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Gynecomastia in adolescents.

Christina A Nordt¹, Amy D DiVasta

¹Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. christina.nordt@childrens.harvard.edu

Current Opinion in Pediatrics

|July 16, 2008

Summary

Gynecomastia in adolescent men is usually benign. While hormonal imbalances are common causes, other factors like leptin may be involved. Reassurance is key for physiologic cases, but surgical options are increasing.

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Area of Science:

Endocrinology
Adolescent Medicine
Men's Health

Background:

Gynecomastia, or male breast enlargement, is a common condition in adolescent males.
It is often benign and rarely indicates a serious underlying pathology.
Primary care providers must be able to differentiate between physiologic and pathologic causes.

Purpose of the Study:

To review the epidemiology, pathogenesis, evaluation, and treatment of gynecomastia in adolescents.
To equip primary care providers with knowledge for thorough evaluation.
To differentiate benign from pathologic breast enlargement.

Main Methods:

Literature review focusing on recent findings in gynecomastia.
Analysis of epidemiological data, pathogenetic mechanisms, and treatment strategies.
Emphasis on clinical evaluation, including patient history and physical examination.

Main Results:

While estrogen-androgen imbalance is a known cause, other factors like leptin and hormone receptors are implicated.
Newer treatments like raloxifene show promise but require further study.
Surgical intervention is becoming more common due to limited pharmaceutical options.

Conclusions:

Adolescent gynecomastia is typically benign and rarely pathologic.
Thorough history and physical examination (breast and testicular) are crucial.
Assessing the impact on adolescent mental health is important.
Reassurance is the standard for physiologic gynecomastia; workup for pathologic causes is infrequent.