Gynaecomastia in 786 adult men: clinical and biochemical findings

TY - JOUR

T1 - Gynaecomastia in 786 adult men

T2 - clinical and biochemical findings

AU - Mieritz, Mikkel G

AU - Christiansen, Peter

AU - Jensen, Martin Blomberg

AU - Joensen, Ulla N

AU - Nordkap, Loa

AU - Olesen, Inge A

AU - Bang, A Kirstine

AU - Juul, Anders

AU - Jørgensen, Niels

N1 - © 2017 European Society of Endocrinology.

PY - 2017/5

Y1 - 2017/5

N2 - OBJECTIVE: Gynaecomastia is a benign proliferation of glandular tissue of the breast; however, it is an important clinical observation because it can be the first symptom of an underlying disease. Some controversy exists concerning the clinical importance of an in-depth investigation of men who develop gynaecomastia. We hypothesise that a thorough work-up is required in adult men with gynaecomastia.DESIGN: All adult men (n = 818) referred to a secondary level andrological department at Rigshospitalet in Copenhagen, Denmark during a four-year period (2008-2011) under the diagnosis of gynaecomastia (ICD-10: N62) were included.METHODS: Thirty-two men who did not have gynaecomastia when examined were excluded; leaving 786 men for final analyses. They underwent an andrological examination, ultrasound of the testicles and analysis of endogenous serum hormones levels.RESULTS: In 43% of men with adult onset of gynaecomastia (≥18 years) an underlying, and often treatable, cause could be detected. In men younger at onset an underlying cause for gynaecomastia could be detected in merely 7.7%. The study is limited by the fact that we did not have access to investigate men who were referred directly by their GP to private clinics for plastic surgery or who sought cosmetic correction without consulting their GP first.CONCLUSIONS: Our study demonstrates the importance of a thorough examination and provides a comprehensible examination strategy to disclose the underlying pathology leading to the development of gynaecomastia in adulthood.

AB - OBJECTIVE: Gynaecomastia is a benign proliferation of glandular tissue of the breast; however, it is an important clinical observation because it can be the first symptom of an underlying disease. Some controversy exists concerning the clinical importance of an in-depth investigation of men who develop gynaecomastia. We hypothesise that a thorough work-up is required in adult men with gynaecomastia.DESIGN: All adult men (n = 818) referred to a secondary level andrological department at Rigshospitalet in Copenhagen, Denmark during a four-year period (2008-2011) under the diagnosis of gynaecomastia (ICD-10: N62) were included.METHODS: Thirty-two men who did not have gynaecomastia when examined were excluded; leaving 786 men for final analyses. They underwent an andrological examination, ultrasound of the testicles and analysis of endogenous serum hormones levels.RESULTS: In 43% of men with adult onset of gynaecomastia (≥18 years) an underlying, and often treatable, cause could be detected. In men younger at onset an underlying cause for gynaecomastia could be detected in merely 7.7%. The study is limited by the fact that we did not have access to investigate men who were referred directly by their GP to private clinics for plastic surgery or who sought cosmetic correction without consulting their GP first.CONCLUSIONS: Our study demonstrates the importance of a thorough examination and provides a comprehensible examination strategy to disclose the underlying pathology leading to the development of gynaecomastia in adulthood.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biomarkers/blood

KW - Denmark/epidemiology

KW - Gynecomastia/blood

KW - Humans

KW - Male

KW - Middle Aged

KW - Testosterone/blood

KW - Young Adult

U2 - 10.1530/eje-16-0643

DO - 10.1530/eje-16-0643

M3 - Journal article

C2 - 28179453

SN - 0804-4643

VL - 176

SP - 555

EP - 566

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

IS - 5

ER -