Medical Syndromes that May Cause Gynecomastia

NOTE: The following information is meant for educational and informational purposes only and is not intended as a tool to diagnosis or treat any medical condition.

Andropause

What is Andropause?

Andropause refers to a decline in testosterone in men, with a group of symptoms, physical changes on the body, and specific blood tests. Andropause may be associated with other related hormone imbalances, particularly increased estrogen (the main female hormone). The term "andropause" comes from the Greek prefix "andro" meaning male or man and the suffix "pause" meaning cessation or stopping.

Other terms for andropause are:

  • Androgen Deficiency in the Aging Male (ADAM); androgen refers to male-like hormones
  • Partial Androgen Deficiency in the Aging Male (PADAM)
  • Viropause (decline in virility or masculinity)
  • Male Menopause
  • Male Climacteric

Symptoms

There may be only a few or many symptoms, and not all men will have all symptoms, which may include:

  • Lower energy or fatigue
  • Lower sex drive or libido
  • Softer erections, erectile dysfunction or loss of morning erections
  • Breast discomfort or gynecomastia (enlargement of breasts possibly with a more female appearance)
  • Hot flashes or night sweats

Other non-specific symptoms may include:

  • Loss of motivation and self-confidence
  • Feeling sad, depressed, or anxious
  • Poor concentration
  • Declining memory
  • Sleep disturbance
  • Increased need for naps
  • Decreased physical strength

Causes

Testosterone levels in men start to decline at age 30, due to aging itself. Cells in the testicles make less and less testosterone as men become older. According to the New England Journal of Medicine, approximately 10% men in their 40s have low testosterone; 25% of men in their 50s; 45% of men in their 60s; 70% of men in their 70s; and further increases in older men. Men with the following conditions are more likely to develop or have andropause:

  • Diabetes or pre-diabetes
  • Obesity
  • Alcoholism
  • Emphysema (chronic lung scarring) or chronic bronchitis
  • Liver cirrhosis (scarring)
  • Chronic kidney disease
  • Sleep apnea (stopped or shallow breathing while sleeping)
  • HIV-AIDS
  • Prior illegal steroid use
  • Other hormone imbalances
  • Chronic pain that requires narcotic medications (other hormone declines may also occur)
  • Shortened telomeres. (Telomeres are the tips of chromosomes in cells that become shorter as we age)

Diagnosis

As with all medical diagnoses, andropause is diagnosed by a constellation of symptoms, blood measurements, and physical examination by a physician who is qualified to make the diagnosis. Sometimes another abnormal test may be a tip-off for possible andropause. For example, a bone fracture might indicate low bone density that would be measured on a scan. Low bone density is a possible abnormality of andropause.

Treatment

After a competent physician has diagnosed andropause, the most common treatment is testosterone replacement therapy (there are other possible treatments). The most common testosterone treatment would be a gel, cream or patch on the skin or by injection (shot) in the muscle. Sometimes a specific cause for andropause is found when that cause is treated, and the andropause may resolve. Depending upon associated hormone imbalances other than testosterone itself, the treatment might be another hormone or hormone blocker.

Excerpted from an article by Harvey S. Bartnof, M.D., Founder and Medical Director at California Longevity and Vitality Medical InstituteВ® San Francisco, California. Dr. Bartnof passed away in 2015 and Gynecomastia.org and Miguel Delgado, MD are deeply appreciative of his contribution. Copyright 2011- All rights reserved