Considering surgery , need advice !

[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