What are the available treatments for gynecomastia?

Question

Hi doctor,

My issue is that I have developed gynecomastia and love handles that will not go away. Despite working out and losing a significant amount of fat, the fat in these areas remains stubborn. I am concerned that there might be a hormonal imbalance, such as elevated estrogen levels. What tests should I undergo to check for hormonal imbalances? I have had this body type since childhood, particularly after puberty. Please review the attached picture.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Gynecomastia is quite common and often requires treatment for cosmetic reasons. It may be a natural consequence of obesity or due to a hormonal imbalance. It is important to have a checkup to determine if there is any hormonal imbalance. Basic tests typically include a testicular examination and assessments of serum thyroid levels and testosterone. Often, these tests come back normal. If that is the case, there are two main options:

Aggressive weight reduction and bodybuilding, which you are already pursuing. This approach can be effective if you are highly motivated.
Surgery, which is a common procedure where fat around the nipples is removed. This is also a permanent solution.

Do not be overly concerned; this type of surgery is routine and often yields excellent results.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

You can start with a few preliminary tests to assess whether there is a hormonal issue. However, keep in mind that sometimes these tests may fall within the normal range, which could indicate that your gynecomastia is physiological. For a basic assessment, you should have a blood test for TSH (thyroid-stimulating hormone), LH (luteinizing hormone), LFT (liver function tests), prolactin, creatinine, total and free testosterone, and estradiol.

Kind regards.

Answer 3

Hi,

Welcome back to icliniq.com.

I have reviewed your blood reports (attachments removed to protect the patient’s identity). The results are both positive and challenging. On the positive side, all your test results are normal and within acceptable limits. This indicates that your condition is not due to any hormonal disturbances but is instead physiological. Therefore, drug therapy will not be effective at this time.

What you are experiencing is not true gynecomastia but lipomastia, which is a collection of fat tissue. To address this, you will need to focus on reducing breast fat and tightening your underlying chest muscles. Aim to lower your BMI (body mass index) to below 22. Joining a gym can provide you with guidance on weight reduction and muscle toning.

Effective exercises include:

Push-ups: These tighten the upper chest muscles and help reduce their size.
Incline dumbbell press: This can lift and reduce the saggy appearance of chest fat.
Seated row: This works the pectoral muscles, helping to firm up the chest.

If, after more than a year of consistent treatment and exercise, there is no significant improvement, surgery may be the only remaining option.

I hope this helps you.

Thank you.