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A Detailed Explanation Of Gynecomastia Essay

2038 words - 8 pages

What is Gynecomastia?DefinitionGynecomastia is a common disease of the male breast where there is a benign glandular enlargement of that breast at some time in the male's life. It usually consists of the appearance of a flat pad of glandular tissue beneath a nipple which becomes tender at the same time. The development may be unilateral or bilateral. There is rarely a continued growth of the breast tissue; ordinarily the process is of brief duration and stops short of the production of permanent enlargement of the breast.CausesA great number of patients who suffer from this disease have a disturbance in the proper ratio of androgen and estrogen levels. The normal ratio of the two hormones in plasma is approximately 100:1. "The etiology of gynecomastia in patients with a known documented cause appears to be related to increased estrogen stimulation, decreased testosterone levels, or some alteration of the estrogens and androgen so that the androgen-estrogen ratio is decreased"(Williams 373). From this information it was discovered that there is also a lower ratio of weaker adrenal androgens (delta 4-androstenedione and dehydroepiandrosterone) found in youths with this disease. It was once believed that there was an imbalance in the ratios of testosterone to estrogen or estradiol, but this is now know to be untrue.There are three areas the can be attributed to the cause of gynecomastia: physiologic, pathologic and pharmacologic. "Enlargement of the male breast can be a normal physiologic phenomenon at certain stages of life or the result of several pathologic states."(Isselbacher, 2037)In the case of physiologic gynecomastia the disease can occur in a newborn baby, at puberty or at any time in a man's life. In the newborn, transient enlargement of the breast is due to the action of maternal and/or placental estrogens. The enlargement usually disappears within a few weeks. Adolescent gynecomastia is common during puberty with the onset at the median age of 14. It is often asymmetrical and frequently tender. It regresses so that by the age of 20 only a small number of men have palpable vestiges of gynecomastia in one or both the breasts. Gynecomastia of aging also occurs in otherwise healthy men. Forty percent or more of aged men have gynecomastia. One explanation is the increase in age in the conversion of androgens to estrogens in extra-glandular tissues. Drug therapy and abnormal liver functioning can also be causes of gynecomastia in older men.When the disease is pathologic the patient can have increased estrogen secretions, increased conversion of androgens to estrogens or decreased androgen activity due to a failure in protein receptors. Increased estrogen secretions are found in such diseases and disorders as Hermaphroditism, Kleinfelter's syndrome, congenital adrenal hyperlasia, and adrenal carcinoma or testicular tumors. In the second case some examples are adrenal carcinoma, liver disorders, malnutrition and thyroidtoxicosis. Decreased...

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