Gynecomastia history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

The hallmark symptom of gynecomastia is breast enlargement. The majority of patients with gynecomastia are asymptomatic. Pain is a common symptom in gynecomastia. Less common symptoms depend on the underlying cause.

• Physiological gynecomastia has trimodal distribution occurring in neonatal, in pubertal age and in the elderly.^[1][2]
• Pathological gynecomastia can occur at any age secondary to any condition causing increased free estrogen to androgen ratio.

• Gynecomastia is associated with a past medical history of cirrhosis, chronic renal disease, hyperthyroidism, orchitis, trauma to testis or use of medications (eg, prescription medications, over-the-counter medications, recreational drugs).^[3][4]

• Patients may have a history of use of illicit drugs or decrease in libido which might suggest hypogonadism.^[5]

Common symptoms include:^[4]

• Breast pain
• Breast enlargement

Less common symptoms of gynecomastia include:^[4]

• Symptoms of chronic liver disease
  • Abdominal distention secondary to ascites
  • jaundice
• Symptoms of chronic kidney disease
  • Persistent nausea
  • oliguria
  • fluid retention
  • fatigue
• Symptoms of hyperthyroidism
  • weight loss
  • tremors
• Symptoms of depression
  • Decreased sleep
  • Decrease appetite
  • Decrease concentration
• Symptoms of hypogonadism
  • Decreased libido

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