Another comprehensive paper on gynecomastia

[Hypo-is-here]

http://www.endotext.org/male/male14/male14.pdf


Some notable quotes verbatim made within are;

Quote
In fact, androgen deficiency (hypogonadism) from whatever cause constitutes most cases of gynecomastia.
Unquote

A very bold comment, I'm not sure if the association is as strong as that stated, but certainly it concurs with every single decent medical paper in recent years that clearly states how significant hypogonadism is as a cause for gynecomastia. 


Under the title "Laboratory Evaluation" this paper supports the campaign I have been waging on this site for the past two years, that of the need for all gynecomastia patients to have an endocrine referral with an appropriate specialist.

Quote
All patients who present with gynecomastia should have serum testosterone, estradiol, LH and HCG measured.  Further testing should be tailored according to the history, physical examination and the results of these initial tests
Unquote

It doesn't quite go far enough for me, in that I think more initial tests should be undertaken, nevertheless it supports the need for every man with gynecomastia to have blood pathology to attempt to ascertain the cause of their gynecomastia, in conjunction with an appropriate consultation.

The need for an expert in the aetiology of gynecomastia- an experienced hormonal specialist/endocrinologist as opposed to a gp is again is highlighted by;

Quote
In order to properly diagnose the etiology of the gynecomastia, the clinician must understand the hormonal factors involved in breast development
Unquote


A quote that highlights the fact that glandular excision is appropriate to remove glandular tissue is detailed below;

Quote from Title "Surgical Treatment".
This includes the removal of glandular tissue coupled with liposuction, if needed. 
Unquote

There is no mention of lipo suction only, a procedure that we have seen fail many men on this website for several years.


Another notable quote or at least what is implied (or perhaps my inference drawn) relates to what many have argued here on the site;

quote
It is important to remember that some cases of pubertal gynecomastia may resolve spontaneously
Unquote

The above says that "some" cases "may" resolve.  This is a far cry from the idea that most cases of this nature resolve, something that many people have doubted.  This statement would appear, at least in my view to lend some credence to that view.


But forget my quotes, read the paper for yourselves and pick up what you can; though difficult in parts it is worth persevering with.










 

[Mr_Nip]

I'll admit that I didn't have time to read the whole document, but I did glance over a few sections.  Thanks for sharing it and pointing out some of your personal observations.  It's good to see that it gives validation to some of the things we've observed and been saying in these boards.   

[headheldhigh01]

kind of scanned it through, it's an 18 page pdf though a dense read at times.  complex mechanisms, interesting diagnosis flow chart. 

the digitalis reference seemed strange since you would think binding to e receptors would inhibit rather than promote gyne? 

no reference to the recent connections to melaleuca (tea tree oil) and/or lavender i think it was, though the text may have predated them.   

diagnosis defined as 2 cm or greater subareolar tissue.  another hit against dismissing "mild" cases. 

also interesting they refer to medical treatment, p.12, though i still think, and they kind of hint, that wouldn't help the advanced stuff.  i wouldn't mind a placebo effect though, 12%'s not bad, maybe time to whip up a few sugar pills

There is no mention of lipo suction only, a procedure that we have seen fail many men on this website for several years.

true, and though i had thought it worked fine for many and would have deserved a mention too, it leaves you wondering if there's more residual tissue after those procedures than you'd expect. 

p.s.  nice new avatar mr nip