Consulted a GP

[iwannabefree]

I took a big step today and consulted a GP about my gynecomastia. He did a physical exam for me where he inspected my genitals and breasts. He was very knowledgable about the condition unlike most of the doctors ppl on this forum have met in the past - he asked questions like:

Do you feel pain? - NO
Nipple discharge? - No
Sexual desire, morning erections? - Normal
Testicular issues? - no pain, normal size (which he later confirmed)

He looked at my breasts and said that yes there is some breast tissue, but mostly fat (which is stubborn i suppose). he said for some reason my body seems to have stored fat in a feminin manner (after seeing love handles). I told him that I have lost some weight and that the appearance has gotten better.

He told me that the hormone which causes gynecomastia is prolactin and said that I may wanna get a test for it although he doesn't feel the need since my testies r fine, no pain, & normal sexual desire.

he suggested that i stick to my weight loss and the situation should improve a bit more.

My thoughts:

- Feels liberating to talk about it and finally addressing the issue. Was the first time i spoke to anyone about it and I was lucky to get an understanding, knowledable doc
- I may test for prolactin + hormones. Question for you guys: do these feminin hormones make it harder to lose weight?
- I am still overweight and so I am not even gonna consider surgery until I am in 100% good shape. got a new sense of motivation to work out.

This was a big step for me - so I wanted to share it with you guys. I have gotten a lot of courage from you guys - hopefully my situation keeps improving and may be i'll even get a surgery some day.

[marffeus]

Good post, thanks. I've never consulted a GP about my gyne, but it sounds similiar to yours ... I store fat in a feminine manner. I have laarge areolas tho and I wonder if this is a sign that its more fat than breast tissue? Either way I'm still hoping to get my surgery in sept. I started a weightloss regimen back in early april and have lost 20 lbs so far but have another 10 to go but I think I can do that before sept

[haisook]

Storing fat in the chest is not feminine for men. In fact, the first two places in a man's body targeted by fat is the chest and the abdomen. What would be called feminine fat distribution in men is fat accumulating in the buttocks, thighs, and legs. That's why it's very common to see chubby men with hung bellies and big breasts, but with normal-sized thighs and legs.

Prolactin only causes gynecomastia when there's associated increase in estrogen. Elevated prolactin alone causes galactorrhea (milk secretion in males), not gynecomastia. However, you still should get this hormone and others checked. The important hormones in this case is:

- Testosterone
- Estradiol
- LH
- B-HCG
- Prolactin

As to your question about the feminine hormones and losing weight, firstly, not because you have excess fat in your chest that means you have excess estrogen. As I said fat normally gets stored in the chest in men. The hormones work-up will tell you if you actually have excess estrogen which could be the cause, which is unlikely because you're overweight, and so the fat on your chest is part of your obesity. Secondly, it should go the other way round, losing weight decreases the levels of estrogen or at least lowers its efficacy. If you're through puberty (12-18 years old), I'd try to get in shape and lose as much fat as possible. This increases the chance of both the fat and the gland going away. If you're out of puberty, working out will decrease the fat portion but not the gland.

Hope this helps.

[Paa_Paw]

Well said, I agree.

[iwannabefree]

Thank you all for your feedback.

I will keep a lookout for those hormones when I do get a test.

As for the fat distribution aspect of it, my chest looks very much like breasts and nothing like the "pseudo-gynecomastia" that I have seen on this form. and i have fat hips and thighs. BUT ALSO, fat on the abdomen like most other men.

I guess it was somehow re-assuring to hear the doc say that there is alot of fat - which mean i can get rid of a significant portion of it before (or if) I chose to get surgery - meanining in better results. Otherwise, its really discouraging to workout when you think there is nothing you can do about it. 

[haisook]

Most gynes are fat + gland, with fat constituting the majority. For this reason I think that working out in a way that makes fat gets re-distributed evenly or cut in amount will diminish the size greatly. I also have excess body fat, and I plan on lowering it before I ever consider surgery. I have a strong belief that by getting in shape (although I'm within the normal BMI) my chest will look pretty much normal. Those whose gyne is only gland are really unlucky.

[iwannabefree]

thanks haisook. totally agree with you. surgery is the last resort for me.

i dont need to look like a perfect male model. if i can get into a decent enough shape that my moobs dont look so disturbing i'm satisfied (even if they r slightly larger than normal).

one more question for you haisook, since you are a doc. i remember hearing that you lose fat in the same order in which you gained it. is that true?

for me, i first got gyne, then fat on hips, then stocmach and other places. so does that mean i'll lose it stomach, hips then boobs. cuz that can be a problem for me as u can understand.

[haisook]

thanks haisook. totally agree with you. surgery is the last resort for me.

i dont need to look like a perfect male model. if i can get into a decent enough shape that my moobs dont look so disturbing i'm satisfied (even if they r slightly larger than normal).

one more question for you haisook, since you are a doc. i remember hearing that you lose fat in the same order in which you gained it. is that true?

for me, i first got gyne, then fat on hips, then stocmach and other places. so does that mean i'll lose it stomach, hips then boobs. cuz that can be a problem for me as u can understand.

Although this statement is pretty common, there's no scientific back up for it. I'm not an expert on physical fitness, but I've read that the hardest place to lose fat from is your stomach. I think a general work-out like running, plus targeting the chest area (with say push-ups, chest expanders), PLUS good dieting, will help a lot. I still advise talking to a specialist, may be a gym coach. He/she may have more details.

For me, I'm still experimenting with a work-out program.