Treatment of gynecomastia in adolescent boys. Causes and diagnosis of swelling of the mammary glands in adolescent boys At what age can the disease occur

Gynecomastia in adolescents is an increase in the size of the mammary glands, which occurs in boys aged 12-15 years. This condition occurs in about 30-50% of adolescents. Some boys do not pay any attention to youthful gynecomastia, others are psychologically difficult to endure incomprehensible changes in their bodies. Sometimes there is a need to treat this condition.

Because of what happens

Adolescent gynecomastia occurs during the period when boys are puberty, which is why it is also called pubertal gynecomastia. Youthful changes in the structure of the boy's body are explained by hormonal changes in the body, its temporary imbalance. This imbalance develops for several reasons:

Insufficient production of testosterone or the conversion of part of it into estrogens (female sex hormones).
The increase in body weight due to the adipose tissue of the boy (obesity in a teenager).
The use of certain medications by adolescents long-term treatment serious illnesses.
Tumors of the pituitary, testicles, adrenal glands.
Trauma and direct damage to the area of the mammary glands of a teenager.

The lack of testosterone production is facilitated by factors that change its synthesis by the testicles and adrenal glands. Most often this happens with youthful functional immaturity of these organs during puberty. With a "hormonal explosion" in boys, part of the testosterone can be converted into estrogens due to an increase in the activity of the aromatase enzyme. An increase in blood estrogen is manifested (except for gynecomastia) by acne of adolescence, increased oiliness of the skin, deposition of subcutaneous fat according to the female type (on the chest, hips, abdomen), and some nervousness.

Obesity in boys leads to the fact that adipose tissue deposits estrogens, which maintains a state of hormonal imbalance. Juvenile gynecomastia occurs when a teenager is treated for tuberculosis, HIV, severe liver and kidney diseases. The medications taken affect the synthesis of sex hormones in boys, increasing the content of blood estrogen. Regular drug use (including juvenile alcoholism, early initiation of smoking) leads to the same results.

A pituitary tumor (prolactinoma) stimulates the rapid growth of the mammary glands, gynecomastia in boys reaches a large size. In adolescents, prolactinoma causes a delay in sexual development due to inhibition of testosterone synthesis. Tumors, injuries, inflammation of the testicles, adrenal glands of adolescence can also cause a decrease in the level of male sex hormones, the appearance of an increase in the mammary glands during puberty. A rare option is their increase in a teenager due to their tumor, unilateral development of the process in boys is more common.

Signs and reasons for visiting a doctor

Pubertal gynecomastia appears at the age of a teenager of 12-15 years. Usually it does not cause inconvenience, as it passes quickly and imperceptibly in 1-2 years. In other cases, an increase in the mammary glands is accompanied by unpleasant symptoms:

Hypersensitivity of the nipple area.
Feeling of swelling of the chest area, painful induration.
Discharge from the nipples.
Visible increase in size.

An increase in the size of a teenager's breasts can be normal with age-related gynecomastia, not exceeding 1.5-2.5 cm. Large sizes have a different structure, they resemble a female breast in shape. They include:

Adipose tissue.
glandular tissue.
Mixed structure (both tissues meet).

The deposition of fat in the chest area is usually accompanied by general obesity of a teenager, as shown in the photo on the Internet. Excessive development of glandular tissue leads to its functioning, the release of a whitish liquid, much less often - bloody.

In all cases, when breast augmentation draws attention to itself, causes some inconvenience, is accompanied by a separated secret, an urgent visit to a doctor, examination, treatment is necessary.

How the doctor works

Gynecomastia, about which adolescents turn to a doctor (pubertal), always requires clarification of the cause before starting treatment. The large size of the mammary glands raises the suspicion of the presence of a prolactinoma (pituitary tumor). The unilateral course of the process can be with a banal inflammation or a malignant neoplasm (this is shown in the photo). In addition to a general examination, the endocrinologist prescribes an examination:

Detects the presence of enlarged lymph nodes axillary, cervical areas typical for inflammation or tumor formation.
V general analysis blood is looking for confirmation of their suspicions.
Be sure to conduct a study of blood hormones for the content of sex hormones, prolactin, thyroid hormones (their level is inversely related to prolactin).
MRI or CT scan of the head to look for a brain mass as the cause of the condition. Ultrasound of the abdominal cavity, testicles for the same purpose.
Biopsy for unilateral tumor process.

If the studies did not lead to the identification of the disease, all results are normal performance, there is no reason to worry. A teenager is recommended to adhere to the principles of a healthy lifestyle (normalize weight, include mandatory physical activity in the daily routine, which helps to quickly cope with hormonal imbalances). The best exercise for puberty is push-ups from the floor up to 25-30 times a day. How to perform push-ups can be found in the photo on the Internet. This exercise eliminates youthful excess fat in the pectoral muscle area, increases testosterone synthesis. Observe the patient until the end of puberty (usually until adolescence 18-19 years), if there is any reason.

We will describe when medicines are needed, an operation. When a neoplasm of the pituitary gland is detected in a teenager, the active use of medications begins. It is usually recommended to take Bromkriptin, its analogues for several months. If the tumor is large, it is removed surgically. If the tumor is found in the testicles, adrenal glands, breasts, they begin with surgical treatment. In the future, the hormonal level is corrected with pills or injections. These drugs are used to treat an unexplained cause of severe hormonal failure during puberty.

The operation can be performed on a teenager or after puberty for cosmetic purposes. It is possible to remove fat by liposuction or mastectomy (removal of the gland). Of such kind surgical treatment belong to the section of plastic interventions. What to choose specifically for each patient with juvenile gynecomastia, only an experienced doctor can advise.

Gynecomastia is quite common. This pathology is a significant increase in the mammary glands in men. The most common cause of this condition is hormonal problems in an adult male. The amount of estrogens in the blood is growing rapidly, and androgens - significantly reduced. Such a pathology is accompanied not only by aesthetic defects, but also adversely affects psychological condition person.

Before starting treatment, it should be established what exactly could lead to the appearance of such a pathological condition. To date, the most common causes of the development of the disease are:

an increase in the level of the hormone prolactin in the blood in a man
imbalance between estrogens and androgens
dysfunction of the pituitary gland
reception hormonal drugs to quickly increase testosterone in the blood
constant heavy physical activity
frequent drinking of beer
wearing an uncomfortable bra for women
taking certain antifungal medicines and diuretics
chronic liver disease
problems in the functioning of the gastrointestinal tract
frequent debilitating diets with an improperly selected diet
uncontrolled use of steroids by athletes

In some cases, pathology does not act as a separate disease, but is a consequence of other health problems. Gynecomastia in adolescents can also appear after prolonged use of hormonal drugs.

Gynecomastia in women and men, as well as the juvenile form of the disease, does not pose a particular danger to health in general. But if it is not cured in time, then the pathology can develop into breast cancer. In men, the mammary glands do not always increase evenly. It happens that one breast remains normal and does not cause any discomfort, while the second begins to hurt and protrude. Many men suffering from this disease have problems with the psychological state.

The main risk group is children and adolescents. Their hormonal background is established for a long time, which can affect their health. Elderly men are also susceptible to the development of pathology, in which the amount of androgens in the blood decreases during the aging process.

Gynecomastia in puberty often goes unnoticed, because in adolescence many men do not yet understand what exactly is happening to them, and do not attach much importance to changes in the body.

Classification of gynecomastia

Gynecomastia is usually divided into true and false.

MKB code 10 N62.

False gynecomastia is often found in overweight men. This happens due to rapid growth adipose tissue in the area chest. True gynecomastia is divided into the following forms:

pathological
physiological

The physiological form is quite easily treated at home. The main task of the therapy is to eliminate the main cause of the pathology. The following age groups of men are most susceptible to this form of the disease:

Newborns and children up to one year of age. In this case, the cause of gynecomastia can be the constant use of hormonal drugs during the bearing of the baby. This type of gynecomastia does not require special treatment and goes away without any medical intervention as the child grows.
Teenagers. Juvenile gynecomastia is quite common. Puberty in boys is characterized by hormonal changes and a surge of hormones. All this can lead to the predominance of female sex hormones over male ones. If there are no concomitant pathologies, then teenage gynecomastia is not treated in any way and disappears after a while on its own.
Elderly men. After 50 years in the body of a man, androgens practically cease to be produced, while female hormones are produced in the same amount. In this case, gynecomastia develops due to hormonal imbalance.

Experts also talk about unilateral gynecomastia, when only one gland suffers and increases in size, and about a bilateral form of the pathology, covering both mammary glands.

The presence of pathology is determined by the presence of specific symptoms. The main signs of gynecomastia directly depend on the stage of development of the disease:

At the very beginning, uncontrolled proliferation of connective tissue occurs. Gynecomastia affects both the smallest and largest thoracic ducts. This condition is usually observed for about 4 months. With proper treatment, the pathology does not develop further and recovery occurs.
The intermediate stage of gynecomastia is most often delayed up to six months. A man's chest is rapidly increasing in size due to excessive growth of glandular tissue.
The last stage is that connective tissue fibromatosis also joins the active growth of fat cells. All this leads to the appearance of seals in the thickness of the gland. In this case conservative treatment may not give positive results. It is better for a man to resort to the help of a qualified surgeon.

Gynecomastia in men is often accompanied by a specific discharge from the nipples that resembles colostrum. The patient may not experience any pain. He is only concerned about the heaviness and discomfort in the chest. Even in the case when only one gland is enlarged, the second one can also be covered by the pathological process.

If the pathology is bilateral or unilateral, but with specific seals that bring pain and discomfort, and the skin of the gland changes color and becomes tense, a man should immediately consult a doctor. In the case when an increase in axillary lymph nodes is added to the manifestations on the chest, we are talking about the presence of a neoplasm.

What is dangerous gynecomastia for men

Physiological gynecomastia does not pose a threat to a man's health. She can self-regress. In this case, there is only emotional and aesthetic discomfort, which eventually passes.

Nodular gynecomastia, as well as fatty gynecomastia in men, progresses rapidly and can provoke the appearance of breast cancer. This applies to both men and gynecomastia in women. Appearance spotting from the nipples and dense formations in the gland itself requires immediate medical attention.

Diagnosis of the disease

Often the question arises which doctor to contact for the final diagnosis of gynecomastia. In this case, a man should contact an endocrinologist. After a thorough examination, palpation and examination of complaints, the patient may be referred for such additional examinations:

blood chemistry
Ultrasound of the scrotum and bilateral examination of the mammary glands in a man
CT scan of the lungs
MRI of the adrenal glands

If, when studying the results of the tests, a significant increase in the average level of the hormone hCG and estradiol is revealed, the man will definitely need to undergo studies that will help exclude the presence of malignant tumor. If comorbidities are identified, they require immediate treatment.

Treatment in this case depends on the cause that caused the appearance of gynecomastia in a man. Before making a final diagnosis, the presence of a malignant tumor is excluded. A man is recommended to be observed by several highly specialized specialists. Improvements occur approximately six months after the start of treatment. If positive dynamics is not observed, drug therapy correct.

Proper nutrition for gynecomastia

When gynecomastia occurs in men, it is required to observe strict diet. This is necessary to increase or correct the level of testosterone production. At proper nutrition a man quickly restores a normal rational hormonal balance. All this contributes to setting up and significantly speeding up all metabolic processes and rapid removal of toxins from the body.

The diet should include: porcini mushrooms, boiled dietary meat, berries, cereals and fresh fruits. With such nutrition, estrogens from the body of a man begin to be excreted faster, which reduces the possibility of the appearance of malignant tumors.

It is very important for gynecomastia to make the right drinking regimen. A man needs to drink at least 2 liters of non-carbonated water per day. The necessary hormones are produced faster with regular physical activity. Sports often help a man overcome many diseases.

Conservative treatment

In most cases, various hormonal medications are used for treatment, based on pure progesterone. They work well with the insufficiency of one or both testicles, as well as some antiestrogens that can block the main hormones of women.

With gynecomastia in men, the following drug therapy regimen is mainly used:

Thiamine Bromide in the form of a common B vitamin for the rapid transformation of male hormones into female ones. Assign 1 time per day in the form of injections for 14 days.
Vitamins B1, which is used mainly to block the production of the hormone aromatase. Used for gynecomastia intramuscularly. Injections are recommended for at least 20 days.
Androgel is an ointment based on pure testosterone. Apply only in the morning.
Dydrotestosterone. The drug contributes to the speedy utilization of excess adipose tissue in case of poor development of the gonads in men.
Tamoxifen is designed to reduce the level of estrogen production, which increases the susceptibility to the formation of neoplasms of various etiologies.
Clomiphene citrate contributes to a significant decrease in the level of estrogen in the blood, which prevents male breast growth. It is used 1 tablet for 30 days.
Sustanon is a unique blend of essential testosterone esters. This oil is applied intramuscularly. It is usually administered once every 3 weeks for 3 months.

Each of these hormonal drugs is prescribed only by the attending physician individually for a particular man.

There are other drugs for treatment without surgery. They can be in the form of creams and ointments:

Anastrozole
Ganaton
Dimexide
Letrozole
Proviron
Progestogel
Turinabol
Tamoxifen

You should not self-medicate. To prevent the development of unwanted side effects, all drugs and their dosage should be prescribed by a qualified specialist.

Surgical intervention

Treatment should be based on elimination main reason that caused the disease. Removal of gynecomastia in men is prescribed only in the most severe cases, when no previous drug treatment does not bring the desired results.

4 main methods of surgical treatment:

Mammoplasty with superficial liposuction. In this case, all excess adipose tissue is excised, and the breast acquires its initially normal shape.
Mastectomy is a radical and most complete excision of the entire affected breast.
Endoscopy - removal of the gland using a special endoscope. Small incisions are made in the skin, usually under the arm, and an endoscope is passed through them.
Laser removal - all pathological tissues are removed with a laser, and later their contents are pumped out through small incisions in the skin using a vacuum.

If the operation to eliminate gynecomastia in a man went without any complications, the patient is allowed to go home and is monitored for the next six months. In this case, maintenance drug therapy is prescribed, the duration of which depends on the patient's condition.

Folk methods in the fight against the disease

In the postoperative period, long-known folk remedies. However, they are welcome only in case of addition to the main treatment. Most often, for the treatment of gynecomastia, medicinal decoctions based on honey, ginseng and lovage petals are used.

To combat pain in the area of the mammary glands in men, they put special compresses of honey. It is applied to the painful area and covered with cellophane, after which it is fixed with a cloth. The compress is placed at night.
A decoction of ginseng is drunk 3 times a day before meals for three months. An infusion of lovage root is poured exclusively with red wine. Insist 3 days and drink 100 ml after meals.
They also take baths from a decoction of thyme 2 times a week for about 20 minutes.

Home treatment can help only at the beginning of the disease, when the pain has only recently begun to bother a man. Before using all the decoctions, it is advisable to treat the chest with hydrogen peroxide. In the later stages, treatment no longer gives the expected results.

Prognosis of disease progression

The prognosis of physiological gynecomastia in men is almost always favorable. If this is pubertal gynecomastia, then with proper growth and normal hormonal levels, all symptoms disappear after the end of adolescence. With the progression of a disease such as gynecomastia, the prognosis can also be favorable if the man adheres to all the recommendations of the attending physician and undergoes treatment on time.

A man must completely abandon all bad habits, strictly adhere to the most correct lifestyle and, without fail, follow the established diet. Treatment of this pathology should be correct and justified. Only then can the disease be overcome.

Pain in the nipples can be caused by hormonal changes in the body, which are diagnosed by an endocrinologist. But hormones are not the only factor that contributes to the appearance of painful sensations in the nipples. So why can nipples hurt in boys?

Causes of painful nipples in boys:

Growing up in adolescence. There is pain when touched. This condition is temporary, it is associated with the restructuring of the hormonal background;
Blow, bruise, cut;
Allergic reaction;
Infection on the wound (purulent inflammation resembling mastitis);
- an endocrine disease that accompanies breast enlargement;
Diseases of the testicles;
Diseases of the pituitary gland;
Diseases of the adrenal glands. This gland, together with the testicles and pituitary gland, is responsible for the production of male hormones. Violation of their work leads to the predominance of female hormones in the body;
is a rather rare occurrence. In this case, in addition to pain in the nipples, there may be discharge from them;
Diabetes mellitus (endocrine disorders occur)
Stop taking aabolic steroids. Many steroids are analogues of testosterone that are able to convert into female sex hormones and suppress the production of natural testosterone. Athletes, after stopping the use of anabolic steroids, observe not only pain in the nipples, but also breast enlargement, as well as a decrease in testicles in size.

Gynecomastia is the cause of nipple pain in boys

The most common disease that can cause sore nipples in males is gynecomastia. I would like to take a closer look at this disease. So, gynecomastia is manifested by an increase in the mammary glands. The disease can be true and false. The false nature of gynecomastia can be associated with the usual increase in body weight, that is, with obesity. True gynecomastia is caused by hormonal imbalance in the body, a decrease in the secretion of sex hormones, an increase in the level of female hormones, which often occurs due to kidney disease. In this case, there is a sharp decrease in the function of decomposition of female sex hormones (estrogens).

Treatment of gynecomastia includes identifying the cause of the disease and taking appropriate measures to eliminate this cause. If the nipples continue to hurt after treatment, the doctor decides on the introduction of male hormones into the body until the pain in the nipples completely disappears.

Unfortunately, nipple pain is not uncommon. But as such, it does not pose a danger, subject to a thorough examination. Therefore, when soreness appears in the juices, it is necessary to consult a doctor for examination, diagnosis and treatment.

Pubertal gynecomastia in adolescent boys is a benign enlargement of the mammary glands with a diameter of more than 1.5-2 cm during puberty.

More than half of all teenagers face this problem at the age of 12-15 years.

The disease in most cases goes away on its own, but, like it, it causes physical and mental discomfort to the child's fragile body.

Symptoms and signs

The disease is typically asymptomatic, but with a pronounced enlargement of the mammary glands, the pathology can manifest itself.

This is expressed as follows:

pressure, fullness and itching in the region of the mammary glands;
when palpated, a dense, painless formation is determined that is not soldered to the surrounding tissues;
lymph nodes are normal, the general condition of the patient is not disturbed.

At what age can it occur?

Approximately 50-70% of healthy male adolescents aged 12-15 years experience .

For some, this process is observed at the age of 16.

How often does it occur?

The statistics on this problem are somewhat underestimated, since parents and doctors do not always pay attention to minimal changes in the mammary glands in a teenager, and the young man himself may not be psychologically ready to talk about his problem.

How long does it take?

In most cases, gynecomastia disappears on its own at the age of 15-16, in rare cases remaining until the age of 19.

In a number of patients, gynecomastia persists for a long time - then this condition is referred to as a pathology and they begin to actively look for the cause of the disease.

Causes

A common cause of gynecomastia is an excess of estrogen in the male body.

This condition may occur in the following cases:

Physiological reasons

neonatal: in the blood of newborn boys, an excess of estrogens is often observed. This condition is rarely permanent and resolves on its own within a few weeks.

juvenile gynecomastia (mcb 10): boys in adolescence may experience excessive activity of the enzyme - aromatase, which converts testosterone into estrogen.

Pathological causes

taking some medicines that affect the amount and production of estrogens (antidepressants, anti-tuberculosis drugs, opiates, antiandrogens, etc.);
regular use of alcohol, heroin, marijuana;
tumors (hormone-producing tumors of the testis or adrenal glands);
endocrine pathology (Cushing's syndrome, acromegaly, etc.);
systemic diseases (liver pathology, HIV infection, severe kidney disease);
other conditions (trauma or shingles in the area of the mammary glands, overweight, etc.).

Gynecomastia in boys in adolescence is most often physiological and after some time passes on its own.

To determine the exact cause of the development of pathology, consultation of one or more specialized specialists is required.

Why is the disease dangerous?

The disease in adolescents has a favorable course and spontaneously disappears after a certain period of time.

Gynecomastia can lead to psychological trauma in a teenager, and severe enlargement of the mammary glands can cause a feeling of pressure, increased sensitivity and trauma to the nipples.

With unilateral breast enlargement, the risk of developing a tumor process increases, so this condition requires dynamic monitoring and observation by a specialist.

Types of gynecomastia

In medical practice, gynecomastia is not an independent disease, but is a symptom of another disease.

There are several types of the disease:

true;
false;
mixed.

true gynecomastia

Development driven by oversupply female hormone(estrogen) in the male body.

The mammary glands increase due to hypertrophy of the tissues of the gland itself and the milk ducts.

Depending on the causes, there are two types of gynecomastia:

Physiological: neonatal, familial, idiopathic and adolescent gynecomastia.
Pathological: tumors, endocrine diseases etc.

False gynecomastia

is an increase in breast tissue due to the growth and increase in fat cells.

It develops in overweight patients.

Mixed gynecomastia

This type of disease is caused by the growth of both adipose tissue and the own tissue of the breast.

It is classified depending on the degree of severity of certain signs.

Degrees

There are 4 degrees of hypertrophy of breast tissues:

The first is a minimal increase in the gland.
The second is an increase less than the diameter of the areola of the nipple.
The third is a seal within the size of the areola.
Fourth - the diameter of the seal exceeds the size of the areola.

According to the size of the mammary glands, gynecomastia is conventionally divided into moderate (up to 6 cm), medium (6-10 cm) and pronounced (more than 10 cm).

Diagnostics

How to determine yourself?

You can independently suspect the development of gynecomastia in a teenager by carefully examining and probing the mammary glands. They increase in diameter by 2-3 cm or more, the nipples become pigmented and enlarged.

The child may complain of a feeling of pressure in the chest and discomfort when wearing clothes due to severe nipple sensitivity.

Which doctor should I contact?

If you suspect teenage gynecomastia, you should contact a pediatric endocrinologist , who will conduct the necessary examination and prescribe an additional examination.

Survey

The survey includes several stages.

Objective examination, history taking and palpation of the mammary glands

In this case, the patient is asked about the medicines, playing sports, using alcohol, drugs and other significant moments.

Doctors evaluate the degree of development of secondary sexual characteristics and exclude systemic pathology.

On palpation, they look at the size, texture and soreness of the mammary glands and regional lymph nodes.

Analyzes

They determine the level of testosterone, estradiol, hepatic transaminases, prolactin and other hormones.

ultrasound

An ultrasound examination is performed to differentiate true and false gynecomastia, as well as to exclude a tumor process in the mammary glands.

Ultrasound of the testicles is performed to exclude a tumor.

Other types of research

In difficult diagnostic cases, a puncture of the mammary gland is performed to study the cellular composition of the formation and exclude the tumor.

Treatment of gynecomastia in adolescents

Treatment depends on the degree of hypertrophy, hormone levels, the presence of concomitant diseases and other factors.

A moderate degree of gynecomastia without pathological causes is left without treatment, but under the constant supervision of a specialist.

Treatment regimen (conservative method)

Tablets and drugs

Medications are prescribed taking into account the level of certain hormones in the body of a teenager:

"Bromocriptine" and its analogues: stimulate dopamine receptors and block the synthesis of prolactin. Suitable for hyperprolactinemic type of juvenile gynecomastia.

"Thiamin bromide": blocks the aromatase enzyme, which promotes the conversion of testosterone to estrogen.

"Testosterone": used for low testosterone levels in a boy's body. In some cases, the opposite effect may be observed.

antiestrogenic drugs: Clomiphene, Takmoxifen and others. They are used when there is an excess of estrogen in the body.

a course of vitamins of groups B, A and E

The drug "Bromocriptine"

Diet

Compliance with the principles of the diet will give a pronounced effect in the case of false gynecomastia.

If breast enlargement is due to overweight, then only a decrease in calorie intake and regular physical activity help deal with the problem.

Diet principles:

exclude alcohol and low-alcohol drinks from the diet;
give preference to "slow carbohydrates" (cereals, yeast-free bread, brown rice, etc.);
count and observe the number of calories consumed (about 2500 kcal per day);
drink up to 2 liters of water per day;
limit or refuse the use of fried, sweet and starchy foods;
eat foods high in protein (cottage cheese, turkey meat, etc.), vitamins and minerals (broccoli, cauliflower, spinach, etc.).

In cases of true gynecomastia, adherence to the principles healthy eating will not lead to the desired result, but will help strengthen the immunity and mental state of the child.

"Slow carbs"

Exercises

With gynecomastia during puberty, experts recommend increasing physical activity.

In cases of false gynecomastia, this will help to get rid of excess weight, and with true physiological gynecomastia, regular exercise contributes to the production of male hormones.

Effective exercises for gynecomastia:

Banal push-ups will strengthen the pectoral muscles and help get rid of excess fat in the chest area.

Emphasis on slightly bent arms, spaced wider than shoulders.

The body is straight, the socks rest on the floor.

Taking into account physical fitness, 15-20 push-ups are performed in 3-4 sets.

For this exercise, you will need dumbbells and a solid horizontal surface.

It is performed in a lying position on a bench, arms slightly bent at the elbows.

Dumbbells from a position above the head are maximally bred to the sides and then again reduced to their original position.

Perform 10-15 times 4 sets, gradually increasing the weight of the dumbbells.

Folk remedies

Medication treatment traditional medicine Gynecomastia is a highly controversial topic.

The use of sedatives and sleeping pills is acceptable herbal preparations(valerian, motherwort, lemon balm, etc.), if the patient is having a hard time with his condition and he is tormented by neuroses and insomnia.

You can use folk remedies that increase the level of testosterone in the body and reduce the production of female hormones.

Such plants are ginseng root, thyme and lovage.

Recipe 1: chop 40 gr. ginseng root and pour 800 ml of alcohol. Insist in a warm place for 14-15 days. Take a teaspoon of tincture 3 times a day for a month.
Recipe 2: pour 2-3 tbsp. dry thyme with a liter of water and boil over low heat for 10 minutes. Cool the decoction and take half a glass once a day for 2 weeks.

Deletion (operation)

Severe gynecomastia in boys is rarely reversible.

In such cases, doctors prepare the child and his parents for surgery, which is performed under general or local anesthesia.

The choice of anesthesia and the volume of surgical intervention depends on the degree of hypertrophy of the gland, the amount of adipose tissue and concomitant diseases.

With true gynecomastia, a subcutaneous mastectomy is performed from an incision around the areola of the nipple.

With false gynecomastia, liposuction or lipectomy is performed (removal of excess adipose tissue).

Important! It is forbidden to bandage, rewind the mammary glands with elastic bandages and other devices.

These methods lead to clamping of the lymphatic and blood vessels and can cause the development of malignant neoplasms.

Rehabilitation

It is well tolerated by patients, and a month after surgery, the patient returns to his usual lifestyle and sports.

Questions for the doctor

Question: How to treat gynecomastia at the age of 14 in a son if the endocrinologist did not reveal any significant abnormalities in the teenager's body and advised him to simply monitor the child?

Answer: Moderate juvenile gynecomastia in the absence of clinical significant reasons resolves on its own over several years. Your task is to listen to the doctor's opinion and conduct an explanatory conversation with your son in order to exclude the formation of complexes and psychological problems in him.

Question: At the age of 23, the doctor diagnosed me with severe gynecomastia and insists on surgical treatment. My father had the same problem when he was young, and he says the tumor cleared up on its own at 25. Does it make sense for me to wait for it to decrease or do I need to do something?

Answer: There is such a thing as familial gynecomastia, when breast enlargement occurs in several generations of men. In your case, the probability of reducing severe breast hypertrophy is very low, so it makes sense to listen to the opinion of a specialist and perform an operation.

What is gynecomastia in teenage boys? Gynecomastia is an enlargement of the mammary glands in males.

It is not an independent disease, but combines a number of characteristic clinical manifestations that have arisen.

Men note an increase in one or both mammary glands, the presence of painful seals, swelling of the nipples.

Physiological gynecomastia occurs in infant boys, adolescents and the elderly. It is a variant of the norm.

In newborns, glandular enlargement develops as a result of transplacental penetration of maternal estrogens.
In men of mature age, similar symptoms occur due to a shift in the androgen-estrogen ratio.

However, the most common cases of physiological gynecomastia in children, which develops with the onset of adolescence and disappears after 1-2 years.

Gynecomastia develops in adolescents 12-15 years old and is due to the changing ratio of hormones in the body. As a rule, this type of gynecomastia is bilateral, but there is also a lesion of the gland on the one hand.

ATTENTION! If gynecomastia is accompanied by soreness and enlargement of the testicles or signs of incomplete masculinization, urgent medical attention should be sought.

Symptoms

Juvenile gynecomastia is characterized by a number of defining symptoms:

Enlargement of the mammary glands. Their weight can reach 150 g, and the volume is 10-15 cm. Gynecomastia can be either symmetrical, that is, equally affecting both sides of the chest, or asymmetric.
In the region of the glands, painful seals can be observed, more often of a homogeneous nature.
Nipples and areolas darken, acquire increased pigmentation. The radius of the areola becomes wider, is formed according to the female type. In some cases, the nipple may retract and become flat.
Many patients have hyperplasia, that is, growth, of the epithelium of the ducts of the mammary glands.
Patients complain of discomfort in the chest area, a feeling of heaviness.
In some cases, whitish or transparent discharge from the nipples is noted.

Pubertal gynecomastia in boys does not require specific treatment, however, there are symptoms, the appearance of which is a reason for medical intervention:

Intolerable pain in the region of the mammary glands.
Bloody discharge from the nipples, areola cracks, violations of the integrity of the skin.
Lymphadenitis, enlarged axillary lymph nodes.
Ulcerations and papules on the chest.

ATTENTION! Similar signs signal the development of carcinoma. When they appear, you should immediately consult a doctor.

Causes

in puberty - an increase in the mammary glands associated with hormonal changes in the body during puberty. Find out about the false type of disease.

Testosterone, which actively begins to be produced at this stage, ensures the development of secondary sexual characteristics:

Male pattern hair.
Increase in muscle mass.
Low voice.
Pronounced Adam's apple.
Body structure: narrow hips, broad shoulders.

In addition, it is testosterone that is responsible for sexual desire and spermatogenesis. However, in some cases, for example, with obesity, the hormone is not produced intensively enough. At the same time, it can be replaced by estrogen, which ensures the development of female secondary sexual characteristics in the body.

ATTENTION! Also, an excess of testosterone in the body under the influence of various factors can lead to the fact that the hormone begins to be processed into estrogen.

When the hormonal background is extremely unstable, many young men have an imbalance between the synthesis of estrogens and androgens, resulting in the development of teenage gynecomastia.

May exacerbate the problem excess weight because fat cells produce an enzyme that converts testosterone to androgen. In addition, young bodybuilders who take steroids are at risk, since the use of such drugs in adolescence very often provokes hormonal disruptions.

As a result of various diseases

Normally, gynecomastia in teenage boys, caused by a hormonal surge, disappears after 1-2 years, without causing much discomfort to the patient. However, in a number of young men, an increase in the mammary glands is not an independent syndrome, but only a symptom of the disease.

Gynecomastia can be provoked by:

Klinefelter syndrome. A genetic disorder caused by the presence of an extra X chromosome in DNA.
Boys have a high growth, reduced testicular volume, a certain percentage of patients have mental retardation and various malformations of the cardiovascular system.

Gynecomastia in patients with Klinefelter's syndrome persists throughout life.
Reifenstein syndrome- a hereditary disease that often develops in several family members. Puberty of patients is accompanied by the development of some secondary sexual characteristics of the female type: pubic hair, gynecomastia, the formation of wide hips and narrow shoulders.
hypothyroidism, i.e. disruption thyroid gland, leads to the development of hormonal imbalance and, as a result, an increase in the mammary glands.
Cirrhosis of the liver also often leads to hypogonadism, that is, atrophy of the gonads and the formation of gynecomastia.

To exclude the presence of such diseases, identifying gynecomastia in a 12-year-old boy, you should definitely consult a doctor and conduct a differential diagnosis.

The following video discusses gynecomastia as a symptom of various diseases:

Complications

Pubertal gynecomastia normally disappears 1-2 years after the onset. In this case, the only thing that threatens to increase the mammary glands is psychological discomfort. Many adolescents with a similar disease are embarrassed to play sports, use shared locker rooms, and go to the pool. In some cases, gynecomastia leads to severe problems in the socialization of a young man.

Breast enlargement that persists for more than a year can cause fibrosis, that is, scarring of the tissue. This greatly complicates drug treatment.

In a small percentage of patients, gynecomastia can lead to carcinoma. When severe pain in the gland, strange discharge or swelling should see a doctor as soon as possible.

Treatment

In adolescents 12-15 years old, an endocrinologist or endocrinologist-andorologist prescribes. If the tests do not reveal any dangerous abnormalities, chromosomal abnormalities or tumor markers, then the doctor will suggest monitoring the teenager's condition for 6 months. As a rule, during this period the disease begins to regress.

If gynecomastia persists for more than six months or begins to increase, then drug therapy is prescribed.

The endocrinologist prescribes the drug after he establishes the cause of the progression of the disease. Most often, Parlodel or Bromkriptin is prescribed to suppress the release of prolactin, Clomiphene to stimulate the secretion of luteinizing hormone.
In some cases, the use of hormone replacement therapy is also required: Sustanon or Omnadren.

All drugs in the treatment of gynecomastia should be prescribed by a doctor in an individual dosage. Self-treatment attempts can lead to worsening of the condition and the development of complications.

If drug treatment does not give the desired result or the volume of the mammary gland is too large, a mastectomy is performed - resection of the gland and skin tightening.

Military service

Do they take in the army with gynecomastia? By itself, gynecomastia is included in the "Schedule of diseases" that exempt from conscription. However, an increase in the mammary glands, which persists up to 18 years or more, most likely indicates that the young man has endocrine system disorders.

In this case, the young man should be registered with an endocrinologist-andrologist and subject to exemption from military service with gynecomastia in connection with article 13 of the "Schedule of Diseases", which includes violations of the functioning of the endocrine system.

Gynecomastia occurs in about 50% of adolescents and resolves spontaneously 1-2 years after onset. However, if any symptoms of breast enlargement appear, you should consult a doctor to prevent the development of any pathologies and, if necessary, start treatment in a timely manner.

Useful video

The following video talks about the causes and features of gynecomastia in adolescents: