Gynecomastia Misdiagnosis?

[nogyne]

Hi - I'm new to this site, so I apologize for starting on page 1 when you're all probably into chapters of your gynecomastia experience. 

My husband was just diagnosed, but I don't think he has it.  He is very slim and has been healthy as a horse until his first x-ray, mammogram, ultra-sound for pain in his left breast area this week.  He has a lumpy mass just on that side that hurts.  It's hard for him to raise his arm.

Looking through this site I notice obesity as a term that comes up often, or steroids or drugs.  None of these apply to him.  He does not have breast cancer and he has been checked for the Klinefelter which he does not have and the Gilbert syndrome - we are waiting for bloodwork results (which would not explain just one breast.)

He has scheduled an appointment with the surgeon and now I see that most of these surgeries are for aesthetic purposes.  Would we have to pay even though this is really hurting him.  No one else can notice this mass, but he is totally embarrassed about the whole diagnosis and the mammogram process he went through.  How can I look into this further yet be sensitive to his psychological well-being.

Any of your thoughts or similar situations would be much appreciated. Thank you.

-The Wife

[gyneman]

Firstoff, I would like to say is your husband is not alone with the pschological pain he goes through with gynecomastia. I, myself, am very slim and developed a large mass under each nipple. My breast itself was not big, just the nipple area poked out, very noticeable through a t-shirt. I've had the condition since puberty, around 12 or 13, and just finally had the operation 3mths ago. I am now 32 and feel like I can start living life again. I missed out on swimming, beaches, and alot of outdoor activites, thes are things I love to do. My PS told me this condition can be idiopathic, which mean nobody knows the cause of the condition. Best stated, my PS told me problem hormonal changes through the pubescent years caused mine. Just because your husband doesn't engage in drugs or steroids, just from taking prescription or over the counter meds can be attributed to his gynecomastia(if he has it). If he does have gynecomastia, the only way to rid yourself is through a surgical procedure. They cut a small half moon shape incision around the areola and excised the glandular tissue which is causing the pain. Good luck and be sensitive to him during this time. He probably feels embarassed about this whole thing, like many of us on this site. You sound like a woman who really cares about her husband. Good luck to you both.

[Time_to_fix_it]

Hi - I'm new to this site, so I apologize for starting on page 1 when you're all probably into chapters of your gynecomastia experience. 

My husband was just diagnosed, but I don't think he has it.  He is very slim and has been healthy as a horse until his first x-ray, mammogram, ultra-sound for pain in his left breast area this week.  He has a lumpy mass just on that side that hurts.  It's hard for him to raise his arm.

Looking through this site I notice obesity as a term that comes up often, or steroids or drugs.  None of these apply to him.  He does not have breast cancer and he has been checked for the Klinefelter which he does not have and the Gilbert syndrome - we are waiting for bloodwork results (which would not explain just one breast.)

He has scheduled an appointment with the surgeon and now I see that most of these surgeries are for aesthetic purposes.  Would we have to pay even though this is really hurting him.  No one else can notice this mass, but he is totally embarrassed about the whole diagnosis and the mammogram process he went through.  How can I look into this further yet be sensitive to his psychological well-being.

Any of your thoughts or similar situations would be much appreciated. Thank you.

-The Wife

Hi,

Firstly welcome to the boards.  It is refreshing when a girlfriend or a wife looks at or contributes to this forum as it can be a huge support to a man when he develops this condition.

I see you doubt the doctor’s diagnosis basing your doubt on your husbands previous good health, slim build, the fact that he didn’t take drugs or steroids and has been given the all clear from Klinefelters and Gilberts syndrome.  You say he has had a mammogram and an ultrasound examination and I assume it was these that detected the mass.  I would suspect that he will also have a biopsy taken of the mass to confirm it is normal breast tissue and not a tumour.  You don’t mention this but it is quite likely that he will already have had this done.  Finally you say you are waiting for the results of blood tests which “wouldn’t explain just one breast”.

I would like to say that it is still highly probable that he does have gynecomastia especially given the tests he has undergone.  You see all of the things above applied to me when I developed pain in one breast at the age of 42.  Like your husband I had never taken drugs: always been very fit and slim.  I went through all the embarrassing tests and examinations you list and many more.  For a man I found it hugely embarrassing and I reached the point where I was seeing so many doctors that I couldn’t bear to look at my chest anymore.  I would simply look at the ceiling as they all prodded and poked me.

You don’t say how old your husband is but assuming he is well over the age of 20 and has never had anything like this before, it is good medical practice to investigate fully “late onset” gynecomastia.

You will have read about the causes of glandular gynecomastia and you will already know it has only one cause and that is a hormonal imbalance.  What causes that hormonal imbalance is the tricky part.  It is perfectly normal for this to happen at puberty and the body usually corrects itself and any gyne that may have occurred recedes over a year or so.  When it happens later in life it could be due to a number of conditions or diseases and this requires investigation.  That is where the blood tests are vitally important and you should wait for these.

You might be interested in the following data.  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                              (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)

When you get the blood results back I would suggest that you find a good Endocrinologist to interpret them, preferably one with a good working knowledge of reproduction issues.  Many Endos specialise in diabetes or liver disease and these may not know enough about the complex balances and workings of testosterone, oestradoil, Luteinizing hormone and Sex Hormone Binding Globulin (to name a few) in men.

For now I would suggest you just wait and see what results the blood tests produce and keep a copy of them.

As for treatments, yes there are many, but firstly you need to know the underlying cause. When that is addressed then you can look at your options.  Surgery is usually the only way to remove glandular gyne when it has been there for a year or more.  However there are drugs which have been shown to have good effects on sizeable percentages of sufferers if taken in the early stages of growth.  But lets not put the cart before the horse.  Get the blood tests looked at by a good Endo and go from there.  In the meantime try to support your husband through what is a very difficult time for most men.

If you are up for a little reading you might like to look at a post I put on here a while ago.  It was in reply to someone doing some research for a documentary and I was feeling a little agrieved at life and wrote down how the onset of gynecomastia affected me.  I’m not suggesting what I went through is the same for everyone but there are some common factors in there.  It might give a little insight into how your husband might be feeling.  It’s reply #10 on this thread: 
http://www.gynecomastia.org/smf/index.php/topic,7059.msg56461.html#msg56461

Please feel free to ask questions and please keep us updated as to how your husband gets on.

[Grandpa Bambu]

Hi - I'm new to this site.

Welcome! 

My husband was just diagnosed, but I don't think he has it.  He is very slim and has been healthy as a horse. Looking through this site I notice obesity as a term that comes up often.

Gynecomastia can strike thin men as well as obese men. Gynecomastia in most cases is not weight related. Gynecomastia is caused (most often) by a hormonal imbalance. Thinking that the sufferer has gyne solely as a result of being obese is a massive misconception.

IMO, the reason why many gyne sufferers are obese is that the sufferer avoids most physical activities that many 'non' sufferers take for granted. Most sufferers become introverted and shy away from many activities. Shutting themselves out from the rest of the world.

Depression plays a big part in having Gynecomastia. When one is 'Depressed', one seeks comfort. A quick and easy fix for that is 'food'. So... the lack of physical activity and the added calories from 'comfort' food, has only one result... Obesity.

Steroids, drugs, none of these apply to him.

Is your husband on any meds at all? For example, Propecia, a drug to counteract baldness can cause Gynecomastia. Any drugs that alter your hormonal balance can have gynecomastia as a side effect.

  He does not have breast cancer and he has been checked for the Klinefelter which he does not have and the Gilbert syndrome - we are waiting for bloodwork results (which would not explain just one breast.)

Gynecomastia in just one breast is called 'Unilateral Gynecomastia'. While the majority of sufferers have Bilateral Gynecomastia (both sides), many do have it on just one side. It's not uncommon.

He has scheduled an appointment with the surgeon and now I see that most of these surgeries are for aesthetic purposes.  Would we have to pay even though this is really hurting him.

'If', and that's a BIG 'if', you get your health insurance to fork out the dough to have the gland removed, they will not cover the liposuction portion of the procedure.

No one else can notice this mass, but he is totally embarrassed about the whole diagnosis and the mammogram process he went through.  How can I look into this further yet be sensitive to his psychological well-being.

Gynecomastia and embarrassment are synonymous (so to speak...) As long and your husband has the condition, he will be embarrassed. Tell him that Gynecomastia affects many men and that he is not 'The Only One'. Tell him that you will be by his side no matter what. Tell him that you don't love him any less as gyne sufferers feel that their partners see them as inferior, less masculine, unworthy of your love.

Stress to him that Gynecomastia is a normal biological condition and that it can be fixed.

GB