Gynecomastia: Etiological Analysis Beyond Hormonal Imbalance.

Area of Science:

• Endocrinology
• Urology
• Men's Health

Background:

• Gynecomastia, a benign enlargement of male breast tissue, has diverse etiologies.
• Common causes include idiopathic factors, medications, hormonal imbalances, and underlying diseases.
• Adult and middle-aged men are most frequently affected.

Purpose of the Study:

• To investigate potential differences in serum estradiol (E2) and testosterone (T) levels, and their ratio, in men with gynecomastia compared to healthy controls.
• To assess the association between hormonal profiles and gynecomastia, considering limitations in hormonal data and statistical power.

Main Methods:

• Retrospective review of 68 men diagnosed with gynecomastia and 10 healthy controls.
• Hormonal analysis (serum E2 and T) performed on a subset of 37 patients and all 10 controls.
• Calculation and analysis of the E2/T ratio as a continuous variable.

Main Results:

• The mean E2/T ratio was higher in patients (12.0 ± 1.8) than controls (7.1 ± 0.5), but this difference lacked statistical significance (p=0.07).
• No statistically significant differences were found for E2 (p=0.21) or T (p=0.34) levels.
• Among tested patients, 13.5% had low T, 24.3% had high E2, and 43.2% had elevated E2/T ratios.

Conclusions:

• The study did not find significant evidence to support an independent association between circulating E2, T, or the E2/T ratio and gynecomastia.
• Clinical assessment of gynecomastia should encompass age, comorbidities, and medication history alongside hormonal evaluation.
• Further research may be needed to clarify the role of hormones in specific subgroups or multifactorial cases.