is this Gynecomastia?!?!----[Pics included]----

[Dr. Elliot Jacobs]

The question of the hormonal cause for gyne has been discussed many times.  Many times we talk about the hormones being "out of whack."  Bottom line, though, is that every person goes through puberty and their hormones frequently vary considerably.  So why is it that only certain guys develop gyne which remains after puberty?

My own gut feeling is that there is a hereditary pre-disposition to the condition.  One may inherit tissue which is more sensitive to the circulating estrogen.  That means that given two guys with the same estrogen levels, one may develop gyne and one may not.

I had an interesting case several years ago.  A father brought a 15 year old to me -- with a significant case of adolescent gyne.  The father himself had had the condition.  The father was also a pediatric endocrinologist -- and having had gyne himself, was especially attuned to watching for it in his son.  Sure enough, his son started to develop gyne around age 12.  The father then did a series of hormonal studies on his son over several years.  Guess what?  The son never had abnormal levels of estrogen and had normal levels of testosterone during the entire time.  His hormones were never out of whack!

Now, one case cannot be conclusive.  But it makes a point.  As much as doctors know, there is a lot we simply do not know.  One cannot be cavalier and just say "his hormones are out of whack."  In essence, we simply do not know what the true causes of gyne really are.

Dr Jacobs

[Gyne-Sucks]

What do you think will happen if he decides to have the surgery? Now remember he is only 16. Obviously his hormones are out of wack. Do you agree? After surgery his hormones are still going to be out of range. This means there is a very good chance the gyno will come back. Is this making sense cupcake?

No, sorry, it doesn't make sense because nothing was mentioned about his hormones being "out of whack".  No blood tests were mentioned.  No testosterone levels were mentioned.  No estrogen levels were mentioned.  Most of the guys on this site and guys with gyne, in general, have hormone levels that are within the normal range. 

All indications are that this young man's gyne is stable.  If it is NOT stable, or if he were having current growth and pain/tenderness, then THAT would be a reason not to have surgery right now.  You don't operate on gyne that is in an active state, because, as you said, it could return.  But if the gyne has been stable for some time, as his apparently has been, then surgery would be a viable option, even at his age. 

Completely aside from all this, though, you were advocating giving Tamoxifen to someone whose gyne appears to be established and stable (3 years).  To do such a thing would be irresponsible and pointless.  Tamoxifen would no more get rid of HIS established gyne (enlarged breast tissue) than it would a female's breast tissue after 3 years.  Once tissue is fibrotic, no medicine is going to make it magically disappear.  If the tissue is still in an active state of change (and growth), the medicine can be beneficial.  But this does not appear to be the case with this individual. 

just to mention, i did go to the doctors about a year ago and they said that i had a hormone im balance and i did a urine sample to test it

[Raider Fan]

just to mention, i did go to the doctors about a year ago and they said that i had a hormone im balance and i did a urine sample to test it

You had a hormone imbalance?  What did they do about it and exactly what was wrong?  Was your testosterone too low?  Was your estrogen too high?  Or did they basically just chalk it up to "hormone levels being out of whack" without giving you any specific numbers?

You had your hormones checked with with a urine sample or a blood test?  Do you still have a known hormone imbalance? If so, that's the place to start to deal with your gynecomastia.  

[Gyne-Sucks]

i forgot i think it was a urine sample im sure it was cos they also checked for diabetes which came back negative

but they either said i had too high testosterone levels or too low estrogen levels i totally forgot

How could i solve an imbalance?

Once the imbalance is solved what should i then do?

[Dr. Elliot Jacobs]

If there is any question of a hormone imbalance at the present time, you should first seek consultation with an endocrinologist.  Once the exact situation is determined, treatment may be necessary.  That should absolutely be done prior to any contemplated surgery.

Dr Jacobs

[jojo82]

The question of the hormonal cause for gyne has been discussed many times.  Many times we talk about the hormones being "out of whack."  Bottom line, though, is that every person goes through puberty and their hormones frequently vary considerably.  So why is it that only certain guys develop gyne which remains after puberty?

My own gut feeling is that there is a hereditary pre-disposition to the condition.  One may inherit tissue which is more sensitive to the circulating estrogen.  That means that given two guys with the same estrogen levels, one may develop gyne and one may not.

I had an interesting case several years ago.  A father brought a 15 year old to me -- with a significant case of adolescent gyne.  The father himself had had the condition.  The father was also a pediatric endocrinologist -- and having had gyne himself, was especially attuned to watching for it in his son.  Sure enough, his son started to develop gyne around age 12.  The father then did a series of hormonal studies on his son over several years.  Guess what?  The son never had abnormal levels of estrogen and had normal levels of testosterone during the entire time.  His hormones were never out of whack!

Now, one case cannot be conclusive.  But it makes a point.  As much as doctors know, there is a lot we simply do not know.  One cannot be cavalier and just say "his hormones are out of whack."  In essence, we simply do not know what the true causes of gyne really are.

Dr Jacobs

There was an article I read a while back from a professor (wish I could find it) that postulated the same thing- some boys may have a genetic predisposition to having fat deposited in the chest, which may have some impact on localized stimulation of breast tissue even without a global hormone imbalance.