Gynecomastia PAIN

[Zim]

Hello,
I'm not sure how I developed gyno, I'm 27 years old, slim and with normal hormone levels.
Anyway I've had this pain behind the nipples for almost a year now. It was confirmed by a scan that it was growing glandular tissue. About a month ago I started taking Raloxifene and Anastrazole, blocking estrogen receptors in the breast tissue and stopping the aromatization of testosterone to estrogen.
I'm surprised that I still have the pain as I thought basically nuking my estrogen would stop it. My estrogen levels were normal before I started these meds so they should be very low now.
The lumps are very small and the gyno is only visible if I'm warm. However I want to get surgery. I know the drugs won't reverse gyno but I was hoping they would stop the growth and stop the pain.

My question is - can I even get surgery while the pain is present? The gyno should be stable before surgery right? Doesn't this mean the gland is growing, and after the surgery it will just start growing back? I don't think I want full gland removal as I understand that's quite difficult and often comes with complications such as concaved nipples.
Any advise greatly appreciated.

[Dr. Elliot Jacobs]

Tenderness or pain in the breast or under the nipples is usually indicative of growth.  when contemplating possible surgery, it is best if your situation is quiescent -- ie no pain/tenderness.  Thus, would continue your regimen and be patient until things settle down.

You may also benefit from an evaluation by an endocrinologist -- there are other hormones besides testosterone and estrogen that could be in play -- such as prolactin, thyroid hormone, etc.

Dr Jacobs