Gynaecomastia
August 18th, 2017
Overview
How to Elicit
- Using the thumb and index finger, gently pinch around the male areola, feeling for enlargement of glandular and ductal breast tissue.
Differentiate from pseudogynaecomastia, as a result of obesity.
Abnormal If
- >2cm of glandular tissue.
Causes of Gynaecomastia
- Physiologic - until puberty
- Chronic liver disease (decreased oestrogen excretion)
- Chromosomal - Klinefelter syndrome
- Testicular - congenital absence, castration, viral orchitis, tumours
- Hyperprolactinaemia
- Hyperthyroidism
- Drugs - anabolic steroids, oestrogens, androgens, growth hormones, finasteride, dutasteride, spironolactone, metronidazole, PPIs
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