How common for one side?

[ddgun]

Hello everyone. I'm 37 year old male.

I have been dealing with this problem for several months now, and I seem to keep going in circles with my doctor(s).

I first noticed a swelling in my right breast in July/August.

I have had a CT scan of my brain, an MRI of my brain, at least 4 blood tests checking for all kind of stuff, and an ultrasound (which I think was worthless).

Anyway, I thought we had ruled out cancer and then the Dr. mentioned it again as a possibility this past visit. I'm switching Dr's and going to the UAB Kirkland Clinic Dec 6. They have very good reputation. I hopefully will not have to start all over again, but I was not confident about the Doc in the box situation. The Dr seemed competent and smart, but when you're seeing several hundred people a week...

To make a long question short, how common is this for just one side?

My first blood test showed high prolactin, after that my prolactin was fine but I had barley low testosterone 2 times, although the last one came back normal.

I have some back, side, and shoulder pain\discomfort (all on the right side) but not sure if it is related. My breast does not "hurt" but it sometimes seems uncomfortable.

I do not think that the swelling has grown over these last few months. It seems to stay about the same. Sometimes I think it will get bigger and smaller during the day, but this could be my imagination.

The swelling is barley noticeable, especially when I'm standing up. The biggest concern for me is the anxiety of not knowing what is going on and the frustration of making no progress.

Any insights would be very much appreciated. Thanks for letting me whine on your board.

[J03L]

really rare on one side only, but it happens.

[Time_to_fix_it]

Hi and welcome to the boards,

I completely understand your concerns and impatience, but you have to have a clear view of what needs to be done and more importantly, who you need to be seeing.

My gyne first appeared in my late 40s and (rightly so) this rang alarm bells within the medical fraternity, because it is unusual in middle years.  Gyne is common during puberty and later age (60+).  It is uncommon in the middle years and needs to be investigated.  Regarding your question about gyne on one side only ... no I believe it is not that uncommon to have it on one side only; my surgeon who does several hundred gyne ops a year says he sees quite a lot of unilateral gyne.

It sounds like your early experience of doctors was not unlike mine.  Although my GP was great and referred me onto various local hospitals, it soon became apparent that the people I was seeing were out of their depth.  I needed to see a good Endocrinologist (hormone specialist) preferably one who specialises in reproductive matters.  There is a contributor on these boards called Hypo_is_here who, if he reads this, can give you some names.  If he doesn’t pick up on this try sending him a Personal Message.

Assuming your gyne is glandular and not just fat, then there are many possible causes for your gyne appearing when it did, but it is almost certainly because your male and female hormones (androgens and oestrogens) have fallen out of balance.  What is causing that imbalance to happen is what the doctors have to find out.  It could simply be a side effect of some medication you are taking .. it could be something more complicated but as far as I am aware all are treatable.

The following causes of gynecomastia and percentages are taken from a medical paper .. The Endocrinology of Gynaecomastia by AAA Ismail and JH Barth (Department of Clinical Biochemistry and Immunology, Leeds General Infirmary, England.)

Cause                                (%)
Idiopathic (unknown)           25
Puberty                              25
Drugs                              10-20
Cirrhosis or Malnutrition        8
Primary Hypogonadism          8
Testicular tumour                 3
Secondary Hypogonadism      2
Hyperthyroidism                   2
Renal Disease                      1
Others                                6

If you want to read a little deeper on the subject then I suggest you Google this paper and download it.

A good Endo will know what tests to run and very importantly when to run them.  He or she will carry out a full medical examination of you, including your testicles, and take a medical history.  You may have already been through all of this but another going over won’t do you any harm and it will amount to a second opinion.  It was my early experience for instance that the doctors I first saw didn’t realise that blood tests should be taken in the morning.  Consequently I was getting erratic results when one set was compared to another simply because some were done at 9am and others done at 4pm.  I’m not suggesting that this would account for your varied results but I’m trying to make the point that a good Endo will know the correct procedures to use.

Discomfort or pain (bearing in mind different peoples perception of pain) in the breast is again not uncommon.  Some get it and some don’t.  In my case it was the first thing that sent me to the GP long before I felt a lump.  I got to the stage when I knew my oestradiol levels were up and the gyne was growing simply because the tenderness reappeared.  It had to be confirmed by blood tests of course but I was right every time.

Like you I found the whole investigate process slow and worrying.  In the early days it was obvious that the people I was seeing really didn’t have the skills or the experience to help me.  Finally I saw a Professor of Endocrinology and more latterly an Andrologist who knew EXACTLY what to look for and what tests to run.

Finally ... stay focussed.  Find the expertise who can help you, you may have to research them yourself but hopefully Hypo_is_here will give you a list of those in your area.

Keep us posted as to how you get on.  Ask questions.  You may like to post your lab results on here (with the relevant lab ranges) because there are one or two people on here (not me) who although layman, have a huge amount of knowledge on matters hormonal.

Good luck and end of ramble 

[ddgun]

Thank you very much for your replies. Very helpful. 

I did have a vasectomy right before this started happening. The Doctor's swear up and down that a vasectomy can't cause this. But the funny little pause they have right before they say it made me curious.

So when I investigated it, I found that apparently trauma to the testicles can cause your hormones to get out of wack. And I suppose they don't consider digging around in your testicles with a surgical instrument to be trauma?

Anyway, I will be going to another GP Dec 6 in Birmingham at UAB, but he will be able to refer me to someone who is better informed on these matters.

My previous Doctor had got to the point where he had referred me to a surgeon. But he wanted to send me to one of the Doctors around where I live even though I told him I wanted to go to Birmingham. And a lot of these Doctors around here can't find their ass with both hands half the time.

There was an article in the paper just recently where a Doctor in this area took out this guy's kidney because he thought it was a tumor. True story.

[Time_to_fix_it]

I did have a vasectomy right before this started happening. The Doctor's swear up and down that a vasectomy can't cause this. But the funny little pause they have right before they say it made me curious.

EXACTLY the same happened with me.  Two months before this blew up I also had a vasectomy.

If you get a chance have a look at a book called The Testosterone Revolution by Dr Malcolm Carruthers.  He is a worlds leading Andrologist who I see on a regular basis for treatment.  He has a whole chapter devoted to vasectomies and has titled it “The unkindest cut of all”

Good luck.

[DrBermant]

Hello everyone. I'm 37 year old male.

I have been dealing with this problem for several months now, and I seem to keep going in circles with my doctor(s).

I first noticed a swelling in my right breast in July/August.

I have had a CT scan of my brain, an MRI of my brain, at least 4 blood tests checking for all kind of stuff, and an ultrasound (which I think was worthless).

Anyway, I thought we had ruled out cancer and then the Dr. mentioned it again as a possibility this past visit. I'm switching Dr's and going to the UAB Kirkland Clinic Dec 6. They have very good reputation. I hopefully will not have to start all over again, but I was not confident about the Doc in the box situation. The Dr seemed competent and smart, but when you're seeing several hundred people a week...

To make a long question short, how common is this for just one side?

My first blood test showed high prolactin, after that my prolactin was fine but I had barley low testosterone 2 times, although the last one came back normal.

I have some back, side, and shoulder pain\discomfort (all on the right side) but not sure if it is related. My breast does not "hurt" but it sometimes seems uncomfortable.

I do not think that the swelling has grown over these last few months. It seems to stay about the same. Sometimes I think it will get bigger and smaller during the day, but this could be my imagination.

The swelling is barley noticeable, especially when I'm standing up. The biggest concern for me is the anxiety of not knowing what is going on and the frustration of making no progress.

Any insights would be very much appreciated. Thanks for letting me whine on your board.

One sided or Unilateral) surgery is the ultimate in trying to make perfection since it can be very demanding to make a surgical site look like no surgery has been performed. You can see typical swelling after my unilateral one sided surgery here. And here is another example of my one sided sculpture.

I see many patients with asymmetrical gynecomastia. Actually it is quite common for the two sides to be different in size.  It is less common for one side to be large and the other have no problem at all.  Price of surgery depends on the problem to be treated.  Jane is my office manager and can better explain costs.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[CorpusSancti]

Sadly, I'm an example of what the Doc described above - a unilateral condition in my right breast, where the left breast is not affected whatsoever. It is QUITE noticeable, as I am a pretty skinny guy (6 feet, 140 pounds) and the affected tissue is rather solid.