Endocrinologist Results

[Corey10]

I am a male 25 years old 5'9 184lbs. I have unilateral gyno that started when I was 23. I have never taken steroids, but have taken some supplements around the age of 21. As of recently my gyno has doubled in size and is very painful.

I've been to 3 doctors and an endocrinologist. My blood work came back 100% normal. Every single doctor I've been to has been stumped by me. I'm not overweight and workout 5 times a week. I would say I have a muscular build with minimal body fat. What could possibly be the reason for this painful large tissue behind and around my left nipple? Any thoughts would really help. I can't be the only person having this type of problem and is unable to be diagnosed.

Thanks.

[patrickwkimball]

Hey Corey, how many times have you had your blood work done and what exactly was tested?

[Corey10]

It was done one time. I'm no doctor and do not have my receipt, so I'm not sure what was tested. I know my hormone levels were tested including testosterone as well as about 10 other things. I don't think much was left out on the blood test; the tech that did my test was surprised at the amount of things that were being done. 

[patrickwkimball]

I understand how frustrating it must be as I've experienced it myself.  I've been working with an endocrinologist for several months now and have had blood tests multiple times.  You'd be surprised at how much the levels can vary.  I would get three blood tests under your belt before you really start to analyze the findings.

If you're getting gyno without steroids or any other hormonal medication I would think it would have to be an imbalance between testosterone and estrogen.  Were your E2 levels checked? 

I wouldn't give up though.  Look up some of the more renowned doctors in your area for endocrinology and set an appt.  Keep meeting with specialists and don't give up but IMO one blood test doesn't provide enough evidence.  Something is going on with you hormonally you just may need to keep digging to find the answer.   

[Raider Fan]

Welcome to gyne.org, Corey10. 

If you're experiencing painful gynecomastia, that is generally an indication that it is in an "active" (growing) state.  My endocrinologist prescribed Tamoxifen to specifically deal with the pain.  It is very good for the pain that gyne can bring and typically works rather quickly.  Sometimes, you'll get lucky and the medicine will even result in the tissue decreasing.  However, that is usually more likely to happen in the early stages of gyne.  The sooner you get on the medication when you first notice symptoms, the greater the success rate seems to be. 

So you might ask your endo about Tamoxifen, or possibly an aromatase inhibitor, like Arimidex. 

Be advised, however, that both of these medications are not without possibly severe side effects.  You can discuss those with your doctor and decide if you want to try them.  Both of these meds are typically prescribed to women who have had breast cancer.  They usually take them for a long time (i.e., 5 years), whereas, you are more likely to try them only 2 or 3 months.

Good luck. 

[Dr. Elliot Jacobs]

Agree with all the above posts.

If you are experiencing pain, tenderness, growth, etc, it shows that your gyne is in the active state.  Hormonal blood tests are excellent -- but do not provide all the answers.  You should examine your life as well -- ie are you taking any medications which could have gyne as a side effect?  Are you taking supplements of any kind??

Surgery may still be in the offing for you -- but not now.  You should wait until everything stabilizes, the pain disappears, etc. And just be aware -- there are times when all the tests in the world cannot provide an answer for your problem -- medicine is frustrating at times.

Good luck!

Dr Jacobs

[DrBermant]

I am a male 25 years old 5'9 184lbs. I have unilateral gyno that started when I was 23. I have never taken steroids, but have taken some supplements around the age of 21. As of recently my gyno has doubled in size and is very painful.

I've been to 3 doctors and an endocrinologist. My blood work came back 100% normal. Every single doctor I've been to has been stumped by me. I'm not overweight and workout 5 times a week. I would say I have a muscular build with minimal body fat. What could possibly be the reason for this painful large tissue behind and around my left nipple? Any thoughts would really help. I can't be the only person having this type of problem and is unable to be diagnosed.

Thanks.

Unilateral Gynecomastia does exist, but is more often Uneven Gynecomastia where one side is larger than the other. Tenderness and growth can also be different on both sides. It is not common for the uninvolved side to have no tenderness at all for those with an underlying issue, yet even that can happen.

Gland growth and discomfort are common Symptoms of Gynecomastia that are better stabilized before surgery.  Although I target gland first, gynecomastia surgery does not stop further breast growth. Working with an experienced Endocrinologist can help find the Cause of Gynecomastia.  Unfortunately, endocrinologists like surgeons each have their skills and areas of expertise. This is an area of medicine that can take a meticulous Sherlock Holmes like personality to focus on a vague and sometimes hard to define issue.  Hormone levels also bounce up and down during the day in normal individuals. A good endocrinologist will need to know what time during the day the blood was drawn and the quality of the lab evaluating the result.

Stabilizing the problem before considering surgery is the best way to minimize the chance of recurrence.  Recurrence for my patients is quite rare, but I do see quite a few patients with recurrence and regrowth after other surgeons' operations when such issues are not stabilized first.

Until stabilization, Body Shaping Garments can provide temporizing contour control. They are an important emotional band-aid for those stressed out about the shape yet need to get something under control first.

Hope this helps,

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