Considering surgery, hormonal treatment or both , need advice please!

[mayer albert]

I am 25 years and 6 months and suffering from gynecomastia since puberty, or before
This has caused many social and personal problems to me and the gynecomastia was accompanied by other symptoms, and I think it is related to gynecomastia too like frequent urination, as well as my hair appeared to falling from about the year.

I have conducted many tests to diagnose the situation

I make these tests (Fasting blood glucose, Blood glucose 2 hrs p.p, Urine examination, Urine cytology: microscopic hematuria, Blood chemistry (NA, AST ,  ALT ,  TP , ALP  ,  GLOB , CREA A/G)
Abdominal and pelvic ultrasonography (liver, spleen, gall bladder, pancreas and para-aortic area, kidney, urinary bladder, prostate, no pelvic masses or fluid collection) and result was normal



When I make hormones tests, found it’s not to regularly as follows

PRL result 19.70 where normal range 2.5 to 17.5 ng/ml (increased)

Testosterone result 234.00 where normal range to male (20:49) is 270 to 1730 ng/ml (decreased)

Progesterone result 0.28 ng/ml (I don’t know it’s good or not) 

LH result 4.13 where normal range 0.8 to 7.6 mli/ml (seem good)




I feel some confusion and overlapping information so I want some clarification

1 - I want a list of all the necessary tests to make sure that the state of gynecomastia is caused by an irregularity in hormones

2- In the case of considering surgery without hormonal treatment is this enough to end the gynecomastia and did not return

3- Considering surgery as a quick treatment for gynecomastia with hormonal treatment too or preferably start hormone therapy only

4-hormonal treatment is safe or not and can affect sexual ability and to have children as well as

Please explain with details because I search through the internet but I was not able to find cogent answers to these questions

for further clarification i upload 15 images to imageshack.com so you can go to link and see the images (right click on icon and choose copy the image url and paste it in your browser or u will find the link in attachment as a website didn't support to link to another website  but the images are in bigger size to attach )



or just take this link and paste it in your browser     imageshack.com/a/9J1z/1    to see the images



Thanks for your help

[mayer albert]

i didn't receive any reply
is there any thing wrong in my question to explain  it .

[Litlriki]

Sorry to hear about your problems with gynecomastia.  Some of the questions you are posing are beyond the expertise of those of us who answer these questions.  The complexities of the hormonal milieu surrounding sexual development and function are complex, and that's why they are cared for as a subspecialty in medicine, "Endocrinology."  Granted, endocrinologists deal with problems not only of sexual hormones, but also diabetes and other less common conditions.  Your questions regarding evaluation and management of those hormones are better posed to an endocrinologist if it appears your results are not normal.

Additionally, we don't know your history beyond the fact that you've had gynecomastia since puberty.  Since this is a common condition arising during puberty, few children undergo extensive evaluation unless there is some other issue that compels that analysis. In most cases, simple tests will show an aberration in hormonal levels, but further testing to determine the cause is again beyond most of our expertise and would be conducted by an endocrinologist.  In undergoing such evaluation, you should indicate any medications, herbal and "over-the-counter" or "over-the-internet" remedies you've used, and you should provide details of other symptoms to your physician. We have none of this information, and it's not really possible for us to fully assess that information and provide you with feedback of the extent you've requested in this forum.

In other words, your questions are really too hard and the answers too complex to be adequately addressed here.  Someone is doing the testing you've described. You should ask him or her to clearly explain what they are doing and why. Your internet research should serve to clarify the information, not to provide you with diagnosis or treatment.

Good luck,

Rick Silverman