23 years old that randomly got gyno, not sure why?

[umdterps]

Hi. I'm new to these boards and am hoping to get some psychological relief by venting my story and hopefully getting advice from users who are more knowledgeable about gynecomastia than I am.

A little background information. I'm 23 years old, 6 foot, currently 220 pounds. At the time my gyno started (early December), I was about 1 month away from ending my "bulking cycle". I've lifted weights for about 4 years and about 8 months ago I decided I wanted to gain some substantial lean body mass, albeit at the expense of some substantial fat gain. I went from about 195-230 in 6 months or so. At 230 I was pretty fat, probably around 25% body fat but I had successfully added approximately 20 pounds of lean body mass. I did this completely natural with no prohormones or steroids.

Anyway it started in my left areola and began as a pea sized lump that was sensitive to touch. Initially I kinda freaked out and went to my step dad  who is a board certified internist (however I don't talk to my mom much, so we're not very close). I initially suspected gyno because I have been on bodybuilding and powerlifting forums for many years and I have read people venting about it, and from I was experiencing, it sounded alot like what people described. I wasn't sure why it happened and speculated that maybe my sudden fat gain had caused some sort of hormone imbalance or possibly quitting smoking. I also had squeezed the side of my areola very hard trying to pop a small pimple/ ingrown hair.

Make no mistake about it, I wasn't concerned about "man boobs", I was concerned about sensitive areolas, and hard feeling tissue inside. My step dad said he didn't think it was gyno, because "it normally happens in pubertal boys" and it occurs both sides not unilateral. This got me raising my eyebrows because I knew from the great Internet that there is such thing as unilateral gyno. He thought it was a cyst and he proceeded to try and pop it by squeezing very hard. Needless to say, nothing happened except for extreme pain. He then prescribed me a generic antibiotic and said to take it, because there could be an infection in the areola. He also ordered a standard blood screen which turned out to be normal (cholesterol, thyroid, liver). I asked if we could do a hormone screen to test for things such as estrogen and he laughed and said I was not a woman and didn't need to worry about estrogen. Fast forward 3-4 weeks and my gyno had gotten substantially worse. My left areola was protruding outward and my right side began to feel sensitive although no lumps.

I checked back with him and he agreed that it could be gyno. He said it would "probably go away on its own" which I think is complete BS because the tissue is hardened. He asked me if I had any lumps on my testicles which I said none that I knew of.  

Soon after this time I started "cutting" which is basically dieting with the intention of losing fat. I've been cutting for a month now and have lost approximately 10 pounds of fat. However my gyno seems to progressively getting worse. Now, if I lightly squeeze my left areola laterally, i can feel a pretty big lump that is deep to the areola... it could be about the diameter of a quarter. My right areola now feels like my left areola felt back in December- its a small lump with a slight protrusion. They're both extremely sensitive and if something presses up against them, it hurts very badly.  

I just started a new job and just got health insurance, so I'm trying to find an endocrinologist that can help me figure out what's causing this. I'm afraid that they won't know much about gyno however. I considered attempting to obtain some research chems like letro or nolva but decided against it due to legal reasons and I haven't talked to an endo.

I know I'm going to have to get the surgery which is a real bummer but I can't ignore this. I just want to find out what's causing this, and if its going to keep getting worse and how this could effect future surgery.

Any insight, questions, comments or encouragement are welcomed.

Thanks for reading.
 

[headheldhigh01]

welcome to the site.  i think you have a good perspective and most of your suspicions are well informed.  i wouldn't want to say much without knowing more from what the endo had to say.  my non-professional opinion is kind of divided.  on the one hand, i'd personally want to kind of nip it in the bud before it grew and got more extensive than it is.  on the other, i'd think a ps wouldn't be as comfortable working with something where the condition hadn't stabilized, since an unresolved hormone situation could make recurrence more likely.  so after you hear back, i think getting input from a ps that wouldn't hurt either, and it'd be interesting to see anything the docs thought on this. 

[umdterps]

i called two highly regarded hospitals today that have endocrinology divisions that specialize in male hormonal disorders. the one i'd like to go to is booked till July 1st, and the other late April. a real bummer.

i could try and inquire to a local endo but their specialties don't include "male hormonal disorders". how important is this usually?

[Dr. Elliot Jacobs]

The presentation of gyne in an adult should be thoroughly worked-up by an endocrinologist.  The presence of tenderness indicates that some growth is going on.  While a consult with a plastic surgeon could be done, I would strongly recommend that you get to the cause of the problem before considering any surgery.

Would not take any drugs, legal or not, for they would interfere with your workup.

Good luck

Dr Jacobs

[DrBermant]

i called two highly regarded hospitals today that have endocrinology divisions that specialize in male hormonal disorders. the one i'd like to go to is booked till July 1st, and the other late April. a real bummer.

i could try and inquire to a local endo but their specialties don't include "male hormonal disorders". how important is this usually?

Endocrinologists, like surgeons, tend to specialize. Some prefer to manage only diabetes, others only thyroid, yet others reproductive endocrinology. Some are generalists. Some more difficult problems causing gynecomastia take experience and a passion for investigation. Just like any plastic surgeon may have some training in managing gynecomastia, those with experience and a passion for this sculpture tend to have quite a different result than others. For more basic screening, starting local is often a reasonable option unless, in calling an endocrinologist's office, the secretary asks you "what is gynecomastia?" That is one I would tend to avoid.  There are tertiary endocrinologists, who also have started using remote discussions for problem cases reviewing local endocrinologists work ups and testing.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[umdterps]

Thank you for your replies Dr. Bermant and Dr. Jacobs. I think its really cool that you both can find time in your extremely busy lives to respond to forum posters. Thumbs up to both of you.   

Dr. Bermant, approximately how long are surgeries scheduled in advance? I know there is an interview process, and things can vary. I'd imagine more people get this surgery done in the summer? I've read everything I could find on your site which I found very helpful. Once I get my blood work looked at, and make sure this growth is under control and that I'm okay, I'd like to have the surgery performed this year... hopefully with time to still enjoy summer.

[DrBermant]

Thank you for your replies Dr. Bermant and Dr. Jacobs. I think its really cool that you both can find time in your extremely busy lives to respond to forum posters. Thumbs up to both of you.   

Dr. Bermant, approximately how long are surgeries scheduled in advance? I know there is an interview process, and things can vary. I'd imagine more people get this surgery done in the summer? I've read everything I could find on your site which I found very helpful. Once I get my blood work looked at, and make sure this growth is under control and that I'm okay, I'd like to have the surgery performed this year... hopefully with time to still enjoy summer.

Yes you would need to start with a consultation or our Preliminary Remote Discussion (which patients use to minimize travel to Richmond). Actually we have patients who have this done all year long, each has their reasons for having the surgery done at that time. For some it is summer, others fall, winter or spring. Thank you for your comments about my resource on the web, I wrote the entire site myself.

Jane is my office manager and can better discuss what time we have available and lead times needed.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[umdterps]

Dr. Bermant,

Thank you for your reply. I finally was able to schedule appointments with two different endocrinologists, a general endo and one who specializes in sex hormone disorders, but was unable to get my first appointment until the end of March. As soon as I feel like this growth is under control I'll be in contact with your office manager.

If you don't mind, I'd like to ask one more question that perhaps you or Dr. Jacobs could answer.

I notice that my gyno doesn't look as bad when I rise in the morning compared to when I go to bed. My two lumps feel bigger and stick out farther in the evening. I know that when the nipples are erect, it tends to hide the growth but this is not what I'm referring to.

My guess would be that hormones fluctuate throughout the day, with testosterone being lowest at night and highest in the morning? I know this particular question is better suited for a hormone specialist but my main concern is could this effect the success of the surgery since the mass feels bigger and more pronounced in the evening? I assume most surgeries are conducted in the morning or afternoon. Any thoughts on this?

Thanks for any help.

[Dr. Elliot Jacobs]

Can't offer a quickie explanation of your different findings in the morning and the evening -- but rest assured your breast tissue is not expanding and contracting on a daily (or hourly)  basis.  Your findings could be more due to water retention (swelling), normal physiologic changes in your nipples (due to temperature), etc.

When surgery is performed, it is not affected by the time of day that the operation is done.

Dr Jacobs

[DrBermant]

Dr. Bermant,

If you don't mind, I'd like to ask one more question that perhaps you or Dr. Jacobs could answer.

I notice that my gyno doesn't look as bad when I rise in the morning compared to when I go to bed. My two lumps feel bigger and stick out farther in the evening. I know that when the nipples are erect, it tends to hide the growth but this is not what I'm referring to.

My guess would be that hormones fluctuate throughout the day, with testosterone being lowest at night and highest in the morning? I know this particular question is better suited for a hormone specialist but my main concern is could this effect the success of the surgery since the mass feels bigger and more pronounced in the evening? I assume most surgeries are conducted in the morning or afternoon. Any thoughts on this?

Thanks for any help.

Hormones do fluctuate through out the day, but gland changes much more slowly for size. Hormonal changes can affect gland tenderness and sensitivity more rapidly. This tenderness is from gland stimulation. Such stimulation can firm the gland making softer gland feel differently. This different feeling is more one of sensitivity than size. It is possible that stimulated gland can be firmer, but that something that I have never seen studied or proven by testing.

This is why those with endocrine issues are better stabilized first before considering surgery.

Dr. Bermant,

Thank you for your reply. I finally was able to schedule appointments with two different endocrinologists, a general endo and one who specializes in sex hormone disorders, but was unable to get my first appointment until the end of March. As soon as I feel like this growth is under control I'll be in contact with your office manager.

We look forward to helping you explore your concerns. Jane is my office manager.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction