All about gynecomastia

Gynecomastia is a common clinical and psychosocial problem. Gynecomastia is a benign enlargement of the mammary glands in men (unilateral or bilateral) associated with the growth of glandular, fibrous and adipose tissue.

The problem is caused by an imbalance between estrogens and androgens (mainly testosterone) and their effect on the glandular tissue of the breast. The development of gynecomastia may be associated with increased activity of the aromatase enzyme, which causes estrogenism - the conversion of androgens (male sex hormones) into estrogens (female hormones). Sometimes the fault lies in the abnormalities of the estrogen and androgen receptors.

What is gynecomastia?

In men, under normal (physiological) conditions, the mammary gland is under the depressive effect of male sex hormones, especially testosterone. Breast enlargement in boys or men caused by the proliferation of glandular tissue (and sometimes fat) is called gynecomastia.

The primary mechanism of gynecomastia is the relative superiority of the effects of estrogens (female sex hormones) over androgens on tissues (including breasts). The etiology of gynecomastia is usually mild.

The high concentration and increased activity of estrogens lead to the growth of the ducts of the glands, their lengthening and dilation of blood vessels. The initial phase of gynecomastia is called active or "blooming". Most often, the disorder manifests itself in symmetrical bilateral breast enlargement (in rare cases, unilateral enlargement). Patients may complain of breast swelling and pain (so-called mastodynia). The lesions are characterized by an increase in soft tissues with hardening near the nipple (they can be palpated by touch).

The first phase of gynecomastia usually lasts from 6 to 12 months. The right action, performed quickly enough, can effectively undo the changes. However, over time, fibrosis and changes become permanent.

If the fibrous tissue has not yet replaced the glandular tissue, pharmacological treatment is used for gynecomastia. Prolonged gynecomastia usually does not respond to pharmacotherapy. Then there is an effective procedure - surgical treatment - excision of glandular tissue and excess adipose tissue.

There are many classifications of gynecomastia:
glandular form (true gynecomastia),
fatty form (pseudohynecomastia, pseudohynecomastia)
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