increase in mammary gland);
- Subcutaneous mastectomy of periareolar incision preserving the areola;
- Subcutaneous mastectomy with liposuction.
Surgery to remove gynecomastia is well tolerated and does not require long-term hospitalization and rehabilitation. In the first days after the hematoma may be observed, and slight swelling and discomfort in the chest. For 2-3 weeks after surgery it is recommended to wear a special slimming underwear, which helps to reduce the skin and form a proper muscle contour. During the month should be excluded exercise. The recovery period for each patient is different, and the final result is noticeable after about 12 weeks.
Contraindications to the removal of gynecomastia surgery and the following:
- A bleeding disorder;
- arterial hypertension;
- Endocrine diseases;
- Severe disease of the cardiovascular system;
- Cancer and infectious diseases;
- Chest injury;
- Low contractility and elasticity of the skin.
With long-term existence of gynecomastia increases the risk of breast cancer. Therefore, if the presence of this disease appear bloody discharge from the nipples, seals are formed, the skin changes over education, increasing the axillary lymph nodes, you must consult your doctor immediately.