Gynecomastia caused by steroids

In case of suspected drug-induced gynecomastia, it would be opportune considering a therapy discontinuation. In some cases, it could be helpful reducing the doses or substituting the suspected drug with another one belonging to the same class, but with a weaker association to gynecomastia. 3
Mammography scan allows distinguishing with certainty between gynecomastia and pseudogynecomastia. On the other hand, laboratory tests are necessary for identifying other possible causes, checking the renal, hepatic and thyroid functions and the free-circulating hormones levels. 2
Iatrogenic gynecomastia is generally reversible within 6 months or one year since its onset. If drug discontinuation is not enough or not possible (for example with anti-androgens), a therapy based on tamoxifene (20 mg daily) might be taken into consideration. In fact, despite not being approved for this indication, literature data suggest a response rate of 50-80% of cases, with detectable improvements from the first month of treatment. 3 In the rare eventuality of both drug dechallenge and tamoxifene therapy being unsuccessful, it is possible to resort to surgery or radiotherapy, according to the patient’s needs.

Gynecomastia is a common problem, particularly in male babies, teenagers and older men. Many cases need no treatment; however if the man finds the problem distressing he may seek help to remove the breast tissue. If drug treatment fails or is not possible, surgery may be carried out. It is important that the man’s expectations and understanding of the procedure are fully discussed before the procedure. The most common surgery for gynecomastia is a mastectomy, most commonly carried out by a plastic surgeon. This procedure aims to remove most of the breast glandular tissue to try and keep the problem from coming back. Although the procedure is usually straightforward and safe with good long-term outcomes, there can be some side effects such as pain after gynecomastia surgery. After a full discussion with the surgeon, the man may or may not feel surgery is worth undertaking. Following the procedure, most men are happy with the results of the surgery and the appearance of their chest.

True gynecomastia consists of increased fibrous tissue in combination with fat beneath the areola and surrounding skin.  Not infrequently the abnormal tissue is a few centimeters thick and 10-15 centimeters across.  It has a distinctly firmer texture than ordinary body fat.  It is often able to be isolated and moved over the pectoral muscle underneath.  Pseudo-gynecomastia consists of more soft and uniform fat under the skin.  The distinction is important to your surgeon, as it effects the treatment methods.  You may be able to make the distinction by feel, but the best way is to consult an experienced board certified plastic surgeon.  

The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.

  • Hyperthyroidism Hyperthyroidism is an excess of thyroid hormone due to an overactive thyroid gland. Symptoms can include increased heart rate, weight loss, heart palpitations, frequent bowel movements, depression, fatigue, fine or brittle hair, sleep problems, thinning skin, and irregular vaginal bleeding.

    Thank you for your question.  I dedicate a large portion of my plastic surgery practice to the treatment of male chest concerns and gynecomastia.  From your description of "puffy nipples", it sounds like you may actually have some degree of gynecomastia.  My preference in treating many patients with "puffy nipples" is a minimal-incision approach that will remove the gynecomastic/"glandular" tissue thru a tiny "puncture" incision. Many patients have "something" they feel under the nipple as you describe.  This causes the nipple to be "puffy" and more protuberant. I recommend a small incision approach and removal of this tissue.  This allows the nipple to settle back naturally, shrink in diameter to some degree typically without full incisions around the areolae, and it allows the nipple to become flatter in an easy outpatient or even office-based procedure.  I hope this is helpful.  Good luck!

    Gynecomastia caused by steroids

    gynecomastia caused by steroids

    The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.

  • Hyperthyroidism Hyperthyroidism is an excess of thyroid hormone due to an overactive thyroid gland. Symptoms can include increased heart rate, weight loss, heart palpitations, frequent bowel movements, depression, fatigue, fine or brittle hair, sleep problems, thinning skin, and irregular vaginal bleeding.

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