Adolescent Gynecomastia

Gynecomastia, defined as the presence of glandular breast tissue in men, is a common, typically benign physical exam finding during adolescence. Although the exact pathogenesis of gynecomastia is unknown, it is likely due to a hormonal imbalance between estrogens and androgens. Most cases are idiopathic and do not require further evaluation if the history and physical examination are reassuring. Although the majority of cases will resolve spontaneously, surgical correction may be an option for adolescents with persistent and problematic gynecomastia. Gynecomastia can have significant negative impact on one's self-esteem, and it is crucial that primary care providers screen adolescents with gynecomastia for mental health concerns. Future studies are necessary to elucidate the true incidence and prevalence of gynecomastia in adolescent males, and to further investigate the short-term and long-term physical and emotional effects of gynecomastia.