Regulating hormones before surgery

[painInleftchest]

I am 27 and have pubertal gyno.  However, in the last year, my left breast has been painful and is growing larger.  Also I have occasional fluid discharge.  I have had bloodwork and everything seems to be in order, but the pain/swelling and discharge is still there.  I also have pain in the left breast after orgasm.  What should I do?  If I get the surgery done I am worried about the gyno just coming back.  Plus, the pain is really getting to me.  I am worried that my hormones will never regulate themselves and I will be stuck with this pain for life.  Please help. Thanks

[DrBermant]

I am 27 and have pubertal gyno.  However, in the last year, my left breast has been painful and is growing larger.  Also I have occasional fluid discharge.  I have had bloodwork and everything seems to be in order, but the pain/swelling and discharge is still there.  I also have pain in the left breast after orgasm.  What should I do?  If I get the surgery done I am worried about the gyno just coming back.  Plus, the pain is really getting to me.  I am worried that my hormones will never regulate themselves and I will be stuck with this pain for life.  Please help. Thanks

Painful growing breasts with nipple discharge in men is something that almost certainly hormonal related. Just as with Plastic Surgeons, General Practitioners, Internists, and even Endocrinologists all come with different skill levels. If the testing was not done by by someone else, I recommend that my patients be evaluated only by an experienced Endocrinologist. In some cases a more senior or experienced Endocrinologist is needed to come up with some of the more obscure problems I have seen in my practice and demonstrated on my website. Some of those less fortunate patients had had testing done for years by people I can only guess were grossly incompetent. As with surgery, evaluating this condition is an art form. With the varying levels of hormones through out the day, this problem is very difficult at times to define.

Having stable system first is critical to minimize issues of breast regrowth after surgery which I cover in much greater detail here in this forum:

https://www.gynecomastia.org/smf/index.php?topic=22273.msg149731;topicseen#msg149731

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737

[DrPensler]

Typically pubertal gynecomastia is stable at your age and I would refer to the most common type as idiopathic gynecomastia. I am not certain what laboratory tests you had nor do I understand what you are referring to with respect to your hormones regulating themselves. The glandular component of gynecomastia is often painful. Any substantial change in a patient who has a long history of stability particularly if it is unilateral would be of concern to me. I would encourage you to be evaluated by someone who has experience with gynecomastia.
Jay Pensler,M.D.

[painInleftchest]

Thank you for your replies Dr.'s.  When I refered to hormonal regulation, I mean that I am assuming the new growth is from a change in hormone levels.  I had hope they would regulate on their own so the pain would subside, but that is not happening.  Any recommendations on what to ask an endocrinologist to look at or focus on? 

[DrBermant]

Thank you for your replies Dr.'s.  When I refered to hormonal regulation, I mean that I am assuming the new growth is from a change in hormone levels.  I had hope they would regulate on their own so the pain would subside, but that is not happening.  Any recommendations on what to ask an endocrinologist to look at or focus on? 

Since the resources are in the post quoted above, I am answering there.

https://www.gynecomastia.org/smf/index.php?topic=22273.msg149731;topicseen#msg149731

But the basic theme is that there are so many different problems that can cause painful male breasts, if you need to know what questions to ask the Endocrinologist, you are in the wrong doctor's office.

Like with gynecomastia surgeons, different Endocrinologists have different skills. Some doctors have a passion for a certain subspecialty, something they enjoy or are particularly good at. Unfortunately, it is so difficult to find someone who really is good at this hard analysis that for my patients we help them find someone who has this type of passion.

But to better understand the nature of this problem, check that thread.

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737