GYNAECOMASTIA male reproductive system.pptx

GYNAECOMASTIA male reproductive system Adult health nursing

1. GYNAECOMASTIA Deepshikha Kakoty, NEIGRIHMS Dept of Medical Surgical Nursing

2. Defn : Transient, non inflammatory enlargement of one or both breasts :usually temporary & benign. most common cause: disturbance of the normal ratio of active androgen to estrogen in plasma or within the breast itself. accompanied by organic disease: testicular tumors, cancer of adrenal cortex, hyperthyroidism & liver disease. PSEUDOGYNAECOMASTIA

3. Hormonal influences on Gynecomastia: Source: Clinical Endocrinology and Diabetes at a Glance, First Edition

4. Examination Findings: ▶ The Source: uptodate.com

5. Causes of gynecomastia : ▶ Neonatal gynecomastia (60%–90%) : ▶ Early puberty (60%–70%) : ▶ Aging/ senescent (20%–65%, >50 years) : ▶ H ealth problems in men: liver disease, kidney failure or low testosterone level. Drugs: (10 to 25 %): Spironolactone, Isoniazid, Ranitidine, Anti fungal: Ketoconazole, Estrogens , hormal therapy for prostrate cancer, digitalis, CCB, Antibiotics: metronidazole, TCA: Amitriptiyline , some illegal drugs etc. Testicular Tumors

6. Classification: Simon Classified Gynaecomastia into the following groups: Grade I: A slight volume increase with no excess skin. Grade IIa : A moderate volume increase with no excess skin. Grade IIb: A moderate volume increase with excess skin. Grade III: A marked volume increase , skin excess. with excess skin

7. Treatment: Mild cases in adolescence: Advice on lifestyle habits. The underlying disease corrected , offending discontinued. Medication: Selective Endrogen Receptor Modulators (SERM) eg : Tamoxifen ( 10 to 20 mg daily) , Raloxifene ( 60 mg daily) ) & Clomifene (50–100mg/day) Surgery : Subcutaneous Mastectomy, Liposuction Assisted Mastectomy, Mammoplasty.

8. Radiation therapy ▶ Low-dosage external beam radiation therapy (900 cGy or less) is effective.

9. Prognosis : ▶ Pubertal gynecomastia usually regresses spontaneously within 1 or 2 years. ▶ Patients who develop drug-induced gynecomastia generally have complete or near-complete regression of the breast changes if the offending drug is discontinued during the early, florid stage. ▶ Once gynecomastia from any cause has reached the fibrotic stage, little or no spontaneous regression occurs, and medical therapy is ineffective.