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Gynaecomastia

Gynaecomastia: Free advice – ask me today!

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By Dr Helen Webberley MBChB MRCGP MFSRH | GMC no. 3657058

I am a GP and a sexual health and hormone specialist. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.

Gynaecomastia

 

Gynaecomastia (or ‘gyno’) is the development of excess breast tissue in men. It may be related to a hormone imbalance, with too much of the female hormone oestrogen, circulating in the blood. It commonly occurs in men who are overweight, when testosterone is converted to oestrogen in the fat cells, but also can  occur in men who are very fit and work out regularly. In these men it may be particularly distressing because the breast tissue is more obvious when overlying well developed pectoral muscles. It can be reduced with medication but if more severe, may even need breast reduction surgery.

Frequently Asked Questions

Why have I got gyno (gynaecomastia)?
It is probably caused by a hormonal imbalance, with too much of the female hormone oestrogen, in relation to the male hormone, testosterone. This leads to the development of breast tissue.

There is no doubt that being overweight is a risk factor for gynaecomastia as testosterone may be converted to oestrogen in fat cells, as their molecules are very similar in shape. Some overweight men have more fat over their breasts but this is not gynaecomastia.

In some men there is no obvious cause for the gynaecomastia.

Is gynaecomastia (gyno) the same as breast cancer?
No. Gynaecomastia is the development of benign breast tissue in men. Although the breasts may feel lumpy it is extremely unusual for them to become cancerous. If you are at all concerned then you should seek medical advice and have them properly examined.
Is gynaecomastia related to age?
Gynaecomastia can occur at any age. It is common in newborn boys as they still have high levels of maternal oestrogen in their bloodstream. It is also common at the time of puberty when there are large shifts in levels of oestrogen and testosterone. This usually settles once puberty finishes.

In older men, testosterone levels may fall off leaving relatively higher levels of oestrogen, which again may cause breast development.

Can anabolic steroids cause gynaecomastia (gyno)?
Yes they can. It is sometimes difficult to be certain whether the anabolic steroids have directly caused gynaecomastia as users often take other performance enhancing medication as well. These may include, spironolactone, growth hormone and human chorionic gonadotrophin (HCG).

However the association between anabolic steroids and gynaecomastia has been well proven.

Are there medical treatments for gynaecomastia?
There are several different approaches to treating gynaecomastia. As gynaecomastia probably occurs as a result of having too much oestrogen compared to testosterone, then correcting this hormone imbalance can be beneficial.

Weight reduction can have significant effects on gynaecomastia and this may be all that is needed.

The drug, tamoxifen (which has been used for years in treating breast cancer), blocks oestrogen receptors on cells, not allowing oestrogen to exert its effect.

Clomid works in a similar way to tamoxifen.

Aromatase inhibitors (including anastrozole and letrozole), block the conversion of testosterone to oestrogen, lowering oestrogen levels in the blood and these may also have a beneficial effect on gynaecomastia.

Medication

Tamoxifen

This drug which has been used for years to treat breast cancer, can be very helpful in gynaecomastia. It blocks the receptors that oestrogen attaches to, so that the oestrogen can’t exert its effect. It is very safe and well tolerated

Clomid (clomiphene)

This drug has also been used for years for improving fertility in women. It acts by blocking oestrogen receptors in the same way that tamoxifen does. It is very safe and well tolerated.

Aromatase inhibitors

These include anastrozole (arimidex) and letrozole. They act by preventing the conversion of testosterone to oestrogen, thereby lowering oestrogen levels in the blood. They can be highly effective in treating gynaecomastia and are very safe.

Safe, real prescriptions for Gynaecomastia.

Blood Tests

Hormone profile

This includes oestrogen, FSH, testosterone, free testosterone and sex hormone binding globulin

Liver function test

Just occasionally gynaecomastia can be associated with liver problems and so it is important to exclude this as a cause.

Contact me now for advice, prescriptions, blood tests and referrals.

Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness.

It is never to be used in the case of a medical emergency.

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