Doctors Visit

[Dudewithboobs]

I had my first dr appointment in 5 years with an NP who looked relatively older on her online profile and when she walked in was surprised she looked relatively my age 38-45 age range. Even told her I mean this not to insult I was hoping you’d be older lol. 
We went through what brought me in she didn’t do a traditional physical and basically told me unless I have issues to go over or concerns she doesn’t typically ask to do the turn and cough. We went over concerns I had about digestion and such and then I requested a hormonal work up cause of issues with ED and continued development in the last year with gynecomastia. She ordered lab work and recommended where I could go for semen work up if fertility is a concern and then asked if it would be ok to give me a breast exam to see if she notices anything with gynecomastia being mentioned. 
She had me lay down and extend my arm and felt around and it was incredibly embarrassing. She was attractive and my age and just felt super uneasy about it but appreciated she was willing to give a professional exam as it is a concern that I’ll be too embarrassed in this type of scenario to try to keep myself healthy in that area by having a check up for it. 
She then had me sit up and did a pinch test then asked if I’d sit slightly angled and put my arms straight and hands on knees to see the extent of tissue development outside of the pinch test. And said this was to help see where it may be fat compared to glandular outside of touch exam. 
Overall she said literally “you definitely have moderate breast development but good news is from what I can feel and see your breasts are totally healthy. If you’d like a mammogram I can order one but based on information here today it doesn’t seem necessary until you’re 40 but can if you’d like for any assurance”. I declined but it was so weird to hear someone other than my internal voice refer to my chest as breasts. 
Overall I was 8/10 with my visit I wish we’d gone over more but if nothing to see and do here is the case then perhaps why it felt so quick of a visit. 
Idk it was the first visit I had in years and I’ve grown almost 3 cup sizes since seeing my dr during my initial onset of gynecomastia and thought I’d share in case anyone is my age and nervous about bringing it up. It’s not a shame free moment in my opinion but it is nice when the embarrassment washes away from a true professional experience. 

[WPW717]

Well past 38-45 y/o ( mid 70s) The Docs did a lot to ignore the complaints I had re gynecomastia/ hot flashes and other endocrine symptoms. The NP was the only one listening. My initial reaction was oh wow, not expecting the strip for a breast exam but got over it quickly as I was an OR RN.
The same quick embarrassing moment for the resultant mammogram that happened ( had 2 now) second one was also handled with good professionalism also. It was me and the NP that got the focus on the patient issues as a whole than lead to the proper diagnosis of Multiple Endocrine Neoplasia 
If your hormone profile comes back skewed beyond estrogen dominance or low testosterone you would best be served by more frequent doctor visits. There can be more here than meets the eye.
Best wishes to you 

[Dudewithboobs]

Thank you. I asked for a full work up but she said she would call for a total testosterone test and go from there to see if it calls for further tests rather bill me for everything if not needed. Unsure if that’s normal but I’d have preferred a full estrogen and testosterone work up to see what is low high or normal to just cover all bases regardless. It was embarrassing having someone who was her age and appearance confirm and call them as is and would have imagined that in itself would have caused for further looking in to but who knows. I believe my old doctor would have given a vast history with him and knowing me and my weight and such history to know it isn’t from pizza lol 

[Johndoe1]

Good for you on getting examined. My first breast exam was embarrassing too, but it confirmed a lot of things for mine too was performed by a woman but in my case it was a MD and she was very professional and matter of fact but I have had NP perform them as well and just as professional. It was an NP who suggested years ago when I brought up I was experiencing discomfort when exercising that I should consider support if I were not going to have reduction surgery and she would have the doctor, another woman, talk to me about options and bras were in the mix as well. 

Just the other day I had to go to a emergency med center for a GI issue and the nurse asked me to "remove my top" as she held up a gown in front of me for modesty. So at least the female medical professionals get it, or at least the ones who I have dealt with. 

[Dudewithboobs]

Thanks John!  I looked for an MD near me and just so difficult to find a GP who was an md it seemed so went with an np as to my understanding they are fairly close idk. 
When doing her exam she asked if there’s any tenderness or pain in various areas examining and some yes some no. She asked if any activities are hindered due to any discomfort I said not really as even when braless it’s tolerable. But overall I feel I should have been honest and said not really but I do feel my chest move about a bit and it does cause noticeable discomfort but not pain. But idk something bout her age and such made me embarrassed to lean in to that much detail :/ 

It’s nice they recognize the need for modesty and are attentive to that detail on all people. I imagine more so for men so any passerby’s aren’t more drawn to what may be seen. I’m glad everyone seems to have positive experiences anytime these things are discussed 

[mgr]

Helpful information.  My interest has given me multiple breast exams over the years. I lay on the table with my arms above my head and she palpitates my entire chest. I have some glandular tissue, but most if my breasts are fatty.  However, given my family history of breast cancer, I have had 5 mammograms.  My doctor has always spoken to me openly about my breasts and told me I have to take care of them just as a woman of my age would do. That is when she ordered the first mammogram. 

I am not embarrassed as others have indicated. I think I lost all of my modesty while being treated for prostate cancer. Everything exposed all the time during those exams.  

All the techs that gave me my mammograms were considerate and understanding except for one older female.  One of my earlier techs asked me how long I was on hormones (meaning Estrogen).  She should not have assumed, but I was not bothered by it.  I give her the background, which she found interesting.

The last tech asked if I felt I needed to wear support, especially when active. That was nice of her.
  

[Dudewithboobs]

Beauty about age is the loss of care what others may think during otherwise uncomfortable or embarrassing moments others may feel. Definitely don’t think the tech should have assumed anything. I tend to be quick witted and lack the ability to care for most feelings and feel I’d definitely snapped back with something of a comedic intended effort to make her feel either touché or wow did he just say that lol 

[Johndoe1]

I have told this before but several years ago I was hospitalized for a heart issue. One of the follow up tests was a comprehensive sonogram of my heart. Around 60 pictures. The tech was a male in his late 20s or early 30s. After setting things up, he lifted the gown and saw my chest and immediately put a sheet over my chest and did the entire procedure by touch while my chest was covered. Needless to say my left breast didn't make it easy for him but he performed the procedure as he would have for a woman being careful around the breast to minimize discomfort. I was not embarrassed at all and was glad he treated my chest as any woman's chest would be treated in that situation. I didn't feel judged at all. I actually felt a little sorry for him. It couldn't have been easy fighting my breast like that. 

[Sophie]

I had my first mammogram when I turned 30. I was still presenting as a man with a bit of an androgynous style. I sat down and filled out the questionnaire then I was taken to an exam room. The tech asked me to remove my top. She was a bit surprised when she saw my 38DDD bra filled with full breasts. She had thought that I was there just because of my family history. She had men put mt top back on and brought me to the changing room and gave me a pink robe to put on and wear during the mammogram. 

There was obviously a note placed in my chart because every year after that. I was brought to the changing room first. 

And yes! We absolutely need to follow the breast health recommendations. Men, in general may not have the same risk level for cancer as women. However, men in general also don't have the need to wear a bra. If your estrogen and progesterone levels are high enough and that caused your breasts to increase to the point where you need the support of a bra, you need to consult your physician about having a diagnostic mammogram to at least establish a base line for any future issues. 

[WPW717]

On further thought, a total testosterone is a start but it would be best if there was a fractional testosterone level done. Free versus total testosterone in essence.
This is true for some of these tests we do for hormonal exams i.e. prolactin.
The endocrinologist thought my high level was a ‘ macro prolactin molecule therefore inactive. After a period of estrogen dominance I went to a zero level of estrogen & testosterone. Yet with no circulating estrogen my breasts were still enlarging. A repeat level  of prolactin yielded similar results but when the fractional test was done … surprise … it was all active hormone. 
 Persistence is your friend here, no amount of sloughing this off can justify the loss of years of less than optimal health. It has taken 4 years to get a solid diagnosis and plan and that will be completed in the next month post surgery. Long road back to health but it was so worth it as I feel great now.
Stay strong friend.
Sophie is correct about the breast facts on men vs women, luckily my mammograms have all shown no evidence of disease. 
Best wishes…

[Sophie]

I would like to add one thing. Insurance does not want to pay for a male to have a mammogram, breast ultrasound or breast exam. However, if it is ordered as a "diagnostic mammogram " it usually goes through without a hitch.

You really need to be your own advocate when it comes to gynecomastia. When it comes to breast development, all of our breasts, male and female develope, grow and fill out because of exposure to the same hormones at various levels. And thank you WPW prolactin or pitocin is another hormone that also augments breast development. Pregnant women will exhibit a marked increase in prolactin as well.

Edit: Jessica, one our surgeons who performs biopsies and mastectomies, has said, if they need a bra than they probably need a mammogram. 

I am soooooo happy that so many of you here are taking your breast health seriously. ♥️♥️♥️♥️♥️♥️

[Justagirl💃]

I would like to add one thing. Insurance does not want to pay for a male to have a mammogram, breast ultrasound or breast exam. However, if it is ordered as a "diagnostic mammogram " it usually goes through without a hitch.

You really need to be your own advocate when it comes to gynecomastia. When it comes to breast development, all of our breasts, male and female develope, grow and fill out because of exposure to the same hormones at various levels. And thank you WPW prolactin or pitocin is another hormone that also augments breast development. Pregnant women will exhibit a marked increase in prolactin as well.

Edit: Jessica, one our surgeons who performs biopsies and mastectomies, has said, if they need a bra than they probably need a mammogram.

I am soooooo happy that so many of you here are taking your breast health seriously. ♥️♥️♥️♥️♥️♥️

I have recently ran into this problem with my insurance as well. The centre has now stopped scheduling my mammograms for this very reason. 
The local university does have a mammogram bus that makes rounds around town about once a year with "low cost" mammograms that I will be taking advantage of. 

Birdie 💝

[Dudewithboobs]

It’s a shame how our insurance industry works regarding this. If you have a legitimate cause for concern or just general use for annual physical such as a mammogram for preventative care due to having significant, moderate or minor enlargement of breast tissue that goes beyond reasonable measure or what a typical male may have to otherwise deal with, it should be covered same as a woman. I can understand if a man has little to no development and there’s no real reason to go for a mammogram to reduce patient volume or costs or if going it be considered elective rather than preventative. But if a man has noticeable breast volume and general exam confirms it is indeed breast tissue not fat and the patient suffers from discomfort or pain when unsupported than insurance should support it same as a woman to ensure they are doing their due diligence in making sure his breasts are just as healthy as hers at the same cost and care. 

[Johndoe1]

It's because insurance companies are run by people who do not have developed breasts so they have no point of reference or understanding nor care. 

[Dudewithboobs]

Ehhh I’m sure that’s not the case lol. I often wonder if trans women are able to get them at little to no cost due to transitioning and having an F on the chart rather than an M.