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Gynaecomastia

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I think I might have minor gynecomastia but I'm not really sure I'm 20 years old, I have puffy nipple that are a little sensitive and every now and then when I squeeze them they discharge a yellow like substance. Ive been working out for a little over 2 years now I'm 5'11 and a 178lb at about 14% body fat. Is there something I can do about this?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 25 Doctors Online

Hello,

Thank you for choosing DoctorSpring.

I would like to know some additional details from you so that I can provide a solid and learned opinion.
You can reply as a followup

1. Do you have pus coming out on pressing from both nipple or single nipple ?
2. Do you have a decreased libido ? (or feel like lack of sexual desire or anything recently ?)
3. Do you get morning erections ?
4. Do you have any visual disturbances ? Like trouble in seeing 1 part of the eye or so ?



Thank you


Patient replied :

1. No there is no puss
2. I don't know fore sure but as fare as my sex drive goes I feel fine
3. Yes
4. My eye site is fine


Hello,

You do appear to have some breast tissue enlargement, most possibly gynaecomastia . At you age of 20 this is not uncommon. The post pubertal hormonal changes can result in slight enlargement
of breast tissue. This is called Persistent pubertal gynecomastia

Generally there is nothing to worry about. This should resolve in 6 months to 1 year. However the discharge you are having is not typical of this condition. You have not mentioned whether the discharge is from one side or both sides. In view of this discharge I would recommend a baseline tests . This should include :

1. Physical examination
2. Testicular examination
3. Live Function Tests
4. S.Testosterone, LH, hCG
5.S.Prolactin

All of these tests are not must. Your Doctor can decide on them after a physical examination
Basically there is nothing much to worry. Most likely this is pubertal gynecomastia. But you can get it checked with your GP / or during an annual physical if it is coming up soon. In case if there is persistent discharge or if there is discharge from single nipple you should surely get the above mentioned tests. Stay physically active.

Hope this helps
Feel free to ask followups
Thank you


Patient replied :

Yes it is from both sides, thank you for all the help though


Both sides rule out local caused like any tumor or mass. And it also means it is more likely to be post pubertal in aetiology.
Wish you good health
Thank you


Patient replied :

I've doing a little research on it and it sounds like the only way to get rid of gynecomastia for good is surgery and I don't think that's really an option for me are there any other ways?


Hello,

First of all real Gynaecomastia can only diagnosed by a direct physical examination. As I said earlier, the hormones has got a role in this. So if you can be patient of an year and a half, it could naturally regress.

Trimming down could help you. General weight loss has shown to improve Gynaecomastia . (although not in all cases). My recommendations would be - physical examination , followed by baseline blood tests if needed. Exercise and Diet targeted at weight loss. If no chance in 1.5 - 2 years consider surgery.

Hope this helps
Thank you


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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