Gyno? One Doctor Says No, One Says Get Checked Out Immediately

[GynoHelpWanted]

Hi, I seem to be developing some slight/moderate gynecomastia.  It may be tough to tell in the photos, but this gyno is really starting to bother me.  Compared to the other photos I have seen, this is nothing.  But, it is very painful, and other people have commented on it.  The fact that I am skinny may make it appear less obvious.  It is also getting worse, very slowly, and I have other symptoms of what seems to be a hormonal imbalance of some sort.  I have had blood tests done, and my free T is a bit low, and my Estrogen is slightly high. I would really appreciate some help/insight on what to do next....it seems like my entire body is changing

THINGS that make my gyno/other symptoms worse, roughly in order of worst to not so bad of an impact:

• Alchohol (I only drink a few times a year now, but it has a dramatic affect for a few days after)
• Ejaculation
• Lack of sleep, even 1 hour or so
• Later in the day, After about 7pm or so
• Exercise
• Heavy Stress (does not happen often, as I am pretty stress free, but I definitely notice it, as I feel the gyno during stressful times)
• Going over about 3 hours without eating

Brief Summary:

• Took Propecia 2 years ago, for a week, 1/2 dosage
• I am 30 years old now
• Immediately noticed some extra fat on chest the day after.  Did not know gyno could even be a symptom of propecia until I started noticing symptoms and having chest pain.  Stopped immediately.  Started noticing a tightening of the lymph nodes(?) in my armpit, and occasional nodules that were tight in the same spot, but came and went during the day.  Sometimes this was quite painful.  Exercise at the time made this worse.  The tight "lymph nodes" remain, and are marked with black lines on one of the photos (3 on each side of my chest)
• Mass is more pronounced around the armpit area, and protrudes towards the nipple area, but there is no mass underneath the nipple area at all.  When I lay down, and rub my skin between my fingers, I feel some lumps that also seem to come and go.  I tried to illustrate all of this on a photo.  The mass is more on the side of my chest, on both breasts; and again, not underneath the nipple, although there is some extra fat there.
• Sex drive decreased, Erections weakened after propecia, morning erections stopped.  Exercise seems much more difficult.  I was extremely fit before.  Slightly more irritable when hormones seem to be off, and it seems like my shoulders are caving inward (more recent), and I have suffered muscle loss and weight loss (tough to differentiate, but weight loss not intentional, nor did it occur quickly, though..just a couple lbs per week.  It seems like the bones on my wrist are smaller, and under my eyes has caved in slightly.  I have red veins on my eyes now, which started at the same time, but have stopped. worsening, although they are not improving.  Some times I get very tired.  Sleep always seem to make all symptoms slightly better.  I get about 9 hours/night now, every night for the past year.
• Slight joint pain, comes and goes with other symptoms.  Had severe brain fog for 3 months; but no longer.  Immensely tired, and slept for 15 hours/day for 3 months after, without trying to.
• Gradually pain/fat in chest seemed to turn into some rubbery tissue. This is thicker by both armpits, and thins out towards the nipple area
• Gyno discomfort is worse at night, as well as the day after any ejaculation (often times better for a few hours afterwards), or exercise (immediately worse).  I would not call this pain at all…it is just a discomfort that was never there before, centered around my outer breasts.
• This discomfort seems to get worse on some days, then improve; same with what seems like extra fat.  The rubbery portion, which I tried to outline on the photo, remains.  This worsening/improving still continues today, so I think my hormones are still off somewhat.  The mass, as a whole, has VERY slowly continued to grow.  It is always worse at night than during the day.  There are times when I do not feel any pain/discomfort in my chest unless I press on the rubbery mass.  I do not feel pain, but I do feel the mass.  Other times, again, moreso at night, I feel some discomfort.  It seems like my hormones are off more at night, and that the gyno is still growing.

QUESTIONS:

• -I visited an endocrinologist a year and a half ago, when the symptoms of the hormonal imbalance were worse, but the gyno was more fat than rubbery tissue.  At that time, he did not think this was gyno.  I am planning on another visit soon, as it has continued to get much worse.

• -Does this seem like gyno?  There is definitely a rubbery mass in my chest that was not there at all pre-propecia.  I can probably notice it much more, as I can feel it.  This mass has very slowly continued to grow.
• -If this is gyno, should I consult with a plastic surgeon now, as I am skinny, and the mass is easily felt?  Would it be better to bulk up a bit, to a more normal weight before considering surgery.  This may be small, but it is very bothersome.
• -Since my gyno is definitely worse one day than the next, and with the other symptoms, it seems like my hormones are not balanced.  Should I wait to consider surgery?  It seems like it would just continue getting worse post-surgery.  Is there any alternative (tamoxifin?) I should try?  I am trying diet/exercise (my diet has always been impeccablely healthy), but exercise seems to make things worse now.  I am concentrating my diet on estrogen reducing foods now.
• -If surgery is considered, since this mass is not centered underneath my nipple, would that still be the best spot for the incision?

[GynoHelpWanted]

Photos from Today:

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See the area that seems elevated in the photo, extending from my armpit towards my nipple?  This is the area that feels like a "rubbery" mass.  This is on both sides.  At one point, my right breast seemed to be slightly worse than my left...now, my left is worse than my right....It sure seems like everything is getting worse, very slowly.
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(Very crude MSPaint of this.  The three dark lines on each side, near my armpits are the lymph node like things that I feel.  They feel like taught strings.  The yellow dots are small circular lumps I can feel when I lay down, and press my skin between my fingers.  These come/go.  The dark red is the spot where the rubbery mass is the deepest, maybe 3/4" or so, and then the pink/white is where it is not as prominent.  Maybe down to about 1/16" where it is marked white (closer to the nipple).********************************************************************************

[Paa_Paw]

I see no sign of Gynecomastia and the area you are indicating is likely to have swollen lymph nodes though they should diminish over time unless there is an active infection somewhere.

I think your Endocrinologist was right.

A GP might not be of much help, but an Internal Medicine Specialist Might be.

[GynoHelpWanted]

Thanks a lot for your advice, Paw Paw!  It certainly seems as if something happened right after I took propecia.  I didn't even know about the gyno symptom of propecia, but noticed something was going on right away. 

If I haven't added actual glandular tissue, I've certainly added some fat to the area.  While my overall body fat level has declined (even my watch needs about 3 rings taken out of the metal band), there's certainly something going on on my chest/armpits.  The entire breast feels like it has added fat, with the glandular tissue I feel in the area I marked.  I could be mistaking what glandular tissue feels like, though, and as I understand it, this is not a common place for gyno to develop.  I do feel lumps, closer to the nipple, though.

I've never had more than 14% fat, and have always been very fit and skinny.  The day after I took propecia, I woke up in the morning and thought my chest looked different in the mirror.  I jumped up and down a couple times, and noticed some extra fat bouncing around, but wasn't sure if my mind was just messing with me.  3-6 Months later, I could feel it when I was walking (this lasted about a year, I no longer feel it while walking, but do with tighter shirts).  Maybe a year ago or a year and a half ago, I could feel the "lymph node" area really causing some discomfort/pain, and now everything seems to be getting worse very slowly.

The fact that I can still feel discomfort at times, and those times are definitely linked to: less sleep, alchohol, going too long without eating, or eating in general, stress, ejaculation, being later at night, or even exercise, it seems as something hormonal is still out of wack.

Has anyone here noticed these items causing discomfort in your chest, when your gyno was growing?  Also, something I'd really love to know, is did this feeling go away after your gyno was more stabilized.  I think I could deal with the added fat or tissue on my chest, if I knew that this would go away.  Now, I have a constant, daily reminder at times, that keeps coming and going.  I've dropped all alchohol, changed my diet, started practicing meditation/yoga, and started to take it a little easier on the exercise; and it's frustrating to not see results.

Paw Paw, when you mention an Internal Medicine Specialist, what are you referring to, and would you recommend I see him/her for the hormonal issues, or for the supposed "gyno"?

[tpuk]

dont look anything like gyno as I know it.....

gyno is not located up near the armpits as far as I know......have a look at all the pics of other guys on here & make an objective comparison.

Are your breasts clearly visible through a t-shirt & still make you super self-conscious?

the 4 pic seems to clearly show that you dont have fat/tissue around the breast/nipple area......

[fguss01]

Hi,
Interesting case, mirrors mine in many respects.

Mine started 18 months ago after 5 days of motilium, symptoms virtually identical to yours - the cycle of development/discomfort/pain is very unpleasant.

For a year the docs thought I was crazy but after 18 months I have gyne that us judged moderate but visible with some palpable glandular tissue.

My bloods are on the face of it OK, moderate test and high normal E2 - energy levels are OK compared to my peers but are not what they were - I am 53.

The problem is when to have surgery - mine is still developing after 18 months and could grow back after surgery  - I am seeing the surgeon again in a few months to decide whether or not to go down this route, seeing the endo in Feb to check blood levels  - will be six months since last bloods.

BTW I have tried Testosterone, Arimidex and Tamoxifen under endo supervision to no avail - the only effective treatment was Tamox which stopped the gyne but did not reverse it - i did not like the sides so came off it.

There are others on this forum in the same position - no clear answers for our type of gyne as far as i can tell.

Regards
Fguss01