Teen Gynecomastia: Are Hormone Tests Needed?
If you’re a teen with gynecomastia, you and your parents may be wondering what kind of medical evaluation to seek. Should you worry that your man boobs signal something is really wrong? Should you have your hormones tested?
We have been treating guys with man boobs in New York for a great many years, and teens with gynecomastia are a sub-specialty of ours. We consult with young people who have seen other doctors, and we also see guys who elect to visit us first. With this experience, we have long felt it’s not necessary for adolescents with gynecomastia to undergo a battery of exams and tests. We are glad there’s now scientific evidence to uphold this view.
Endocrinology: Results of a Recent Study
Since out-of-whack hormones are the root cause of gynecomastia, it’s logical for patients to consider visiting an endocrinologist, or hormone expert, for testing. A new study published in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic Surgeons, shows that in the majority of cases this step is not warranted.
A team of Canadian researchers studied nearly 200 adolescents with gynecomastia through a review of medical records over a 26-year period. Most patients had lab tests to measure hormone levels—a standard practice in many areas—and only three showed abnormal results. According to the research team, this means that no additional information was revealed through expensive hormone workups in 99% of cases.
The doctors concluded, “We do not suggest routine endocrinology workup, as it adds little value.” We agree, for almost all our young patients with man boobs in New York. So did one parent we worked with when his son began to develop gynecomastia. The father, a pediatric endocrinologist, ran a series of tests and found absolutely no hormonal irregularities!
What Works for Teens with Man Boobs
Reviewing the records, the scientists conducting the Canadian study were able to identify obvious risk factors for teen gynecomastia for the majority of the patients studied. More than half were overweight; a condition that often causes enlarged breasts consisting of fat that triggers gland growth. 15% of the group had a family history of gynecomastia, and in 8% of patients the cause was thought to be drug-related (antidepressants, anti-seizure medications and so on).
These results are on track with what we discover in our consultation room. Through a process including careful examination and a detailed patient and family history, we can at least make an educated guess about the cause in most cases. For some guys, whatever prompted the growth of moobs remains unknown. Nevertheless, since gynecomastia is almost always a benign condition—at least physically—the actual cause is less important than the course of action each patient decides.
What’s Really Important
In the final analysis, what’s critical is peace of mind for each teen with man boobs. For our New York patients and their parents, this is our goal.
In a few cases, a referral to an endocrinologist is actually a good idea. For example, if we suspect Klinefelter’s Syndrome—a relatively rare XXY genetic configuration—we’ll suggest a visit to a hormone expert for analysis and treatment. Male breast reduction is certainly still an option for most guys with Klinefelter’s.
When a patient has had gynecomastia for less than two years, especially if he is quite young, we discuss the wait-and-see option. Many cases of adolescent man boobs resolve on their own, and we can suggest support resources to help “wait it out.” We reassure teens that we’ll be here for them should their moobs persist.
In the Canadian study, the researchers found that about 70% patients experienced psychological distress due to their condition. We know that man boobs can be devastating during the teen years when self-esteem is in the formative stages.
About 44% of the young men studied ultimately chose male breast reduction surgery. Of course that figure is much higher in our practice, since young guys who walk in the door have already felt enough anguish to research their condition, talked it over with their parents in most cases and determined to find out in person whether surgery is the right option.
We are gratified to serve this group of guys—man boob surgery is truly life changing for them. To find out more, give us a call at 212-570-6080.