Pubertal gynecomastia normally occurs as a transient phenomenon of several months duration, whereas marked pubertal gynecomastia (more than 6 cm in diameter) may persist into aduldhood. In the present study the possible involvement of prolactin (PRL) secretion in the development of marked pubertal gynecomastia was investigated. The diurnal variations of PRL, luteinizing hormone (LH), follicle-stimulating hormone (FSH), as well as the basal values of testosterone (T) and estradiol (E2) were determined in 5 pubertal boys with marked gynecomastia and in 5 age-matched controls. Mean age of all patients was 14.4 years. The pubertal development was classified as P 3–4.
In comparison to controls, boys with marked gynecomastia revealed no differences in basal values of PRL, LH and FSH, as well as in peak values of all hormones during sleep. The response of PRL, LH and FSH to LHRH/TRH stimulation was normal for pubertal age in both groups. In comparison to controls, decreased mean plasma T levels (P<0.05) and slightly increased E2 levels (P<0.05) were found in boys with marked gynecomastia. The E2/T ratio was also higher in boys with gynecomastia (P<0.005).
These data suggest that prolactin, a hormone which may be increased in galactorrhea, is not involved in the development of marked pubertal gynecomastia in boys. The above findings suggest that slightly elevated day-time E2 levels may be involved in the development of female-appearing breasts in pubertal boys.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Hamer DB (1975) Gynecomastia. Br J Surg 62:326–329
Nydick M, Bustos J, Dale JH Jr, Chester P, Rawson RW (1961) Gynecomastia in adolescent boys. JAMA 178:449–454
Lee PA (1975) The relationship of concentration of serum hormones to pubertal gynecomastia. J Pediatrics 86:212–215
La Franchi SH, Parlow AF, Lippe BM, Coyotupa J, Kaplan SA (1975) Pubertal gynecomastia and transient elevation of serum estradiol level. Am J Dis Child 129:927–931
Tanner JM (1962) Growth at adolescence. Blackwell, Oxford, pp 28–39
Ehara Y, Yen SSC, Siler TM (1975) Serum prolactin levels during puberty. Am J Obstet Gynecol 117:995–997
Beck W, Wuttke W (1980) Diurnal variations of plasma LH, FSH and prolactin in boys and girls from birth to puberty. J Clin Endocrinol Metab 50:635–639
Bidlingmaier F, Wagner-Barnack M, Butenandt O, Knorr D (1973) Plasma estrogens in childhood and puberty under physiologic and pathologic conditions. Pediat Res 7:901–907
Large DM, Anderson DC, Laing I (1980) Twenty-four hour profiles of serum prolactin during male puberty with and without gynecomastia. Clin Endocrinol 12:293–302
Faulborn KW, Fenske M, Pitzel L, König A (1979) Effects of an intravenous injection of tetracosactid on plasma corticosteroid and testosterone levels in unstressed male rabbits. Acta Endocrinologica 91:511–518
Turkington RW (1972) Serum prolactin levels in patients with gynecomastia. J Clin Endocrinol 34:62–66
Marynick SP, Nisula BC, Pita JC Jr, Loriaux DI (1980) Persistent pubertal macromastia. J Clin Endocrinol Metab 50:128–130
Large DM, Anderson DC (1979) Twenty-four hour profiles of circulating androgens and oestrogens in male puberty with and without gynecomastia. Clin Endocrinol 11:505–521
Chaussain JL, Roger M, Brijani A, Georges P, Job JC (1978) Endocrine studies in boys with pubertal gynecomastia. Pediat Res 12:1086
Latorre H, Kenny FM (1973) Idiopathic gynecomastia in seven preadolescent boys. Am J Dis Child 126:771–773
Buckman MT, Maclean C, Peake GT, Rhodes JMd, Srivastava LS (1980) Absence of prolactin hypersecretion during sleep in men with gynecomastia. Horm Metab Res 12:344–345
About this article
Cite this article
Beck, W. Normoprolactinemia in boys with marked gynecomastia. Eur J Pediatr 137, 41–44 (1981). https://doi.org/10.1007/BF00441168