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ALL / Endocrinology
Gynaecomastia
Gynaecomastia
Gynaecomastia describes an abnormal amount of breast tissue in males and is usually caused by an increased oestrogen:androgen ratio. It is important to differentiate the causes of galactorrhoea (due to the actions of prolactin on breast tissue) from those of gynaecomastia
An example of gynaecomastia. There is a slight asymmetry in terms of the affected breast tissue
Causes of gynaecomastia
- physiological: normal in puberty
- syndromes with androgen deficiency: Kallman's, Klinefelter's
- testicular failure: e.g. mumps
- liver disease
- testicular cancer e.g. seminoma secreting hCG
- ectopic tumour secretion
- hyperthyroidism
- haemodialysis
- drugs: see below
Drug causes of gynaecomastia
- spironolactone (most common drug cause)
- cimetidine
- digoxin
- cannabis
- finasteride
- GnRH agonists e.g. goserelin, buserelin
- oestrogens, anabolic steroids
Very rare drug causes of gynaecomastia
- tricyclics
- isoniazid
- calcium channel blockers
- heroin
- busulfan
- methyldopa
+PassMedicine Notes
Gynaecomastia describes an abnormal amount of breast tissue in males and is usually caused by an increased oestrogen:androgen ratio. It is important to differentiate the causes of galactorrhoea (due to the actions of prolactin on breast tissue) from those of gynaecomastia
Causes of gynaecomastia- physiological: normal in puberty
- syndromes with androgen deficiency: Kallman's, Klinefelter's
- testicular failure: e.g. mumps
- liver disease
- testicular cancer e.g. seminoma secreting hCG
- ectopic tumour secretion
- hyperthyroidism
- haemodialysis
- drugs: see below
- spironolactone (most common drug cause)
- cimetidine
- digoxin
- cannabis
- finasteride
- GnRH agonists e.g. goserelin, buserelin
- oestrogens, anabolic steroids
- tricyclics
- isoniazid
- calcium channel blockers
- heroin
- busulfan
- methyldopa