16yr old son..need help!

[tammersx3]

My son was diagnosed 3 years ago and we were playing the wait & see game. A few months before that the dr had noticed he had one testicle normal and one smaller. I finally had enough so the dr referred us to an endocrinologist. She ran tests to check his testosterone & progesterone levels and they came back fine so she's now referring him to a surgeon for the gynocomastia and nothing is being done about his testicle. After much prodding she got him to confess about doing marijuana which he only had the opportunity to do at the most 20 times. She is saying that all this is due to that.
My first question is, can that little bit really have an effect on both?
My second question is, can the 2 problems be related?

[DrPensler]

An appropriate endocrinologic exam in the case of testicular imbalance should rule out the testicles as a case for the gynecomastia. As an aside does the testicle have a palpable mass? I would make sure the surgeon is experienced with re gynecomastia surgery.There is a debate with respect to marijuana and gynecomastia which is not completely resolved but I suspect it would not be the primary cause of your son's gynecomastia.

[Litlriki]

The relationship between marijuana use and gynecomastia is one that is very tenuous, and quite likely may have grown out of the era of "reefer madness," when marijuana was seen as the source of many problems, both medical and social.  The physiology that could account for the connection comes out looking like a Rube Goldberg device (i.e. very complicated and contrived!)  Moreover, in nearly 20 years of treating patients with gynecomastia, very few--as in a handful--have proposed marijuana as a cause.  I'd be interested to know of the experience of the other surgeons, but I am very skeptical at this point.

That said, limited casual use as you've described is very unlikely to have caused a difference in his testicular exam, and as you've reported, his laboratory studies are normal. If he is past puberty, and the condition has not resolved after being present for at least 3 years, surgery is the best option for correction.

Good luck,

Rick Silverman