Gynaecomastia causes and problems.

Gynaecomastia (often referred to as ‘man boobs’) is the enlargement of male breast tissue. Gynaecomastia appears as a rubbery or firm mass that starts from underneath the nipple and then spreads outwards over the breast area. The tissue is enlargement of glandular tissue, not fat tissue. In about half of cases, enlargement is found in both breasts; in the other cases it only affects one breast.

Gynaecomastia can happen in males of any age or weight. Obese men can appear to have man boobs as they have fat tissue all over the body including the breasts; this is not true gynaecomastia.

The growth of breast tissue can be painful or tender. This should always be checked by a doctor. Gynaecomastia can appear as a small lump that becomes tender as the mass becomes larger.
How common is gynaecomastia?

Gynaecomastia is very common in boys going through puberty, happening in more than half of all normal adolescent males, and usually goes away over time. In older men, enlargement of the breast tissue happens in about one-third of men.
What causes gynaecomastia?

Gynaecomastia commonly appears during infancy, puberty and older age. All males have the male sex hormone testosterone as well as low levels of the female hormone oestrogen, which controls breast tissue growth. When the testosterone to oestrogen ratio changes (that is, there is an imbalance in the levels of these two hormones with relatively higher amounts of oestrogen), breast tissue can grow.

Some men with gynaecomastia have higher than normal oestrogen levels.

Many newborn male babies have enlarged breast tissue because of transfer of oestrogen from the mother during pregnancy. The oestrogen goes down after birth so this type of gynaecomastia is temporary.

During mid to late puberty more oestrogen than testosterone is made by the maturing testis until the time when the testes start to make testosterone at adult levels. Gynaecomastia starting during puberty often goes away, but in less than one in 20 adolescent boys it continues into adulthood.

As men get older there is often a gradual decrease in testosterone levels (and therefore the ratio of oestrogen relative to testosterone goes up) and this can lead to gynaecomastia.

Gynaecomastia can also be caused by genetic problems, chronic diseases (especially kidney and liver disease) or some medicines. Men who take anabolic steroids for sporting performance or body building often develop gynaecomastia. In rare cases, gynaecomastia can be caused by a tumour in the testis or adrenal glands that makes large amounts of oestrogen.
What genetic problems cause gynaecomastia?

Klinefelter’s syndrome (KS), a chromosomal problem that affects one in every 650 males, is the main genetic cause of gynaecomastia. Men with KS have an extra X chromosome and do not make enough testosterone for the body to function normally. Male physical and reproductive development is affected and men with KS have small testes, are almost always infertile and often develop gynaecomastia.

Men with KS have an imbalance in their oestrogen to testosterone ratio because they have low testosterone levels. Testosterone therapy brings the ratio back to normal and helps prevent (when started at puberty) or improve the gynaecomastia, but it may not completely fix it and plastic surgery may be needed.
How can medicines or drugs cause gynaecomastia?

Medicines that can cause breast growth in men include certain antidepressants, medicines used for high blood pressure and tuberculosis, and some chemotherapy agents. Antibiotics, anti-ulcer and cardiovascular medicines have sometimes been found to change the balance of hormones in the body.

Drug abuse, especially the use of anabolic steroids, but also marijuana, opioids and excessive alcohol intake (that has caused chronic liver disease) can cause gynaecomastia.

Medicines that block the effects of testosterone are used in the treatment of prostate cancer and can lead to gynaecomastia.

In rare cases, the partners of women using topical oestrogen cream or gel for hormone replacement therapy may absorb enough oestrogen through regular, prolonged contact to cause gynaecomastia.

Testosterone Boost No Help in Erectile Dysfunction

Preliminary data shows that testosterone supplementation failed to improve mild to moderate erectile dysfunction.

Testosterone supplementation failed to improve outcomes among elderly men with mild to moderate erectile dysfunction, even though testosterone levels were improved, researchers said here.

The Sexual Health Inventory for Men (SHIM) scores showed no differences if the men in the study were treated with testosterone 25 mg a day, testosterone 50 mg a day, or placebo, said Lauren W. Roth, MD, from the University of Colorado in Denver.

The SHIM scale ranges from 1-25, with a score of 1-7 reflecting severe erectile dysfunction and a score of 22-25 indicating no erectile dysfunction. The study participants were about 65-years-old, and more than 90 percent were Caucasian.

In her oral presentation at the annual meeting of the American Society for Reproductive Medicine, Roth said that men did experience an increase in testosterone levels at six months and one year for both the low-dose and high-dose treatment when compared with baseline levels. But that change did not translate into better sexual improvement for the men.

Transdermal testosterone did improve testosterone levels to a normal range. But SHIM scores did not improve.

Erectile dysfunction is not just a problem of low testosterone. It amazing that men with diabetes, high blood pressure, high cholesterol and other factors that impact erectile function will perceive that it is low testosterone that is causing their erectile dysfunction. Maybe 10 percent to 15 percent of men with erectile dysfunction can be helped with testosterone supplementation.

Anabolic Steroid Abuse

Anabolic steroids are substances similar to the male hormone testosterone. They are used to promote masculine features, increase growth, build muscle tissue, and strengthen bones. Common anabolic steroid medicines include fluoxymesterone and nandrolone. All anabolic steroids available in the United States require a prescription and are used to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence.

Some people take legal dietary supplements that have certain steroid hormones also made by the human body. One such drug is dehydroepiandrosterone (DHEA). The body can turn DHEA into other steroid hormones, including testosterone, estrogen, and cortisol. People use it to try to make their muscles bigger. Whether such products actually work has not been proved. But if you take them in large amounts, they can cause the same side effects as anabolic steroids.

When anabolic steroids are taken without a medical reason, it is usually to improve performance in sports or to increase muscle size and reduce body fat. Some teens abuse steroids along with other drugs.

When these medicines are taken to supplement physical development, the dose is 10 to 100 times higher than when they are taken for medical conditions. They may be taken as a pill, an injection into a muscle, or a gel or cream rubbed on the skin. Often more than one of these drugs is used at the same time (stacking), or the drug is taken in a cycle from no drug to a high dose over a period of weeks to months (pyramiding).

Anabolic steroid use can cause a wide range of side effects affecting many systems in the body. Some of these effects can be permanent. Systems affected include the:

    Hormonal system. In men, anabolic steroids reduce sperm count, shrink testicles, cause male-pattern balding, and enlarge breasts. In women, they cause masculine effects, such as decreased breast size and body fat, enlarged clitoris, and a deeper voice.
    Musculoskeletal system (muscles and bones). A teen who abuses anabolic steroids may not reach his or her full adult height, because these drugs can stop bone growth before it is complete.
    Cardiovascular system (heart and blood vessels). Some anabolic steroids affect the level of fat (lipids) in the blood and may cause a heart attack or stroke, even in a very young person. Anabolic steroids also increase blood pressure.
    Liver. Anabolic steroids can cause liver cancer.
    Skin. Anabolic steroids cause oily skin and acne. Skin infections can occur if the person injects steroids. And an infection can become severe if the drug was contaminated with a virus or bacteria during its preparation.
    Brain. Anabolic steroids may cause irritability, homicidal rage, uncontrollable activity level (mania), or false beliefs (delusions).

Testosterone and Erectile Dysfunction

Testosterone and erectile dysfunction go hand in hand. Why? Because testosterone, the main sex hormone in men, is not only a necessary ingredient for libido, it also has a critical role in maintaining nitric oxide levels in the penis. Therefore men who have low testosterone levels may experience erectile dysfunction along with low libido and other side effects associated with low levels of this hormone.

10 Signs of Testosterone Deficiency
The normal range of testosterone is 350 to 1,200 ng/dL (nanograms per deciliter), and what is considered to be “normal” for any man depends on his age. Testosterone levels are highest in men in their early twenties, and up to 50% of all men at age 40 have testosterone levels lower than what was once considered normal, 450 ng/dL. Although there is no definitive figure that identifies testosterone deficiency, 300 ng/dL is usually viewed to be at the lower limit of normal for a healthy man.

Testosterone and Erectile Dysfunction: Benefits of Testosterone Supplementation
If you or your healthcare provider believe testosterone deficiency may be causing your erectile dysfunction, a simple blood test can identify your levels. At that point, you and your physician may discuss the benefits and risks of testosterone supplementation.

A June 2009 study noted that testosterone replacement therapy may provide many benefits for men who have low testosterone, including an improvement in libido and sexual function, bone density, muscle mass, mood, cognition, quality of life, and cardiovascular disease. The study also noted that there is “no evidence to support this risk”

Testosterone replacement therapy is not something you should do on your own: you need medical guidance. First, your doctor should conduct a physical exam and take a medical history if he or she has not already done so. You will then need a blood test panel that includes testosterone levels, PSA, fasting glucose, estradiol (estrogen), and complete blood counts. Along with the PSA level, a digital rectal exam (DRE) should be done as part of prostate cancer screening. Once it has been determined that you can safely take testosterone supplements, your doctor will determine the best approach.

Bioidentical testosterone cream is considered the best choice, because it is readily absorbed into the bloodstream and mimics the body’s natural hormone. Oral testosterone can be rapidly degraded in the liver and result in inconsistent blood levels of the hormone. Request a natural testosterone cream prepared by a compounding pharmacy, as the cost will be considerably less than name brand testosterone creams. You should have follow-up blood testing 30 to 60 days after starting testosterone therapy to make sure your PSA, estradiol, and other blood markers are within normal range. If your doctor finds that the testosterone is converting into estradiol at too high a level, he or she may recommend nutrients that can inhibit excess aromatase activity or prescribe a drug like Arimidex to do the same. You need to have routine follow-up blood tests while on testosterone therapy.

Testosterone and Erectile Dysfunction: Supplements
Natural supplements can complement hormone replacement, or if you choose not to use hormone replacement, nutrients can be an important part of a program to reduce the impact of aging on testosterone and estrogen production. Some of the nutrients and supplements you can consider include those listed under Supplements for ED. One example is a combination of 160 mg of saw palmetto and pygeum twice a day. These herbs can potentially aid in blocking the conversion of testosterone.