Cause of My Gynecomastia

[ewc212]

I am 20 years old. I have had gynecomastia since age 11. I'm wondering what the cause is in my case.

It seems like I had pubertal gynecomastia that did not go away. Does this mean that the high estrogen levels that happen at puberty did not reduce (and the proportion of estrogen/testosterone did not correct itself, and the proportion is still unbalanced)?

I do have some characterisitics that aren't typical of a 20 year old male:

-My voice sounds like an adult female. Before, I sounded like a pre-pubescent boy (which is normal). My voice did lower a little, but it lowered to a level where it sounds like an adult female (not an adult male). I'm ALWAYS mistaken for a female on the phone (called ma'am...I'm often mistaken for my mom/sister), and before as a child I used to be called sir (hate this!). I'm pretty embarassed by my voice...everyone remembers it because its so distinctive.

-Fat tends to store a bit more in my bum/waist. My waist size is slightly disproportional to my height/weight (by about 1 inch), and my bum fat is a little disproportional. This is getting better with weight loss, but still....even though I'm now not overweight, its still a little disproportional

-I have next to no sex drive. But could this be due to stress/being busy/being preoccupied about other things?

-Although I'm not overweight according to BMI, my body fat % is 22% (which is considered overweight since overweight is defined as above 20% body fat)

-Everything else: normal - I do have a beard, normal primary sexual characteristics, etc

When I went to my doctor to discuss gynecomastia, I got a testosterone test. My testosterone levels are in the normal, healthy range (but within the range, its not in the middle...its half way between the low end and the middle end). When I discussed this with my doctor, I asked him if any other tests are necessary, and he said no. I then asked him whats causing my gynecomastia if testosterone isn't low, and he said its simply bad luck...

Could the problem be estrogen levels? Should I still go ahead with my surgery? If I get surgery and I find out later on that I do have hormonal problems and get hormonal therapy, could the gynecomastia come back? If yes, whats the chance of it coming back if I get hormonal therapy later on?

[Paa_Paw]

Nearing the age of 72, I still get the "yes ma'am" treatment on the phone sometimes. By itself, it really does not mean much.

It could just be that you are a bit slow completing puberty (this happened to me) and a trip to an Endocrinologist will soon reveal if there is a problem or not.

Most Doctors in family practice are somewhat limited in their knowledge of how the hormones interact. Commonly they will base their opinions on one or two tests and consider the results by themselves. The hormones do not play solo parts, but they act in concert with each other. It really takes the specialist to properly interpret the results of those tests.

[ewc212]

You need to go see an encronologist or however it is spelled.  A hormone doctor will be able to do the right tests and figure out what's going on.

Sex drive thing is interesting.  A 20 year old male should have it pretty heavy.  Are you taking and medications?

As far as the voice, is it really that bad?  Is it possible that you think it is worse than it actually is?  A lot of people hate how they sound.  It could be more in your head than anything else.  But, maybe not.

Regardless, you can change your voice.  The voice is highly adaptable, and if you tried to deepen it through exercises, it will deepen for sure.

Not taking any medications, so I don't know what is up with the sex drive.

Voice- I think its bad since I'm ALWAYS called ma'am on the phone.I do get embarassed by my voice too. And its very distinctive as well b/c it does sound like a females, but not like most females (its a low female adult voice). Those who know me describe it as "neither female, nor male", and those who just hear my voice and don't know who I am think I'm female. I think its somewhat non-human like. And I don't like how its very distinguished because I don't like standing out among others! But what really annoys me is that before, people always called me sir, now I'm being called ma'am!

To see an endocrinologistm,my family doctor has to refer me. And he doesn't think I have any problems based on the testosterone test...but I didn't tell him about low sex drive.

To go to an endocrinologist,

[Paa_Paw]

I'm not really sure how old I was when I realized that I had a voice that I could have some fun with. Especially so on the phone. I can remember when in my twenties I answered the phone one day and a womans voice said "Hello sweetie, is your mommie home?"

While it was an embarassment most of the time, I enjoyed choral music and found I could easily sing parts written for boy sopranos. It was in my mid 30's that my voice settled down to its present level which is that of a countertenor. (above a regular tenor) My sense of pitch was not all that good and I'd wander off key when attempting a solo part so I had to sing along with, or an octave above, the people near me.

I don't recall that it was ever an issue with the girls.

The issues of fat distribution etc. is really hard to pin down. There are many variations of body types and each is not a specific type as much as it is a range.

Your Doctor has a responsibility to the Insurance Company since they are paying the bills. He also has a responsibility to you and I'm certain that he would not like to have you complaining to the Insurance Company about him. You may have to insist on a referral, but if you do, you will get it.

While I was writing, the question about femininity was asked so I'll address it as welll.

Here again, we are not looking at distinct types but ranges. The normal range for males would overlap that of females without regard for sexual orientation etc.  I think you would have described me as a rather soft sided male. I've been asked by some people if I was Gay, I have no inclination in that direction. Do not be guilty of confusing one issue with another.