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Gynecomastia

Franklyn C. Babb, FAAFP, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Benign glandular proliferation of male breast tissue

  • Increase in estrogen activity relative to androgen leads to the development of gynecomastia.

  • Gynecomastia can be transient and may ...

DIAGNOSIS

HISTORY

  • If suspicious of hypogonadism, ask about erectile dysfunction, muscle mass, and decreased shaving frequency and libido.

  • Obtain a family history including Carney complex and Peutz-Jeghe...

TREATMENT

GENERAL MEASURES

  • Gynecomastia usually regresses spontaneously within 6 months of onset. Monitor for the first 6 months.

  • Neonatal and pubertal gynecomastia spontaneously resolves within 6 to 24...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Every 3 to 6 months for 24 months; consider medical therapy (i.e., tamoxifen) if severe, painful symptoms persist after 6 to 12 months and surge...

REFERENCES

1
Kanakis GA, Nordkap L, Bang AK, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019 Nov;7(6):778-793. 

SEE ALSO

Algorithm: Gynecomastia 

CODES

ICD10

N62 Hypertrophy of breast 

SNOMED

  • 4754008 Gynecomastia (disorder)

  • 237451004 Pubertal gynecomastia

  • 237449003 Drug-induced gynecomastia

  • 237450003 HCG-induced gynecomastia

  • 431498001 Idiopathic gynec...

CLINICAL PEARLS

  • Gynecomastia can be transient and may represent normal physiologic changes in neonates or adolescents. Gynecomastia presenting or persisting in adulthood is pathologic.

  • Lab and radiolog...

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