Gynecomastia - What is Causing it?

[KLM]

I'm 20 years old, and I have had large breasts since age 10. In the past 10 years, I have been healthy weight (sometimes even close to slim), overweight, and obese (my weight has fluctuated in 2 year cycles a lot over the last 10 years). I am currently at the border line of overweight/healthy weight according to BMI (but I lost 20 pounds in the last year, I'm not gaining weight right now, in fact I may be losing right now). In the past 10 years, when I was obese and healthy weight, my breasts were still large and "pointy". It seems like there's a big mass of something in each of the breasts. Do I have gynecomastia?

I asked my family physician at age 16 about my breasts, and he told me that I have soft tissue and that if I do chest exercises, the breasts will get smaller. I asked him if he wanted to examine my breasts, and he said it wasn't necessary. Two ther family doctors that I know, however, said that my condition happens because of puberty (they didn't use the word gynecomastia), and that it would go away in 1 year. The other family doctors have also told me that I should get the surgery by age 18 if it doesn't go away by then. But now I'm 20! Is it possible that my physician does not know what gynecomastia is?

Could the cause of my gynecomastia be high estrogen/hormonal problems? I do have some female characteristics that aren't typical of a 20 year old male. My voice is somewhat like a female's (when I'm on the phone, I'm ALWAYS called "m'aam", and I've been mistaken for my sister a few times...). When I ask others who know me about my voice, they say it sounds "not male", but at the same time "not female". I have a little more fat in the bum/legs (again, like a female) than other males.
Also...I'm too embarassed to tell anyone this (even my physician)...but I'm infertile. I am not capable of conciously ejaculating/reaching orgasm despite trying (and trying is actually boring for me and feels like a waste of time...). I do have a full beard though...

So should I go to my family physician? What should I tell him, assuming he still does not know what gynecomastia is? Is it appropriate to tell the doctor that I want surgery? Typically I never suggest a certain treatment to my doctor, because I've always trusted his judgement...

[PSC0002]

You posed a lot of questions there, I'll see if I can fill some stuff in.

I had large breasts as long as I can remember.  I first remember being made fun of at around 8.  Didn't bother me enormusly till middle school. I too was overweight for a while, lost it all, but still had breasts.  I saw my peditrician when I was younger, he said it would go away.  It didn't.  If you can feel something - it's probably a gland.  Mine was rather firm and it seemed very obvious to me when the PS explained. 

Having surgery by 18?  Nah.  I wish I had it done then, but I waited to 25.  I know there are others on here who waited far longer and had excellent results. 

As for the estrogen levels and all that, I'm no expert - but I have heard that fat increases estrogen which increases breast size.  A vicious cycle.  Whether or not that is true, I don't know.  Best solution I would imagine is talk to your general practitioner, and ask to be referred to a endocrinologist.  They can run your lab values and if anything is out of whack, they could tell.  Research any medications you are on to find out if they are linked to gyne. 

Maybe surgery is right for you.  It was for me.  Spend some time exploring the wealth of information available on this board and good luck

[DrBermant]

I'm 20 years old, and I have had large breasts since age 10. In the past 10 years, I have been healthy weight (sometimes even close to slim), overweight, and obese (my weight has fluctuated in 2 year cycles a lot over the last 10 years). I am currently at the border line of overweight/healthy weight according to BMI (but I lost 20 pounds in the last year, I'm not gaining weight right now, in fact I may be losing right now). In the past 10 years, when I was obese and healthy weight, my breasts were still large and "pointy". It seems like there's a big mass of something in each of the breasts. Do I have gynecomastia?

I asked my family physician at age 16 about my breasts, and he told me that I have soft tissue and that if I do chest exercises, the breasts will get smaller. I asked him if he wanted to examine my breasts, and he said it wasn't necessary. Two ther family doctors that I know, however, said that my condition happens because of puberty (they didn't use the word gynecomastia), and that it would go away in 1 year. The other family doctors have also told me that I should get the surgery by age 18 if it doesn't go away by then. But now I'm 20! Is it possible that my physician does not know what gynecomastia is?

Could the cause of my gynecomastia be high estrogen/hormonal problems? I do have some female characteristics that aren't typical of a 20 year old male. My voice is somewhat like a female's (when I'm on the phone, I'm ALWAYS called "m'aam", and I've been mistaken for my sister a few times...). When I ask others who know me about my voice, they say it sounds "not male", but at the same time "not female". I have a little more fat in the bum/legs (again, like a female) than other males.
Also...I'm too embarassed to tell anyone this (even my physician)...but I'm infertile. I am not capable of conciously ejaculating/reaching orgasm despite trying (and trying is actually boring for me and feels like a waste of time...). I do have a full beard though...

So should I go to my family physician? What should I tell him, assuming he still does not know what gynecomastia is? Is it appropriate to tell the doctor that I want surgery? Typically I never suggest a certain treatment to my doctor, because I've always trusted his judgement...

There are many possible Causes of Gynecomastia. Female body characteristics is one of the many Gynecomastia Signs and Symptoms that are a major Red Flag during my evaluation that prompts me to refer a patient for an Endocrinology consultation.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Paa_Paw]

I still get the "Ma'am" treatment on the phone, but in my case I inherited it.  My mother was in her eighties and still occasionally when she would answer the phone the person on the other end would say something like "Hello honey is your mother home?"

To the point, It sounds to me like you should see an Endocrinologist.