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Questions about hypogonadism and gynecomastia


I was wondering what percentage of people with hypogonadism develope gynecomastia?

I know that roughly 10% of all gynecomastia is caused by hypogonadism, but do all hypogonadal men get gyno?

Also, out of the 10% of hypogonadal men who get gyno, is that including the ones who get gyno in response to treatment for their hypogonadism?


I know that roughly 10% of all gynecomastia is caused by hypogonadism, but do all hypogonadal men get gyno?

Obviously if 10% of gynecomastia suffers have gynecomastia because they have hypogonadism, hypogonadism can cause gynecomastia....think about it.

In terms of the reverse question of how many men with hypogonadism develop gynecomastia......

A very good question for which I do not have statistics.

It must be a fairly substantial number given that gynecomastia is listed as an associated condition and is noted within the AACEs 2002 Hypogonadism guidelines.

I know of a significant number of men that developed gynecomastia as a result of hypogonadism, but this is subjective and is not an answer in terms of statistics.

Hypogonadism itself can be caused by many factors and what these factors are influences how likely it is for the individual to have gynecomastia,


High SHBG can cause gynecomastia with or without elevated estradiol.

Elevated estradiol on its own can cause gynecomastia.

A poor androgen to estrogen balance as seen in metabolic hypogonadism can result in gynecomastia.

Hypogonadism in conjunction with poor hepatic, renal or thyroid function can cause gynecomastia.

Hypogonadism as a result of Klinefelters or other rarer chromosomal factors can cause gynecomastia

Hypogonadism as a result of hemochromatosis can cause gynecomastia.

Hypogonadism as a result of androgen resistance can cause gynecomastia

There are many influencing factors- another being age.

Of course some men with hypogonadism do not develop gynecomastia, because in these people their estradiol is low as a result of limited conversion due to the insufficiency/the deficiency itself.

Again it depends upon the cause (aetiology) of the hypogonadism.

Treatment for hypogonadism may cause gynecomastia to get worse or it may cause it be reduced/resolved.

It depends upon the aetiology again and the individuals body chemistry.

What happens in terms of gynecomastia is also dependant upon the form and dosage of replacement therapy and whether or not the treating endocrinologist understands how to manage estradiol or SHBG if needs be.

But it is just as likely that the quantities (far lower than that of bodybuilder- for which no comparison is worthwhile) of testosterone (if indeed that is the replacement therapy) are as likely to reduce gynecomastia as they are to increase it.

Where gynecomastia does get worse with replacement therapy, it can usually be reduced and sometimes resolved by timely use of aromatse inhibitors or anti estrogens.

Furthermore any increase usually settles down within six months or so and once hormones are balanced correctly and such individuals can have a surgical procedure if they so wish and the gynecomastia should not return.  Of course this is something that could not be said if a hormone imbalance was left undiagnosed and untreated.

For further information on hypogonadism you can just ask here or via PM.

Before doing that though you might want to look in the important information for gynecomastia thread as it may answer many of your questions.

Thanks for the info, it was really helpful.

It's strange how TRT can cause completely opposite effects in regards to gynecomastia according to the individual. What a complicated problem this is.


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