Evaluation of breast enlargement in young males and factors associated with gynecomastia and pseudogynecomastia
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Gynecomastia is defined as a palpable enlargement of the mammary gland in males that is distinguishable from lipomastia. The aim of this study was to assess the prevalence and characteristics of different causes of breast enlargement in young males referred to our tertiary center, and evaluation of the factors associated with gynaecomastia.
Materials and methods
One hundred thirty-five male recruits aged 20–30 years were enrolled in the study. A control group comprising 32 age-matched healthy individuals aged 20–25 years was also studied.
Idiopathic gynecomastia (IG) was diagnosed in 31 of 135 patients (23%) and Klinefelter’ syndrome (KS) was diagnosed in 70 cases (52%). Patients with KS had significantly higher body mass index (BMI) and waist and hip circumference waist/hip ratio than the control group. FSH, LH and SHBG were significantly higher and DHEAS, free testosterone (fT) and total testosterone (tT) were lower in patients with KS than the control group. Anthropometric measurements revealed significant increase in body weight and BMI in patients with IG compared with healthy controls. FSH and LH levels were significantly higher in the patients with IG. Patients with pseudogynecomastia alone were not obese and hypogonadism was observed in 35.1% of patients.
We concluded that gynaecomastia in young adult males is mostly because of KS or idiopathic in origin. IG seems to be the result of androgen resistance and in part increased aromatization because of increased adiposity. Symptoms or findings for hypogonadism must be evaluated carefully in patients with pseudogynecomastia. We also suggest that the presence of both gynecomastia and azoospermia necessitate further karyotypic analyses for KS.
KeywordsYoung men Gynecomastia Pseudogynecomastia Klinefelter’ syndrome Hypogonadism
- 3.Behre HM, Yeung CH, Holstein AF, Weinbauer GF, Gassner P, Nieschlag E (2000) Diagnosis of male infertility and hypogonadism. In: Nieschlag E, Behre HM (eds) Andrology: male reproductive health and dysfunction, 2nd edn. Springer, Heidelberg, pp 90–124Google Scholar
- 4.Santen RJ (2006) Gynecomastia. In: Degroot LJ, Jameson JL (eds) Endocrinology, 5th edn. WB Saunders, Philadelphia, pp 3283–3293Google Scholar
- 7.Abramsky L, Chapple J (1997) 47,XXY (Klinefelter’ syndrome) and 47,XYY: estimated rates of and indication for postnatal diagnosis with implications for prenatal counselling. Prenat Diagn 17:363–368. doi: 10.1002/(SICI)1097-0223(199704)17:4<363::AID-PD79>3.0.CO;2-O CrossRefPubMedGoogle Scholar
- 13.Ley SB, mozaffarian GA, Leonard JM et al (1980) Palpable breast tissue versus gynecomastia as a normal physical finding. Clin Res 28:24AGoogle Scholar
- 27.Sorensen K, Nielsen J, Jacobsen P, Rolle T (1978) The 48,XXYY syndrome. J Med Genet 22:197–205Google Scholar
- 29.Nieschlag E, Behre HM, Meschede D, Kamischke A (2000) Disorders at the testicular level. In: Nieschlag E, Behre HM (eds) Andrology: male reproductive health and dysfunction, 2nd edn. Springer, Heidelberg, pp 133–162Google Scholar
- 30.Griffin JE, Wilson JD (2002) Disorders of the testes and the male reproductive tract. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS (eds) Williams textbook of endocrinology, 10th edn. Saunders, Philadelphia, pp 709–770Google Scholar
- 34.Bauduceau B, Reboul P, Le Guyadec T, Legrelle M, Mayaudon H, Gautier D (1993) Hormonal profile of idiopathic gynecomastia in young adults. Apropos of 488 cases. Ann Endocrinol (Paris) 54(16):3–167Google Scholar