Gynecomastia in men - causes, symptoms, diagnosis, treatment and removal methods. Gynecomastia in men: which doctor to contact for advice and treatment Which doctor treats gynecomastia in men

Beautiful, large breasts for women are the standard of beauty and pride, but if such breasts appear on a man, it causes embarrassment, discomfort and shame. Such unjustified growth of the mammary glands makes you worry about how to treat gynecomastia in men, especially if breast enlargement is accompanied by unpleasant sensations in the nipple area, fluid discharge from them, or even pain. Enlargement of the mammary glands in men is called gynecomastia. This disease is accompanied by hyperplasia of muscle and fat tissue. The appearance of symptoms such as swelling of the mammary glands and darkening of the nipple areola may indicate a serious malfunction in the body, including oncological processes. The causes of the occurrence are various hormonal changes when the female hormone estrogen increases in the male body. A decrease in testosterone levels also leads to the development of this disease. And the manifestation of the disease against the background of various diseases (obesity, genital infections, liver cirrhosis, kidney failure, tumors of internal organs, use of certain medications and drugs) is called pathological gynecomastia.

Diagnosis of gynecomastia

Breast enlargement itself does not pose a significant threat to men's health. This is not considered a disease as such, but is a symptom that indicates a malfunction in a man’s body. Very often, representatives of the stronger sex hope that this manifestation will go away on its own, without the intervention of a doctor, and sometimes they don’t even know which doctor to contact with such a problem. In order for the treatment of gynecomastia in men to be selected correctly, you need to immediately contact your family doctor or therapist. After confirming the diagnosis, the patient will be redirected to a doctor who controls the endocrine system. He, in turn, will order the following studies:

• General blood test and hormone levels.
• Liver tests (if liver cirrhosis is suspected).
• Ultrasound examination of the mammary glands, lymph nodes, mammography.
• Biopsy or puncture of the gland (in an advanced stage).

To understand how to get rid of gynecomastia, you first need to identify its type. During the examination, both true and false gynecomastia can be diagnosed. In the first case, there is an increase and formation of glandular and connective tissues, which lead to the growth of the mammary glands. In the second, the disease occurs due to weight gain, in which fat deposits accumulate in the male mammary glands. If false, this disease does not pose a threat to the patient, but only leads to psychological discomfort (embarrassment for people when changing clothes). When palpating the mammary glands, no lumps are observed, unlike true gynecomastia.

Methods of treating the disease

When determining the cause of breast enlargement in a man, the attending physician prescribes appropriate therapy. If the disease is not in an advanced form, but only at the initial stage, the patient only needs to correct and remove bad habits in order to bring the imbalance of hormones back to normal. To do this you need:

• To give up smoking. Nicotine and harmful tars reduce the production of testosterone in a man's body.
• Drinking beer should also be avoided. It contains female hormones, the increase of which leads to breast growth, and the man’s body itself begins to resemble a woman’s.
• The use of steroid drugs changes hormonal levels for the worse.
• Refusal of semi-finished products. They have a detrimental effect on hormone production.
• Establish proper nutrition (fiber, lean meat, vegetables and fruits, add more greens and grains), remove flour, fat, and sweets from the diet. Such food will normalize the functioning of the body, and consuming fish oil will increase the level of testosterone in the body.

Drug treatment

Therapy is prescribed with the help of medications if true gynecomastia is at the initial stage of development and the mammary gland is not significantly enlarged. This treatment is aimed at normalizing sex hormones in the body. If the cause is a decrease in the production of the hormone testosterone, then treatment of gynecomastia in men will include taking the following medications:

• The drug Testosterone – increases the level of male sex hormone to the desired level. This will allow you not to resort to surgical treatment.
• Injectable drugs containing male sex hormones – Sustamone, Omnadrene. They are good for those who do not like to take medications and do daily injections. These drugs are administered intramuscularly and their effect lasts for a long time.
• Proviron. Compensates for the lack of testosterone, thanks to the active component mesterolone. It is able to reduce such negative manifestations that are caused by androgen deficiency, such as decreased performance, fatigue, irritability, sleep disturbance, depression, and psycho-vegetative disorders.
• Thiamine bromide. It slows down and prevents the production of the aromatase enzyme, which converts male testosterone into female estrogen.

If the cause of gynecomastia lies in an increase in female sex hormones - estrogens, then the therapeutic focus is to suppress its activity and reduce the production of the hormone by the body. When treated with medications, the disease can be cured no earlier than after 5–6 months. Many patients are not satisfied with this and agree to surgery. Positive dynamics after taking the tablets begin to be seen after 2 months of regular use. When prescribing drugs that reduce estrogen synthesis, they also prescribe medications that will, on the contrary, stimulate the production of testosterone in the body. The most effective of them:

• Tamoxifen is a well-reviewed drug that is aimed at blocking estrogen in men. It also has a positive effect on the mammary glands.
• Clomiphene is an effective remedy that monitors the amount of active female sex hormones. It should be borne in mind that when taking these medications you should adhere to a certain diet. What to limit yourself to, check with your doctor. It is strictly forbidden to consume alcohol, fatty and salty foods.
• Nolvadex - this drug is prescribed in the later stages of the disease, but in which surgery is impossible for various reasons (fear of surgery, contraindications).
• Danazol is aimed at reducing the production of female hormones in the testicles, but it is not particularly popular; doctors prescribe it the least often.

You can also use gels and ointments for external use. The patient will receive a significant positive effect by using Androgel ointment by rubbing it into the chest area every day; it helps in 90% of cases.

If the cause of gynecomastia in men is the use of anabolic steroids, then their use should be stopped immediately. But refusal from them is carried out only under the supervision of a doctor. There are cases when stopping steroids is impossible for various reasons; such patients are prescribed the drug Anastrozole, it will help stop the growth of the mammary glands and avoid surgery.

Traditional methods of treating gynecomastia

It is very good to combine drug treatment with the use of traditional recipes for gynecomastia in men, which together give an even greater positive result and can cure the disease without resorting to surgery. All therapy with such prescriptions is aimed at increasing the male hormone testosterone. The most effective stimulant in testosterone production is Ginseng root. It is recommended to consume a small piece of it every day, chewing it thoroughly in the mouth, although it does not taste very pleasant, it helps to get rid of the disease. You can try a drink made from Turmeric. Just dilute a teaspoon in a glass of water and mix well until completely dissolved. Turmeric also increases male hormones in the body and also helps burn fat deposits. To relieve swelling and pain, it is recommended to use cold compresses. To do this, ice wrapped in a towel is applied to the enlarged breast for 2-3 minutes. Salt baths are useful for gynecomastia; sea salt improves blood circulation and relieves swelling around the nipple. Such procedures should be carried out several times a week, for 20 minutes. And yet it should be remembered that it is impossible to cure gynecomastia using traditional methods, especially at a late stage. In this case, gynecomastia is treated by a doctor with a different focus - a surgeon, using surgery.

Surgical method of treatment

For gynecomastia in men, surgical treatment is aimed at getting rid of hypertrophied mammary glands through surgery. It is indicated for the following factors:

• When the mammary gland is enlarged to a very large size.
• If the therapeutic method of treatment does not give a positive result.
• A malignant neoplasm appeared in the mammary glands.
• The patient experiences psychological discomfort.
• The course of the disease is too long.

For gynecomastia, surgery is performed in two ways:

Mastectomy is the surgical removal of the breast. The surgery is performed in a hospital and in most cases is well tolerated by patients. This procedure lasts about an hour and does not require a long hospital stay. It is carried out either under local anesthesia, after which you can immediately leave the clinic, or under general anesthesia, after which you will have to stay for 2-3 days. The excised breast tissue is necessarily sent for histological examination to check the presence or absence of cancer cells. The stitches are removed after 4–6 days. This intervention, although quite serious in approach, is not overly complicated. The most important thing is that after the operation there is no relapse of the disease. In certain cases, patients are advised to undergo drainage. It is imperative to wear a compression bandage - this is the main condition. The scar after such an operation is almost invisible.

Laser liposuction

Laser liposuction - this method is indicated for patients with false gynecomastia (increase in body fat due to excess weight). During this operation, a small puncture is made, about 2-4 mm, and a thin laser is inserted into it. It makes the fat layer less dense. This makes it possible to suck it out through a vacuum device. This method leaves almost no noticeable marks on the patient’s body. It is carried out under local anesthesia, recovery occurs as soon as possible.

After any operation, the patient continues to experience swelling and pain - this is normal. In such cases, ultrasound with hydrocortisone, magnetic laser and microcurrent therapy are prescribed. After the operation, the next day, it is recommended to apply special ointments; they promote rapid scarring of the suture. Compression garments should be worn for at least a month. After surgery, the patient is often interested in the question of which doctor to contact if a relapse of the disease or similar symptoms occurs. A relapse is possible if the operation was performed poorly or the patient did not follow the recommendations for recovery.

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From Latin, the name of the disease is translated as “female breast”, and only men suffer from gynecomastia.

Gynecomastia is a hormonal disease in which men begin to grow breasts.

The causes of the disease differ at different ages:

• In infancy, the disease manifests itself due to the presence of female hormones in the body, transmitted to the fetus from the mother. With age, boys' hormonal levels normalize and disappear;
• there is a surge of androgens, most of which are not absorbed and undergo biochemical reactions. As a result, estrogens appear in the body, promoting breast growth;
• at the age of 55 to 66 years, a period of fading of male sexual function begins and the level of androgens in the body decreases and estrogen production occurs.

The production of estrogen is promoted by the consumption of certain foods and microorganisms.

Some diseases are also a provoking factor:

• hypothyroidism;
• tumors of the testicles, adrenal glands, pituitary gland;
• cirrhosis of the liver;
• leprosy.

Hormonal disorders occur with alcohol abuse, taking certain drugs (spironolactone, phenothiazine, reserpine), and with an abrupt end to sports.

Symptoms of the disease

The main manifestation of gynecomastia is a diffuse or nodular increase in the size of one or both mammary glands.

The nature of changes in the glands depends on the stage of the disease:

1. Initial – growth of connective structures in tissues occurs.
2. Intermediate – lasts about 6 months and is characterized by active breast enlargement due to the development of glandular tissue.
3. Fibrous - the mammary glands become denser due to the growth of fibrous and fatty tissue in them.

Additional signs of the development of the disease are:

• a feeling of discomfort and heaviness in the glands, often accompanied by itching;
• increase in nipple area;
• the appearance of discharge that resembles milk in color;
• decreased sexual activity, erectile dysfunction;
• change in voice timbre;
• decreased body hair;
• emotional instability.

In the next section, read how to get rid of gynecomastia.

Gynecomastia in men: treatment

Before we deal with the question of how to treat gynecomastia in men and how to treat it, let’s talk a little about diagnosis. It is necessary to distinguish between and. A man needs to pay attention to changes in the mammary glands already in the first stages, when a feeling of heaviness and discomfort appears. If treatment is not started, the disease progresses quickly.

Correction of conditions without special treatment is possible only in early childhood or adolescence, since gynecomastia at this time is physiological and does not require treatment.

In adult men, the disease cannot be cured without medical intervention..

It is logical that the question arises: “Gynecomastia which doctor should I contact?, who to go to, who will prescribe treatment? In the beginning, a man should contact a therapist, undergo general tests and get a referral to an endocrinologist is a specialist in gynecomastia.

The doctor prescribes a whole range of tests to identify the causes of the disease. The patient is also prescribed an ultrasound of the mammary glands. If a tumor is suspected, the patient is referred for consultation to a surgeon or oncologist.

Urgent medical attention is needed if complications occur:

1. Rapid increase in body weight.
2. The presence of ulcers and ulcers on the nipples and areolas.
3. Lumps in the mammary glands.
4. Enlarged lymph nodes.
5. Bloody discharge from the nipples.

All these symptoms are extremely alarming and indicate that the disease is rapidly progressing.

IMPORTANT. Nodular forms of unilateral or bilateral gynecomastia are a precancerous condition.

In the presence of nodes, the risk of transformation of the lumps into a tumor is quite high, and the possibility of pathological changes in cells depends on the duration of the disease.

Treatment tactics for the disease depend on the identified causes.

Independent and uncontrolled use of drugs is unacceptable, as it can aggravate the situation and lead to irreversible hormonal disorders in the body.

Treatment for gynecomastia can last from several months to several years..

Conservative methods

Drug treatment is especially effective at the initial stage of the disease. How to get rid of gynecomastia without surgery?

Based on the test results, the doctor prescribes hormonal medications for gynecomastia:

• testosterone;
• clomiphene;
• danazol;
• Nolvadex.

To maintain immunity, vitamins A, E, B are prescribed.

If the cause of the disease is the use of certain medications, they are discontinued or the dose is reduced.

Operative methods

Surgical intervention is prescribed to a man if conservative methods do not produce positive results or the disease is at a precancerous stage.

An operation called mammary mastectomy is prescribed to the patient if there is:

• large tumors;
• advanced forms of diseases;
• psychological discomfort of the patient due to a pronounced cosmetic defect.

There are several options for mastectomy:

1. Endoscopic– minimally invasive technique, performed under local anesthesia. Excessively overgrown gland tissue is removed through a small puncture using special instruments. The technique is effective for small tumors in the early stages of the disease.
2. With preservation of the areola– a microsurgical operation performed through a small incision near the areola of the nipple. Compared to endoscopic surgery, the technique allows you to remove a larger volume of overgrown tissue.
3. With liposuction– a radical method of surgical intervention, used in advanced stages of gynecomastia. Most often, the technique is used when there is a risk of the tumor degenerating into a malignant one. Breast tissue is completely removed along with subcutaneous fat. The operation is quite traumatic and leaves significant scars. At the same time, this is a way to get rid of the disease forever.

Treatment of gynecomastia with folk remedies

How to remove gynecomastia using folk remedies? Bee bread and sea cucumber extract are effective for treatment.

In the presence of tumors or nodes, use:

• cat's claw plant – 1 tablet 3 times a day for 90 days;
• aloe or ginseng juice – 10 ml 2 times a day – six months;
• echinacea – as an immunomodulator for 2 months, a teaspoon 3 times a day.

Infusions of motherwort, valerian, and peony are used as sedatives.. Tribulus terrestris and Eleutherococcus are used as a source of testosterone.

Supporting activities

For any treatment methods for gynecomastia, the doctor recommends following a certain diet and performing special physical exercises.

The diet for gynecomastia is designed to compensate for the lack of zinc in the body, since during the disease this substance begins to be consumed at an increased rate.

• meat: beef liver, rabbit, lamb, beef;
• legumes;
• seafood and sea fish;
• cereals: brown rice, buckwheat, oats;
• vegetables: asparagus, beets, cabbage, lettuce;
• fruits: citrus fruits, figs, dates.

IMPORTANT. The diet should be low in calories, since obesity is often the root cause of gynecomastia.

• push ups;
• swimming;
• cycling.

Physiotherapeutic procedures are used as symptomatic treatment methods: mud therapy, UHF, inductophoresis, laser therapy.

Gynecomastia in men is a disease that is dangerous with many complications, since it is caused by deep hormonal imbalances in the body. Tumors affect the condition of the entire body and are likely to develop into malignant ones. Therefore, at the first signs of gynecomastia, a man should seek medical help.

Useful video

For more information about the treatment of gynecomastia, see the video below:

We hope that this material was useful to you and you now know the answers to the following questions: gynecomastia, which doctor to see for this disease and how to cure gynecomastia in men using different methods.

Gynecomastia is quite common. This pathology represents a significant enlargement of the mammary glands in men. The most common cause of this condition is hormonal problems in an adult man. The amount of estrogen in the blood increases rapidly, and androgens decreases significantly. This pathology is accompanied not only by aesthetic defects, but also has a detrimental effect on a person’s psychological state.

Before starting treatment, it is necessary to establish what exactly could lead to the appearance of such a pathological condition. Today, the most common causes of the disease are:

• increase in the level of the hormone prolactin in the blood of a man
• imbalance between estrogens and androgens
• dysfunction of the pituitary gland
• taking hormonal drugs to quickly increase testosterone in the blood
• constant heavy physical activity
• frequent beer drinking
• wearing an uncomfortable bra for women
• taking certain antifungal medications and diuretics
• chronic liver diseases
• problems in the functioning of the gastrointestinal tract
• frequent exhausting diets with an incorrectly selected diet
• uncontrolled use of steroids by athletes

In some cases, pathology does not act as a separate disease, but is a consequence of other health problems. Gynecomastia in adolescents can also appear after long-term use of hormonal drugs.

Gynecomastia in women and men, as well as the juvenile form of the disease, does not pose a particular danger to overall health. But if it is not cured in time, the pathology can develop into breast cancer. In men, the mammary glands do not always enlarge evenly. It happens that one breast remains normal and does not cause any discomfort, but the second one begins to hurt and protrude. Many men suffering from this disease have problems with their psychological state.

The main risk group is children and adolescents. Their hormonal levels take a long time to establish, which can affect their health. Elderly men, in whom the amount of androgens in the blood decreases during the aging process, are also susceptible to the development of pathology.

Gynecomastia during puberty often goes unnoticed, because in adolescence, many men still do not understand what exactly is happening to them and do not attach much importance to body changes.

Classification of gynecomastia

Gynecomastia is usually divided into true and false.

Code ICD 10 N62.

False gynecomastia often occurs in overweight men. This occurs due to the rapid growth of adipose tissue in the chest area. True gynecomastia is divided into the following forms:

• pathological
• physiological

The physiological form can be treated quite easily at home. The main goal of the therapy is to eliminate the main cause of the pathology. The following age groups of men are most susceptible to this form of the disease:

1. Newborns and children up to one year of age. In this case, the cause of gynecomastia may be the constant use of hormonal medications while carrying a baby. This type of gynecomastia does not require special treatment and goes away without any medical intervention as the child grows.
2. Teenagers. Juvenile gynecomastia is quite common. Puberty in boys is characterized by hormonal changes and a surge of hormones. All this can lead to a predominance of female sex hormones over male ones. If there are no concomitant pathologies, then teenage gynecomastia cannot be treated in any way and goes away on its own after some time.
3. Older men. After 50 years, androgens practically cease to be produced in the male body, while female hormones are produced in the same quantities. In this case, gynecomastia develops due to hormonal imbalance.

Experts also talk about unilateral gynecomastia, when only one gland suffers and increases in size, and about a bilateral form of pathology, covering both mammary glands.

The presence of pathology is determined by the presence of specific symptoms. The main signs of gynecomastia directly depend on the stage of development of the disease:

1. At the very beginning, uncontrolled proliferation of connective tissue occurs. Gynecomastia affects both the smallest and largest thoracic ducts. This condition usually lasts for about 4 months. With proper treatment, the pathology does not develop further and recovery occurs.
2. The intermediate stage of gynecomastia most often lasts up to six months. A man's breasts quickly increase in size due to excessive growth of glandular tissue.
3. The last stage is that connective tissue fibromatosis also joins the active growth of fat cells. All this leads to the appearance of compactions in the thickness of the gland. In this case, conservative treatment may not give positive results. It is better for a man to seek the help of a qualified surgeon.

Gynecomastia in men is often accompanied by a specific discharge from the nipples that resembles colostrum. The patient may not experience any pain. He is only worried about the heaviness and discomfort in his chest. Even in the case when only one gland is enlarged, the second can also be affected by the pathological process.

If the pathology is bilateral or unilateral, but with specific seals that bring pain and discomfort, and the skin of the gland changes color and becomes tense, the man should immediately consult a doctor. In the case when enlarged axillary lymph nodes are added to the manifestations on the chest, we are talking about the presence of a neoplasm.

Why is gynecomastia dangerous for men?

Physiological gynecomastia does not pose a threat to a man’s health. She can regress on her own. In this case, only emotional and aesthetic discomfort arises, which passes over time.

Nodular gynecomastia, like fatty gynecomastia in men, progresses rapidly and can cause breast cancer. This applies to both men and gynecomastia in women. The appearance of bloody discharge from the nipples and dense formations in the gland itself requires immediate consultation with a doctor.

Diagnosis of the disease

The question often arises as to which doctor to contact to make a definitive diagnosis of gynecomastia. In this case, the man should contact an endocrinologist. After a thorough examination, palpation and examination of complaints, the patient may be referred for the following additional examinations:

• blood chemistry
• Ultrasound of the scrotum and bilateral examination of the mammary glands in a man
• CT lungs
• MRI of the adrenal glands

If, when studying the test results, a significant increase in the average level of the hormone hCG and estradiol is revealed, the man will definitely need to undergo tests that will help rule out the presence of a malignant tumor. If concomitant pathologies are identified, they require immediate treatment.

Treatment in this case depends on the cause that caused the appearance of gynecomastia in a man. Before making a final diagnosis, the presence of a malignant tumor is excluded. The man is recommended to be observed by several highly specialized specialists. Improvements occur approximately six months after the start of treatment. If no positive dynamics are observed, drug therapy is adjusted.

Proper nutrition for gynecomastia

When gynecomastia occurs in men, it is necessary to follow a strict diet. This is necessary to increase or correct the level of testosterone production. With proper nutrition, a man quickly restores his normal rational hormonal balance. All this helps to adjust and significantly accelerate all metabolic processes and quickly remove toxins from the body.

The diet should include: porcini mushrooms, boiled dietary meat, berries, cereals and fresh fruits. With such a diet, estrogens from the man’s body begin to be eliminated faster, which reduces the possibility of the appearance of malignant tumors.

It is very important to create the correct drinking regimen for gynecomastia. A man needs to drink at least 2 liters of still water per day. The necessary hormones are produced faster with regular physical activity. Sport often helps a man overcome many diseases.

Conservative treatment

In most cases, various hormonal medications are used for treatment, based on pure progesterone. They work well in case of insufficiency of one or both testicles, as well as some antiestrogens that can block the main hormones of women.

For gynecomastia in men, the following drug therapy regimen is mainly used:

1. Thiamine Bromide in the form of a regular B vitamin for the rapid transformation of male hormones into female ones. Prescribed once a day in the form of injections for 14 days.
2. Vitamin B1, which is used mainly to block the production of the hormone aromatase. Used intramuscularly for gynecomastia. It is recommended to do injections for at least 20 days.
3. Androgel is an ointment based on pure testosterone. Apply only in the morning.
4. Didrotestosterone. The drug promotes the rapid disposal of excess adipose tissue in case of poor development of the gonads in men.
5. Tamoxifen is intended to reduce the level of estrogen production, which increases the susceptibility to the formation of tumors of various etiologies.
6. Clomiphene citrate helps to significantly reduce the level of estrogen in the blood, which prevents breast growth in men. Use 1 tablet for 30 days.
7. Sustanon is a unique mixture of essential testosterone esters. This oil is used intramuscularly. It is usually administered once every 3 weeks for 3 months.

Each of these hormonal drugs is prescribed only by the attending physician individually for a particular man.

There are other drugs for treatment without surgery. They can be in the form of creams and ointments:

• Anastrozole
• Ganaton
• Dimexide
• Letrozole
• Proviron
• Progestogel
• Turinabol
• Tamoxifen

You should not self-medicate. To exclude the development of unwanted side effects, all drugs and their dosage must be prescribed by a qualified specialist.

Surgical intervention

Treatment should be based on eliminating the main cause that caused the disease. Removal of gynecomastia in men is prescribed only in the most severe cases, when no previous drug treatment brings the desired results.

4 main methods of surgical treatment:

1. Mammoplasty with superficial liposuction. In this case, all excess fatty tissue is excised, and the breasts acquire their initially normal shape.
2. A mastectomy is the radical and most complete excision of the entire affected breast.
3. Endoscopy - removal of the gland using a special endoscope. Small incisions are made in the skin, usually under the armpit, and an endoscope is used through them.
4. Laser removal - all pathological tissues are removed with a laser, and later their contents are pumped out through small incisions in the skin using a vacuum.

If the operation to eliminate gynecomastia in a man was completed without any complications, the patient is sent home and monitored for the next six months. In this case, maintenance drug therapy is prescribed, the duration of which depends on the patient’s condition.

Traditional methods in the fight against disease

In the postoperative period, long-known folk remedies are often used. However, they are welcome only if they complement the main treatment. Most often, medicinal decoctions based on honey, ginseng and lovage petals are used to treat gynecomastia.

• To combat pain in the mammary glands, men use special compresses made from honey. It is applied to the painful area and covered with cellophane, after which it is fixed with a cloth. The compress is applied overnight.
• Ginseng decoction is drunk 3 times a day before meals for three months. An infusion of lovage root is poured exclusively with red wine. Leave for 3 days and drink 100 ml after meals.
• They also take baths with thyme decoction 2 times a week for about 20 minutes.

Treatment at home can only help at the beginning of the disease, when pain has only recently begun to bother a man. Before using all decoctions, it is advisable to treat the breasts with hydrogen peroxide. At later stages, treatment no longer gives the expected results.

Predictions of disease progression

The prognosis for physiological gynecomastia in men is almost always favorable. If this is pubertal gynecomastia, then with proper growth and normal hormonal levels, all symptoms disappear after the end of adolescence. With the progression of a disease such as gynecomastia, the prognosis can also be favorable if the man follows all the recommendations of the attending physician and undergoes treatment on time.

A man must completely abandon all bad habits, strictly adhere to the most correct lifestyle and, without fail, follow the established diet. Treatment of this pathology must be correct and justified. Only then can the disease be overcome.

Gynecomastia in men is manifested by pathological but benign enlargement of the mammary glands due to the proliferation of stromal or adipose tissue. In the first case, we are talking about true gynecomastia; the defect usually occurs in newborns, adolescents, the elderly, or due to hormonal imbalance. Lipomastia is associated with excess body weight and does not pose a threat to men's health, but if gynecomastia is not treated, over time the diagnosis can result in serious psychological trauma.

A specialist will help

Gynecomastia is one of those diseases that are very reluctant to discuss among friends or relatives, so not all men know which doctor to contact with a delicate problem. First of all, you should make an appointment with your local doctor, he will conduct an initial examination of the breast and refer the patient to a specialist.

Diagnosis and further treatment of the disease are the responsibility of a mammologist and endocrinologist.

Diagnosis and further treatment of the disease are the responsibility of a mammologist and endocrinologist. If there is a disturbance in reproductive function, the man is additionally recommended to visit a urologist or andrologist; if there is mechanical damage to the pectoral muscles in the gym, the surgeon will assess the condition of the glandular tissue and draw up a preliminary conclusion. With advanced gynecomastia, you cannot do without consulting an oncologist.

Conservative therapy

If the form of the disease allows you to treat gynecomastia at home, then the man should be patient. Depending on the cause of proliferation of glandular structures, the therapeutic course can last from 1-2 months to several years. Thus, hormonal drugs to normalize the level of androgens and female sex hormones are used for six months.

For uncomplicated gynecomastia, doctors prescribe:

Testosterone. Indicated exclusively for deficiency of the steroid or its derivatives. The drug allows you to return the normal size and shape of the mammary gland and optimize overall hormonal levels. It is necessary to remove the aesthetic defect by observing the exact dosage; uncontrolled use of testosterone leads to severe gynecomastia, which is difficult to treat.

Clomiphene. The action of an anti-estrogen is to suppress the synthesis of female hormones in the body of the stronger sex. Activates the natural production of androgen and also reduces the amount of fat deposits.

Danazol. Men with gynecomastia should monitor their hormonal testosterone-estrogen ratio. With the help of a synthetic drug, the production of estrogen slows down and the hormonal balance is normalized. In high doses, Danazol has weak androgenic activity.

Nolvadex. Initially, the medication was used to treat breast cancer; it is effective even in the later stages of gynecomastia. Nolvadex is a selective estrogen receptor antagonist, therefore it affects only the affected areas of the body.

You can artificially restore your hormonal profile at home using capsules or intramuscular injections. It is worth noting that androgen deficiency in mature men is often accompanied by gynecomastia of varying severity. In this case, doctors advise treatment with testosterone with the addition of esters; organic substances maintain the required concentration of the sex hormone over a long period of time. Testosterone propionate, Testosterone cypionate and others are popular in medical practice.

A large amount of prolactin in the blood stimulates the growth of male breasts, for example, after a steroid course. Due to hyperprolactinemia, libido decreases, oligospermia occurs, and the mammary gland may secrete serous or milky secretions (galactorrhea). The drug Cabergoline has a strictly selective effect and effectively fights gynecomastia in men.

Natural solution to the problem

Conservative treatment gives good results in the first 4 months from the onset of gynecomastia symptoms, while alternative medicine methods are appropriate throughout the course of the disease. Herbal medicine, naturopathy, correction of hormonal levels using a specially selected diet and exercises that strengthen the pectoral muscles are aimed at getting rid of physiological gynecomastia and generally strengthening the body.

• Diet food.

Normally, the body of an adult male contains approximately 2 g of zinc, most of which is found in the liver, muscle tissue and pancreas. Against the background of a decrease in microelement reserves, gynecomastia occurs, so doctors recommend enriching the daily diet with zinc.

When treating gynecomastia, it is important to follow a diet with zinc-containing foods, for example seafood.

1. Beef liver.
2. Pumpkin and sunflower seeds, sesame, almonds.
3. Wheat, oatmeal and rice porridge.
4. Seafood (oysters, anchovies, fish roe).
5. Fresh vegetables and fruits (green peas, broccoli, boiled or canned corn, black currants, citrus fruits).
6. Green tea, mineral water.

Men with excess weight and bad habits are at risk. Hops contain powerful phytoestrogens; excessive consumption of beer inevitably leads to endocrine disorders and obesity. To organize a proper and balanced diet, you should consult a nutritionist. Nicotine also has an inhibitory effect on testosterone concentrations, so heavy smokers are at risk of breast enlargement.

Complex treatment of gynecomastia in men involves the use of various exercises that can be performed at home, on the street, or in the gym. Physical exercise promotes weight loss, relieves emotional stress, irritability, and improves sleep quality.

Physical exercise promotes weight loss, relieves emotional stress, irritability, and improves sleep quality.

You can prevent or get rid of gynecomastia by:

1. Pushups. A man should do push-ups in the morning and evening, increasing the number of approaches daily.
2. Jogging at various distances. It is advisable to run in the fresh air in the morning.
3. Cycling. Fights extra pounds, thereby eliminating false gynecomastia.
4. Swimming. Doctors advise men to visit the pool at least 3 times a week.

The listed options are excellent for self-training, however, returning to normal breast size with fatty or mixed type of gynecomastia is a long and labor-intensive process. It is important that the initial level of physical activity is selected by the attending physician.

• Traditional medicine advice.

As an auxiliary treatment of gynecomastia, a combination of traditional methods with drug therapy is suitable. Sometimes the disease is accompanied by aching pain in the sternum. Bee products have a healing effect on the glandular tissue of men.

The honey compress is applied as follows: a thin layer of honey is applied to the mammary glands, covered with plastic wrap on top and tightly fixed with a towel. The duration of the procedure should not exceed 8 hours.

Enlarged breasts can be removed by increasing the concentration of steroids in a man’s body using:

• Ginseng root. Homemade or pharmacy tinctures are designed to enhance testosterone production. To prepare a medicine for gynecomastia, you need to mix 50 g of ginseng root, ginkgo biloba leaves, yohimbe bark, oatmeal and pour in a liter of ethyl alcohol. Place the tincture in a dark place for half a month; after the specified period, strain the liquid. Drink 30 drops per day. The duration of treatment is determined by the doctor, usually the course does not exceed 2 months.
• Dill and valerian seeds. Take a glass of dill seed and 2 tbsp. l. valerian, fill them with 1.25 liters of boiling water. Mix the ingredients and leave in a cool place for a day, then add 200 ml of water. Men with gynecomastia are treated three times a day, using 1 tbsp. l. tinctures 30 minutes before meals.
• Thyme. Drinking a decoction of the medicinal plant for a month will relieve a man of gynecomastia. To prepare the drink, add 2 tbsp. l. herbs with a liter of water and boil over low heat for about 5-10 minutes. It is useful to add honey to the cooled broth to taste.

As you can see, gynecomastia can be avoided by radically changing your lifestyle: giving up bad habits, following the principles of a healthy diet, and regularly training your pectoral muscles. A timely visit to a doctor greatly increases a man’s chances of recovery and allows him to avoid serious consequences. Take care of yourself!

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Gynecomastia is an enlargement of the mammary gland in men due to the proliferation of glandular or adipose tissue, caused by hormonal imbalances in organism. Gynecomastia is manifested by an increase in the size and thickening of the breasts, an unpleasant feeling of heaviness and pain when palpated. In some cases, breast enlargement is physiological and can go away on its own, without any treatment. In other cases, conservative therapy is carried out. If conservative treatment is ineffective or a person is not satisfied with the aesthetics of his own body, a surgical operation is performed during which tissue is removed mammary gland fully.

Brief characteristics of gynecomastia

The name of the disease "gynecomastia" is derived from two Latin words - gynes (woman) and mastos (breast). That is, the literal translation of the term “gynecomastia” is female breasts, which fully corresponds to the main external manifestation of the essence of the disease. After all, gynecomastia is a benign increase in the size of the mammary glands in men. To put it simply, representatives of the stronger sex grow female breasts.

Breast enlargement can occur due to the proliferation of ducts and glandular tissue or due to fat deposits. If the breasts increase due to the growth of glandular tissue, then gynecomastia is considered true, and the increase in breast volume due to fat deposits is false gynecomastia.

The severity of breast enlargement can vary - from 1 to 10 cm, and involve one or both mammary glands. More often, symmetrical damage to both mammary glands occurs simultaneously; enlargement of only one breast with gynecomastia is quite rare. Enlarged mammary glands with gynecomastia usually look like slightly pendulous small female breasts.

The development of gynecomastia of any type is based on an imbalance of sex hormones with a predominance of estrogens. That is, any diseases, medications, drugs and other items that can lead to more estrogen in a man’s body than testosterone can cause gynecomastia.

The fact is that the predominance of estrogens leads to the fact that they begin to affect tissues that are sensitive to them, which include the ducts of the mammary glands. Under the influence of estrogens, breast tissue, which in men is in its infancy, begins to actively grow, forming breasts. That is, there is a process similar to what happens in the body of young girls during puberty, when their breasts begin to grow, the pelvic bones increase, etc.

Normally, breast formation does not occur, since the estrogens present in the male body do not have an activating effect on breast tissue for two main reasons. Firstly, there are very few estrogens, so their effect on the glandular tissue of the breast is not able to remove the latter from the embryonic state in which it is located. Secondly, estrogens are suppressed by a large amount of testosterone, which is produced in the male body and determines characteristic sexual characteristics. But if for some reason the amount of estrogens increases and they begin to prevail over testosterone, then the growth of tissues that are normally in the male body in their infancy is activated. As a result, the feminization of the man occurs, that is, female sexual characteristics appear, which include breasts.

Thus, gynecomastia develops if estrogen predominates over testosterone in a man’s body. Moreover, the cause of hormonal imbalance is not important, since gynecomastia is triggered precisely by an increase in the content of estrogen relative to testosterone.

During the course of gynecomastia, three successive stages are distinguished, such as proliferating, intermediate And fibrous. At the proliferation stage, the process of proliferation of the ducts and glandular tissue of the mammary gland occurs, which lasts an average of 4 months. Next, in the intermediate stage, which lasts 4–12 months, the mammary gland matures. During the fibrotic stage, dense connective tissue and fatty deposits appear in the mammary gland, which completes the complete formation of the organ. Accordingly, during the first 4 months a person notices that his breasts are growing, and then they notice their tightening.

Treatment of gynecomastia can be conservative or surgical. In all cases, they first resort to conservative therapy, which makes it possible to stop the progression of the process and in many situations achieve complete “resorption” of the already formed breast. Surgical treatment of gynecomastia is carried out only if there is a tumor formation in the mammary gland or the man is not satisfied with the appearance of the chest for aesthetic reasons. If there is a tumor in the mammary gland, surgery for gynecomastia is mandatory. But operations to remove breasts for aesthetic reasons are not always performed, since in many cases the appearance of the chest after surgery may be even worse than before it.

Conservative treatment, begun in the proliferating stage, allows for complete involution and disappearance of the breast, since all changes are still reversible. Conservative treatment started at an intermediate stage can only stop the progression of the process, but reverse involution and disappearance of already grown breasts can be achieved only in rare cases. Conservative treatment at the fibrotic stage also only allows you to stop the progression of the process, but with its help it is impossible to achieve the disappearance of the breast under any circumstances. This means that in order to eliminate formed breasts, you will have to resort to surgery, during which glandular and fatty tissue is removed.

Gynecomastia – photo

This photograph shows a young man with gynecomastia before surgery (left) and after breast removal (right).

This photograph shows a man with severe gynecomastia.

Classification and characteristics of types of disease

Currently, depending on the nature of the causative factor and the type of tissue that forms the enlarged mammary gland, gynecomastia is divided into four main types:
1. Physiological gynecomastia;
2. True gynecomastia;
3. False gynecomastia;
4. Idiopathic gynecomastia.

Some scientists and doctors distinguish only two main types of gynecomastia - true and false, and physiological and idiopathic are classified as variants of true. However, in world practice, the above version of the classification is used. We believe that these differences between classifications are not fundamental, since regardless of whether idiopathic and physiological gynecomastia are included in the true gynecomastia or are separated into separate varieties, their essence and characteristics are unchanged. To avoid classification confusion, we will consider the characteristics of all types of gynecomastia in separate subsections with appropriate names.

Physiological gynecomastia

Physiological gynecomastia is a variant of the age-related norm in which the glandular tissue and ducts of the mammary glands grow. It is not a sign of any disease, goes away on its own, and therefore does not require special treatment. Physiological gynecomastia occurs in males during age periods in which hormonal changes occur.

Thus, the following variants of physiological gynecomastia are distinguished, occurring at different age periods in males:

• Gynecomastia of newborns;
• Adolescent gynecomastia (pubertal);
• Senile gynecomastia.

Gynecomastia of newborns appears in infant boys in the first days of life and goes away on its own within 2 to 4 weeks. Typically, gynecomastia is observed in 60–80% of newborn boys and is caused by exposure to maternal estrogens that penetrate through the placenta. When all the estrogens that enter the baby’s blood from the mother’s body during pregnancy are utilized, the gynecomastia will go away, and the mammary glands will involute, turning into completely flat formations with protruding small nipples.

Adolescent gynecomastia also called pubertal, since it occurs at puberty, when the child reaches puberty and undergoes dramatic hormonal changes. In boys aged 12–15 years, gynecomastia is observed in 30–60% of cases, and, as a rule, both mammary glands become enlarged. But in rare cases, gynecomastia affects only one breast. The resulting asymmetry is very noticeable. Sometimes a whitish fluid is released from the nipples of enlarged breasts.

This type of gynecomastia is a variant of the age norm, goes away on its own within 1 to 2 years and does not require treatment. However, if after 2 years the gynecomastia has not gone away, then it is called persistent, is considered pathological and, accordingly, requires treatment.

Unfortunately, the exact causes of teenage gynecomastia have not yet been established. However, it is known that in the early stages of puberty in boys, estrogens are produced in greater quantities compared to testosterone, which is the triggering factor for the development of temporary gynecomastia. As long as estrogens prevail over androgens in a young man’s body, he will have gynecomastia. But when the balance of hormones returns to normal, involution will occur and the grown breasts will collapse.

In principle, teenage gynecomastia is not a pathology, but it can cause serious psychological and sexual disorders in a teenager who experiences fear due to the “wrong” appearance. Therefore, a boy suffering from gynecomastia needs psychological help and moral support for the entire period until his body returns to its normal state. However, parents should remember that if a boy with gynecomastia does not have other signs of puberty (hair growth on the body, in the armpits, on the pubis, change in voice, etc.), then breast enlargement is a symptom of severe endocrine diseases, such as hormone-producing tumors of various locations.

Senile gynecomastia develops in men aged 55–80 years due to a decrease in testosterone production. Due to a decrease in testosterone levels, estrogens begin to prevail, as a result of which gynecomastia develops. As a rule, both breasts become enlarged. Involution of senile gynecomastia occurs rarely, but this condition is a normal variant, so it is almost never treated.

False gynecomastia

False gynecomastia is also called pseudogynecomastia or adiposomastia. With false gynecomastia, enlargement of the mammary glands occurs due to the deposition of fat under the skin in the area of ​​the areola of the nipple. The difference between false gynecomastia and all its other types (true, physiological and idiopathic) is the enlargement of the mammary glands due to fat deposition. And with other types of gynecomastia, enlargement of the mammary glands occurs due to the proliferation of glandular tissue and ducts.

As a rule, false gynecomastia develops against the background of general obesity and can be significantly expressed.

True gynecomastia

True gynecomastia is an enlargement of the mammary glands due to the proliferation of glandular tissue and ducts; it is a pathology and requires treatment. True gynecomastia develops when estrogen prevails over androgens in a man’s body. However, hormonal imbalance is only a trigger factor and provides the necessary conditions for the proliferation of glandular tissue and breast growth. Accordingly, the causes of gynecomastia are factors that cause hormonal imbalance. And the reasons that cause hormonal imbalance with a predominance of estrogen levels over androgens are very diverse, and therefore the range of factors that can lead to true gynecomastia is wide.

It has now been established that The causes of true gynecomastia may be the following factors:

• Production of large amounts of estrogens by hormonally active tumors of the testicle, liver or lungs (for example, germinoma, leydigoma, etc.);
• Insufficient utilization of estrogen in the liver in severe diseases of this organ (for example, cirrhosis, chronic hepatitis, etc.);
• Taking medications that increase estrogen levels and suppress testosterone production (for example, anabolic steroids, glucocorticosteroids, estrogen preparations, cardiac glycosides, drugs, ACE inhibitors, calcium channel blockers, Spironolactone, Furosemide, Diazepam, Reserpine, Theophylline, Methyldopa, etc.);
• Hyperthyroidism (increased levels of thyroid hormones in the blood) or hypothyroidism (reduced levels of thyroid hormones in the blood);
• Androgen deficiency caused by underdevelopment of the genital organs due to genetic diseases (Klinefelter syndrome, Reifenstein syndrome, etc.);
• Testicular feminization syndrome;
• Hermaphroditism;
• Prostatitis;
• Diseases of the adrenal glands;
• Obesity;
• Acromegaly;
• Hypogonadism;
• Impaired functioning of the testicles due to trauma, orchitis, infectious diseases or exposure to ionizing radiation;
• Castration;
• Brain damage (consequences of traumatic brain injury, Parkinson's disease, syringomyelia, epilepsy, meningoencephalitis, Friedreich's disease, pituitary tumors, etc.);
• Continuous use of plasmapheresis against the background of chronic renal failure.

Idiopathic gynecomastia

Idiopathic gynecomastia is a variant of true gynecomastia, in which it is not possible to determine the cause of the disease.

Gynecomastia in women

Strictly speaking, gynecomastia does not exist in women, since this term refers exclusively to breast growth in men. But in everyday life, the phrase “gynecomastia in women” usually means enlargement of the mammary glands at different periods of life. The fact is that the growth of breasts in girls at the stage of puberty does not frighten anyone, but the enlargement of the mammary glands in other periods of life causes concern and is called “gynecomastia”.

However, calling breast growth in women gynecomastia is incorrect. After all, during women’s lives, fat is deposited in the mammary glands, connective tissue grows, and the number of glands increases during pregnancy, which can lead to natural breast enlargement. It is precisely these completely normal and physiological processes that are unreasonably and incorrectly called “gynecomastia.” But women should remember that they do not have gynecomastia.

Representatives of the fair sex have completely different diseases of the mammary glands, which in no way correlate with breast growth, so you should not be afraid of simply enlarged breasts, which are not combined with any other symptoms of trouble in the body. And too large breast size in women is not called gynecomastia, but hypertrophy.

Gynecomastia - causes

So, the causes of true and idiopathic gynecomastia may be the following factors:

1. Tumors localized in the testicles, liver, lungs.

2. Breast tumors.

3. Severe liver diseases (liver cirrhosis, chronic hepatitis).

4. Chronic renal failure with regular hemodialysis.

10. Congenital dysfunction of the adrenal cortex.

11. Dystrophy due to starvation or obesity.

12. Exposure to radiation.

13. Disorders of the hypothalamus (dysregulation of the adenohypophysis, etc.).

14. Diseases in which the function of the pituitary gland is impaired:

• Hypogonadism;
• Acromegaly;
• Itsenko-Cushing syndrome;
• Pituitary tumors (adenoma, prolactinoma, etc.);
• Increased intracranial pressure.

15. Disruption of the brain structures that regulate the production of hormones:

• After a traumatic brain injury;
• Against the background of parkinsonism;
• Against the background of epilepsy;
• Against the background of syringomyelia;
• After meningoencephalitis;
• Against the background of Friedreich's disease.

16. HIV infection.

17. Leprosy.

18. Abrupt cessation of sports activities against the background of previous intense training.

19. Active nutrition after a long period of abstinence from eating.

20. Chest injury.

21. Herpes zoster rash in the chest area.

22. Abuse of alcohol and drugs, especially opium, methadone, heroin and marijuana.

In addition, gynecomastia can be provoked by taking the following medications:

• Estrogens (Estrace, Gynodiol, Alora, Esklim, Senestin, Premarin, Estratab, combined oral contraceptives);
• Antiandrogens (Buserelin, Flutamide, Finasteride, Androcur, etc.);
• Gonadotropin preparations (for example, human chorionic gonadotropin, etc.);
• Testosterone preparations with long-term use (Testosterone propionate, etc.);
• Anabolic steroids (Methandrostenolone, Phenobolin, etc.);
• Glucocorticosteroids (Prednisolone, Dexamethasone, etc.);
• Spironolactone (Veroshpiron, Aldactone, Uractone, etc.);
• ACE inhibitors (Enalapril, Perindopril, Lisinopril, Captopril, etc.);
• Calcium channel antagonists (Nifedipine, Verapamil, Amlodipine, etc.);
• Cardiac glycosides (Digoxin, Korglykon, Strophanthin, etc.);
• Anti-tuberculosis drugs (isoniazid);
• Tricyclic antidepressants (Imipramine, Amitriptyline, Doxepin, etc.);
• Benzodiazepines (Phenazepam, Diazepam, etc.);
• Proton pump inhibitors (Omeprazole, Ranitidine, Cimetidine);
• Antitumor drugs (Vincristine, Myelosan, etc.);
• Tranquilizers (Hydroxyzine, Benactizine, Buspirone, Meprobamate, etc.);
• Neuroleptics (Risperidone, Sulpiride, Tiapride, Azaleptin, etc.);
• MAO inhibitors (Iproniazid, Nialamid, Phenelzine, Eprobemid, Moclobemide, etc.);
• Drugs for the treatment of HIV (Amprenavir, Empricitabine, etc.);
• Amiodarone;
• Busulfan;
• Methyldopa;
• Penicillamine;
• Rauwolfia;
• Reserpine;
• Theophylline;
• Phenytoin;
• Phenothiazine;
• Ethionamide.

Gynecomastia caused by taking medications is not pathological and goes away on its own after stopping the use of the drug that provoked the growth of mammary glands in men.

Gynecomastia - signs

The main symptom of gynecomastia is an enlargement of the mammary glands so that they look like small female breasts. With gynecomastia, the mammary glands can increase from 2 to 15 cm in diameter. At the same time, according to the size of the mammary glands, the diameter of the nipple areola increases, expanding to 3–4 cm. The pigmentation of the areola intensifies.

When palpated, the mammary glands may be dense, with nodular formations inside. You may also feel slight pain when you feel your breasts. The overgrown breast tissue is tightly fixed to the pectoral muscles and skin, so attempts to move the lump in any direction or pull the skin over them are useless. In rare cases, fluid similar to colostrum is released from the nipples with gynecomastia. Also, sometimes men feel a feeling of pressure in the mammary glands and discomfort when clothing rubs against the nipples.

In the clinical course of gynecomastia, three successive stages are distinguished:

• Stage I (proliferation) – lasts about 4 months and is characterized by a progressive increase in the size of the mammary glands. At this stage, all changes are reversible, and if you start conservative treatment, you can achieve complete “resorption” of the grown breast in all cases.
• Stage II (intermediate) – lasts 4–12 months and is characterized by the maturation of grown breast tissue. At this stage, the changes are difficult to reverse, so conservative treatment rarely achieves involution of an already grown breast.
• Stage III (fibrous) – lasts for a long time and is characterized by the growth of connective tissue and fatty deposits in the mammary gland. At this stage, the changes are irreversible, and conservative treatment can only stop the progression of the disease, but it is impossible to achieve involution of the grown mammary glands with its help.

The signs of gynecomastia are the same at stages 2 and 3, but at the first they differ in that the mammary glands progressively increase in size.

Depending on the size of the mammary gland, gynecomastia is divided into weak, moderate And expressed. To determine the size of gynecomastia, the circumference of the breast and its height are measured, after which the index is calculated. If this index is less than 6, then gynecomastia is weak, index 6 – 10 means moderate gynecomastia, and index more than 10 means severe.

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Treatment

General principles of therapy

Physiological gynecomastia is not treated, because it goes away on its own after the hormonal balance in the body is normalized. Fatty gynecomastia does not require treatment, since it is completely safe, and therefore its therapy is carried out only at the insistence of the patient who wants to eliminate enlarged mammary glands for aesthetic reasons. In this case, liposuction surgery is performed, during which the fatty tissue is removed and the breasts acquire normal shape.

Conservative and surgical methods are used to treat pathological and idiopathic gynecomastia. Conservative treatment should be comprehensive and aimed simultaneously at eliminating the underlying disease that provoked gynecomastia and at relieving the effects of estrogen. Often, when the underlying disease cannot be treated (for example, taking medications, etc.), gynecomastia is treated with drugs that suppress the effects of estrogen. Surgical treatment is resorted to only if conservative therapy has proven ineffective within 2 years of its implementation, and the person insists on complete removal of the overgrown mammary glands for cosmetic reasons.

If gynecomastia is caused by a tumor formation in the mammary gland, then the only method of treatment used is surgery to remove the tumor.

It is strictly forbidden to squeeze the mammary glands with tight bandages in order to stop breast growth, since this is not only ineffective, but also dangerous due to impaired blood flow.

Conservative treatment without surgery

If gynecomastia is caused by a high level of estrogen, then drugs from the antiestrogens group, such as Tamoxifen, Clomiphene, and Danazol, are used to treat it. In addition, in addition to antiestrogens, drugs from the aromatase inhibitor group, such as Testoplakton or Thiamine bromide, are used for therapy. In addition to drugs that suppress estrogen activity, injections of vitamin B1 and Aevita are used in periodic courses lasting 20 days. Both antiestrogens and aromatase inhibitors are used in long courses for a maximum of 2 years. If after 2 years a satisfactory result of conservative therapy has not been obtained, then surgical treatment of gynecomastia is performed.

If gynecomastia is caused by partial androgen deficiency, then testosterone and human chorionic gonadotropin preparations in combination with Halidor are used for treatment. In addition, to enhance the effect of hormonal drugs, you can additionally include in complex treatment drugs that improve cerebral circulation (Cavinton, Cinnarizine, Actovegin, etc.), vitamins and metabolites (vitamin B6, ATP, glycine, etc.).

Surgery to remove gynecomastia

Surgery to remove gynecomastia is performed only if conservative therapy is ineffective and if the patient wishes to remove enlarged mammary glands. It must be remembered that the chest after surgery may look even worse than before, so when deciding on surgical removal of the mammary glands, everything should be carefully considered and weighed. To maximize the likelihood of a successful outcome of the operation, it is necessary to carefully select a surgeon who has experience in performing these types of surgical interventions.

Currently, the following types of operations are performed to remove gynecomastia:

• Subcutaneous mastectomy with areola preservation. An incision is made in the area of ​​the areola, and through it all the tissue of the enlarged mammary gland is removed, after which the skin is sutured, forming a beautiful outline of the chest. During this operation, the nipple areola is preserved, the scar is made inconspicuous, which allows for a good aesthetic effect after surgical treatment.
• Subcutaneous mastectomy with liposuction. An operation similar to that described above, but differing in that during the intervention fatty tissue is removed. The operation is suitable for the treatment of false gynecomastia.
• Endoscopic mastectomy. The operation is performed using endoscopic equipment, during which all tissues of the enlarged mammary gland are removed. Since access for surgery is through a puncture in the armpit, the scar is hardly noticeable and the nipple is preserved, which allows for excellent cosmetic results.

The choice of operation is made by the doctor based on the individual characteristics of the person and the characteristics of gynecomastia.

After operation

After surgery to remove gynecomastia, you need to wear shapewear for several days to create a smooth breast surface and reduce excess skin. Since lymph nodes and muscles are not removed during the operation, it is considered low-traumatic, as a result of which men are discharged from the hospital home 2–3 days after surgery. Complete tissue healing after surgery occurs within 3 to 6 weeks, during which it is necessary to avoid heavy physical activity, overwork, etc. After tissue healing, it is necessary to engage in physical exercises aimed at developing and restoring the functions of the pectoral muscles.

Cost (price) of surgery to remove gynecomastia

The cost of surgery to remove gynecomastia ranges from 40,000 to 120,000 rubles. The variation in prices is determined by the policy of the management of the medical center and its form of ownership (private or public). However, when choosing a medical institution for the removal of gynecomastia, it is recommended to focus primarily not on the cost of the intervention, but on reviews of the doctor who will perform the operation.

Which doctor should I contact about gynecomastia removal?

To remove gynecomastia, it is recommended to consult a breast surgeon, plastic surgeon or general surgeon. Unfortunately, in the CIS countries, surgeons have little experience in performing surgery to remove gynecomastia, so surgical intervention can be performed efficiently at a high technical level, but with unsatisfactory cosmetic results, which should be taken into account at the decision-making stage.

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Before use, you should consult a specialist.