What are the symptoms of breast hyperplasia in men?

Most patients with breast hyperplasia are women, but not only women can suffer from breast hyperplasia. Some men may also suffer from breast hyperplasia. The main symptoms of breast hyperplasia in men are local dull pain or pain when touched, and the areola and nipple may become larger. Some patients even have white secretions when the nipples are squeezed.

Symptoms and signs

Men have palpable breast tissue on one or both sides, which is disc-shaped or diffusely enlarged, sometimes accompanied by enlarged nipples and areolas. Local pain or tenderness may be felt, and a small amount of white secretions may be seen when the nipples are squeezed. Pathological gynecomastia caused by organic diseases also has the clinical manifestations of the primary disease.

Medication

1. Dihydrotestosterone enanthate 200mg, intramuscular injection once every 3 to 4 weeks. One group reported that after 3 months of treatment, the breast shrank by 67% to 78%. During the treatment period, plasma DHT increased, and the levels of LH, FSH, T and E2 were suppressed. They returned to normal after 2 months of discontinuation of the drug. There was no recurrence of the disease after 6 to 15 months of follow-up observation. At present, it is still in the trial stage, and no DHT preparation is available on the market.

2. Tamoxifen (tamoxifen) can bind to the estrogen receptors in the target tissue and block the effect of estrogen. The usual dose is 20 mg/d, taken orally in divided doses. Some people report that the breasts shrink significantly after taking the drug for one month. If the effect is not significant, the dose can be appropriately increased.

3. Clomiphene The mechanism of action is similar to that of tamoxifen. Oral administration of 50-100 mg/d has therapeutic effects in about 70% of patients to varying degrees.

4. Testosterone lactone inhibits aromatase and blocks the conversion of testosterone to E2 in the periphery. Some people report that 450 mg/d, taken orally in divided doses, has significant efficacy. No adverse reactions were found. After taking the drug, the ?4A level increased significantly, T, DHEA and E1 increased slightly, the ?4A/E1 ratio increased, and there was no significant change in the levels of LH, PRL and E2.

5. Chinese medicine Traditional Chinese medicine believes that male breast development is caused by liver qi stagnation and phlegm and dampness in the body. The treatment method should be to use drugs that soothe the liver and regulate qi, strengthen the spleen and resolve phlegm. Some people report that Xiaoyao Powder can be effective up to 90%, but unfortunately there is a lack of comparison.

6. Mammoplasty Due to the irreversibility of long-term delayed gynecomastia, mammoplasty is still an important means of treating this disease. Generally, a circum-areolar approach is used to remove the subareolar breast tissue.

Diet and Health

Eat light food and pay attention to eating habits.

Preventive care

Stop taking and using drugs that may cause male breast development. If necessary, use it under the guidance of a regular hospital doctor and have regular checkups.

Pathological etiology

The growth of female breasts depends on the action of estrogen. Giving men estrogen can also lead to breast development, and it cannot be distinguished from male breast development caused by other reasons in histology. Therefore, it can be considered that all male breast development is caused by increased estrogen secretion or a decrease in the androgen/estrogen ratio. Excessive estrogen is the main cause of male breast development. Giving men exogenous estrogen preparations, such as estrogen treatment for prostate cancer patients, long-term use of estrogen by transgender men, and excessive estrogen secretion from adrenal or testicular tumors can all lead to breast hyperplasia. The etiology of male breast development is classified in Table 1.

Disease Diagnosis

A thorough understanding of the patient's medication history helps to identify drug-induced gynecomastia. A careful physical examination, including secondary sexual characteristics, testes, and body shape, plus sex hormone and gonadotropin measurements can help diagnose primary or secondary testicular hypofunction. Liver and kidney function tests can help diagnose liver and kidney failure. Cortisol and ACTH, 17-OHP, 17-ketosteroids and 17-ketogenic steroids can evaluate congenital adrenal hyperplasia. If the results of the above tests are normal, idiopathic gynecomastia can be diagnosed.

Inspection method

Laboratory inspection:

1. Gonadal hormone and gonadotropin measurement. It helps to diagnose whether there is primary or secondary testicular hypofunction.

2. Liver and kidney function tests. Helps diagnose liver and kidney failure.

3. Measurement of cortisol, ACTH, 17-OHP, 17-ketosteroids and 17-ketogenic steroids. It can be used to evaluate congenital adrenal hyperplasia.

Other auxiliary inspections:

1. Breast B-ultrasound and mammography. They can distinguish fat and breast tissue and rule out breast cancer in time.

2. Pathological examination of breast tissue for further diagnosis.