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Gynecomastia (gynaecomastia BE) is the development of abnormal breast tissue on men, small or large, and normally on both sides. The term comes from the Greek gyne meaning "woman" and mastos meaning "breast". The condition is common in adolescent boys, though in 90% of such cases the symptoms disappear in a matter of months to a few years at most; it may also occur in males of advancing years. It is generally a result of an imbalance in hormones, though there are many different possible root causes. Gynecomastia is not simply a buildup of adipose tissue but includes the development of glandular tissue as well. It may take a softer form or include a form of lump-like gland, which should not be confused for cancer.
Causes
Among the various potential causes of gynecomastia are puberty, steroid abuse, obesity, tumors, chronic liver disease, side effects of various medications including those with hormonal effects, castration, aging, and genetic disorders such as Klinefelter Syndrome and Gilbert's syndrome. Marijuana use and animal hormones are also thought by some to be possible causes, though these are still debated.
Medication that can cause gynecomastia includes cimetidine, omeprazole, spironolactone, finasteride and certain antipsychotics. Some act directly on the breast tissue, while other lead to increased secretion of prolactin from the pituitary by blocking the actions of dopamine (prolactin-inhibiting factor/PIF) on the lactotrope cell groups in that organ. Androstenedione, used as a performance enhancing food supplement, can lead to breast enlargement by excess estrogen activity. Although stopping these medications can lead to regression of the gynecomastia, surgery is sometimes necessary to eliminate the condition.
Prognosis
Gynecomastia is not physically harmful, though it can occasionally indicate more dangerous underlying conditions. Its chief destructive effects lie more subtly in social and psychological results, including depression, withdrawal, peer ridicule, and complicated or obstructed relationships. Weight loss may benefit an obesity-related form known as pseudogynecomastia, and endocrinological attention may help during the first approximately 2-3 years. After that window, however, the breast tissue tends to remain, leaving surgery (through either liposuction techniques, glandular excision, or both) the only known physical remedy, ideally by an experienced plastic surgeon.
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