Endocrine Abstracts (2006) 12 P111

Endocrine evaluation of gynaecomastia

KA Ashawesh, A Chakrabarty, T Usman & D Barton


Princess Royal Hospital, Telford, United Kingdom.


Background

The role of endocrine testing in idiopathic gynecomastia is controversial. Previous studies suggested that such testing is rarely productive and best done selectively.

Objectives

A retrospective study was performed to evaluate the usefulness of a routine endocrine testing in patients presenting with gynecomastia.

Methods

The medical records of 71 patients with gynecomastia presenting to the clinic between 2004 and 2005 were analysed. The average of age was 46 years (18–81); 26 (37%) had unilateral breast enlargement. Initial assessment identified medication-induced gynecomastia in 21 patients (30%). The remaining 50 patients (70%) were considered idiopathic and underwent endocrine testing: human chorionic gonadotropin, luteinizing hormone, follicle stimulating hormone, testosterone, estradiol, sex hormone binding globulin, prolactin and thyroid stimulating hormone.

Results

19 patients (38%) had an abnormal hormonal profile; 11/50 (22%) primary hypogoanadism, 4/50 (8%) secondary hypogoanadism, 3/50 (6%) hyperprolactinaemia (secondary to prolactinoma) and 1/50 (2%) androgen resistance.

Conclusion

Routine endocrine testing in gynecomastia is very productive. Gynaecomastia should only be labelled as idiopathic if the hormonal profile is normal.

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