Types of gynecomastia and features of their treatment

Gynecomastia is the growth of mammary glands of female type in men. The degree of manifestation of mammary glands may range from 1 cm up to a full sized female breast. Violation does not bring physical discomfort to a man, but introduces an imbalance in the male form and causes psychological discomfort.

Anatomical types of gynecomastia:

Gynecomastia has three types:

• True pathology is being formed by the glandular tissue growth. Changes in the male body occur that lead to the formation of breast on the basis of the female breast. The chest becomes solid to touch, glandular cells may be palpated, the sensitivity of the nipples may increase and discharge from them may emerge.
• False pathology is the result of fatty tissues proliferation. Visually the patient’s breast acquires a circular shape, but there is no proliferation of glandular tissues. Chest of the man is soft to the touch with a homogeneous structure.
• Mixed pathology combines the changes of the true and false type.

Gynecomastia can vary by the type of localization. It can be single-sided, with an increase of only one of the glands, or two-sided, when the tissues increase evenly on both sides.

Types of gynecomastia

The disease is classified according to the reason that it has caused.

1. Physiological pathology may develop in infants, adolescents and the elderly people.

   • Infants. The mother’s hormones may influence on the formation of mammary glands. The boys may have an imbalance towards estrogen after birth, causing the breasts to grow. Symptom passes off on its own in some time after birth.
   • Adolescents. Gynecomastia develops in 10-14 years as a result of an imbalance of male and female hormones. Often the violation does not bring much discomfort, but in rare cases may increase the breast up to 10-14 cm, which leads to the displacement of the nipple-areola area. Such symptoms require areola plastics after completion of puberty.
   • Elderly people. At the age of 50-55 years the hormone levels are violated towards the estrogens increase. Violation does not require the use of testosterone therapy but may require plastic surgery.

2. Gynecomastia as a result of testosterone deficiency

   It may be developed when there is insufficient production of the hormone or there is a prevalence of estrogen or reduction of the organism’s susceptibility to it.

3. Causes of occurrence:

   • Genetic disorders;
   • Injury, dysfunction or absence of the testes;
   • Testicular tumor;
   • Liver or thyroid diseases.

4. Gynecomastia as a result of taking drugs.

   The risk group includes athletes who take drugs for increasing of muscle mass. The development of gynecomastia may come as a result of formulations containing testosterone. Also a number of drugs for the treatment of prostate diseases, antifungal drugs, drugs for tuberculosis or tricyclic antidepressants may be the reason for the violation.

5. If the causes of the violations have not been identified, the presence of idiopathic gynecomastia is indicated.

Stages of gynecomastia development

There are 3 stages of the disease and complexity of the therapy depends on the degree of desolateness.

• The first stage is indicated by a slight seal in the nipple area. The seal size corresponds to the size of the nipple area, i.e. does not exceed 0.5 cm.
• During the second stage the seal extends into the areola and corresponds to its size.
• During the third stage the expansion of the area goes beyond the areola.

If we divide the disease into periods, the formation of breast enlargement takes an average of up to 1 year. During this period, it is possible to eliminate the problem by conservative treatment. If you do not start treatment, the glandular tissue overgrown as a result of inflammation can be replaced by connective tissue and continues to grow uncontrollably. In this case, it needs a surgery.

In some cases the problem can result in malignant transformation. The risk group includes men and elderly people who suffer from gynecomastia for a long time without proper treatment. Alarming symptoms include bloody discharges from the nipple, seals in tissues, pain in lymph nodes.

Diagnostics

If the violation occurs in patients during their in adolescence life and has no lingering symptoms, the diagnosis is limited to inspection. In other cases, in the presence of complications such as itching and discharge from the nipple, a set of activities can be assigned to the patient.

The following is included in the diagnostics:

• Anamnesis collection (estimation of the patient's lifestyle, sports type, nutrition quality, information about the drugs taken by the patient, the presence of chronic diseases);
• Blood test for hormones;
• Inspection of suprarenal capsules in case of excessive testosterone;
• Breast and testicles ultrasound inspection;
• Mammography;
• Tissue biopsy;
• Ultrasound inspection of the patient’s thyroid.

In order to ask for help timely, it is necessary to carry out self-diagnosis. It is necessary to examine the mammary gland for enlargement or the presence of seals visually and by the touch, check for nipple discharges and pain in the subaxillary lymph nodes.

Aspects of treatment

Methods of treatment depend on the stage of the disease and its type.

• Treatment of false types

  For the treatment of false gynecomastia that has developed less than a year ago, conservative methods were prescribed for the patients. Doctors recommend stop drinking beer and strong alcohol as well as eating foods with a high content of carbohydrates and fats. A number of exercises that activate weight loss are appointed as well. These include running, cycling classes and orbitrek, push-ups and swings with arms with using the dumbbells.

• Treatment of true type

  The administration of drugs designed to normalize the hormonal balance is prescribed for a man. The multivitamin is prescribed as well. If the violation is caused by the medicines, which are prescribed as a therapy for other diseases, their replacement with other drugs is made.

  If the pathology is observed for more than a year and there is a risk of malignant transformation, the operation is performed. False type is being removed by the surgeon by means of liposuction - operation of pumping of the breast area adipose tissue. True type is eliminated by mastectomy. During the procedure the plastic surgeon makes an incision in the areola and removes the glandular tissue through it. The cosmetic seams are applied on the breast after the plasty. Tissues extracted during surgery may be further directed for examination in order to exclude the possibility of malignant transformation.