A Thread Devoted To Gynecomastia

Discussion in 'Men's Health Forum' started by BBC3, Mar 26, 2011.

  1. Martin777

    Martin777 Junior Member

    gynecomastia and breat cancer risk

    got curious what's the relationship between gyno and breast cancer in males and what are the particular statistics.
    First website after the search brougth this:

    ''Forty percent of men with gynecomastia develop breast cancer"

    which did sound totally scary

    source Breast cancer in men - relation to Gynecomastia? Article.

    anyone got more info or perhaps better sources?
  2. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Venkata Ratnam B. How important is "pseudogynecomastia"? Aesthetic Plast Surg 2011;35(4):668-9. How Important Is “Pseudogynecomastia”?

    “If male breast enlargement is caused by glandular proliferation, it is defined as gynecomastia. If it is caused by increased fat deposition, it is defined as pseudogynecomastia [1].” “Pseudogynecomastia is an ideal condition for ‘liposuction alone’, whereas gynecomastia can be treated by surgical excision, liposuction, or a combination of both.”

    These quotes seem to represent the current beliefs of the medical fraternity about enlarged male breasts. Presumably based on such beliefs, patients are advised to undergo radiologic investigations such as ultrasound scanning, mammography, contrast-enhanced computed tomography (CT scan), and magnetic resonance imaging (MRI) to differentiate pseudogynecomastia from gynecomastia. Moreover, these patients are treated by applying liposuction alone for pseudogynecomastia and surgical excision for gynecomastia.

    Some surgeons routinely apply liposuction alone to treat both gynecomastia and pseudogynecomastia patients. However, they likely have encountered some patients who have a partial recurrence of breast enlargement a few months after liposuction [2–4]. In addition, a close look at published “satisfactory” results of treatment using “liposuction alone” shows some breast enlargement remaining in some patients, irrespective of whether they had pseudogynecomastia or gynecomastia preoperatively.

    Liposuction alone, indeed, is a simple procedure for the treatment of enlarged male breasts. However, some breast enlargement is known to return after the procedure for some patients. Neither the cause nor the prevention of this recurrence is known [4].

    Excisional surgery for both pseudogynecomastia and gynecomastia, with or without added liposuction for contouring of the chest and upper abdomen, ensures flat chests and no partial return of breast enlargement [5]. Liposuction alone, however, can be applied for those patients with pseudogynecomastia or gynecomastia who are willing either to accept the possibility of some enlargement returning in their breasts after surgery or to undergo “touch-up” operations at a later date.

    Cosmetic surgery patients are concerned about the appearance of their breasts, not their contents. From an appearance point of view, pseudogynecomastia does not exist. The patients seek flat chests irrespective of whether their breasts contain glands or fat. Some of these patients are dissatisfied by the partial return of enlargement of their breasts after liposuction alone.

    The term “pseudogynecomastia” seems to be the culprit that misleads surgeons because it is used almost synonymously with the treatment method of applying liposuction alone. Avoidance of the term “pseudogynecomastia” could be doubly beneficial. On the one hand, radiologic investigations to differentiate pseudogynecomastia from gynecomastia could be drastically reduced [6, 7]. On the other hand, the incidence of residual gynecomastia resulting from “liposuction alone for pseudogynecomastia,” could be significantly reduced or even eliminated.

    The author has no intention to ignite a controversy but fondly hopes to block or break the chain of unnecessary radiologic investigations, diagnoses of pseudogynecomastia based on these investigations, treatment of pseudogynecomastia with liposuction alone, and the risk for resultant unhappy patients because of residual gynecomastia. The author humbly appeals to the medical fraternity to consider discouraging usage of the term “pseudogynecomastia,” at least until the causes of residual gynecomastia are elucidated, and measures to prevent residual gynecomastia after liposuction alone are established.
  3. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Re: gynecomastia and breat cancer risk

    Zhou FF, Xia LP, Wang X, et al. Analysis of prognostic factors in male breast cancer: a report of 72 cases from a single institution. Chin J Cancer 2011;29(2):184-8. http://www.cjcsysu.cn/ENpdf/2010/2/184.pdf

    BACKGROUND AND OBJECTIVE: Male breast cancer (MBC) in China usually has been studied retrospectively with small sample size, and studies analyzing the prognostic factors are rare. This study was to investigate the prognostic factors of Chinese patients with MBC based on the data from a single institute with a relatively large sample.

    METHODS: Clinical data of 72 patients with histopathologically confirmed MBC who received treatment at Sun Yat-sen University Cancer Center between January 1969 and March 2009, were collected. Kaplan-Meier, log-rank test and Cox regression model were used for statistical analysis.

    RESULTS: The 5-year overall survival rate was 72.4%, and the survival rates for stage I, II, III, and IV were 100%, 74.2%, 57.2%, and 0%, respectively. Univariate analysis showed that the tumor size (P < 0.001), axillary lymph node status (P = 0.001), TNM stage (P = 0.001), operation model (with vs. without: P < 0.001; classic radical resection vs. modified radical resection, P = 0.336) and endocrine therapy(P = 0.02) significantly influenced the survival. Multivariate Cox regression showed that TNM stage (P = 0.035), operation model (P = 0.021) and endocrine therapy (P = 0.019) were independent prognostic factors for MBC.

    CONCLUSIONS: Early diagnosis and comprehensive treatment strategy consisting of surgery and endocrine treatment is essential to improve the survival of the patients with MBC, and TNM stage, operation and endocrine treatment are the significant prognostic factors for MBC.
  4. jonkobeck

    jonkobeck Member

    Re: gynecomastia and breat cancer risk

    I have gyno since I was a small child, only in one breast. Its also full of lumps and small knots.
    My mother died of breast cancer.
    For a while, I was going for annual mammograms until the head of radiology at a hospital in NYC asked me why I was doing this.
    when I explained she told me to stop. She said there was no need to have these screenings with stable gyno.
    She said to only do a mamo if I notice some change.

    I decided to take her advice.

    I am a hypochondriac though.

    I also had a testicular sonogram, for no real reason other then T therapy and my fear that I might have cancer
  5. Martin777

    Martin777 Junior Member

    interesting post above

    on a related note, is this gyno or pseudo gyno?
    what do you think guys?

    Dr. Mordcai Blau, Manhattan, NY Male Breast Reduction Surgery | Pseudogynecomastia Treatment in Manhattan, NY | Corrective Plastic Surgery for Enlarged Male Breasts Before and After Photos

    this patient is definitely significantly overweight, so I wonder, if without resorting to surgery (EDIT: it seems it was only liposuction in this case), would his gyno go away or get reduced to an acceptable standard if the man would simply eat better, exercize and lose 70 lbs or so?

    (not sure re american laws abut linking to copywrighted material, it's just an example patient of Dr Mordcai Blau, I found these pictures searching on google for "pseudogynecomastia")
    Last edited: Mar 17, 2012
  6. BBC3

    BBC3 Member

    Jim, Sorry and did not mean to come of like an ass. And I looking back now see the pot has not business calling anyone's writings "confusing". LOL.. The clarification I was after was how the gyno Related To the Restart.. And ACTUALLY - sorry I think I was confused and you were not referring to any Kind of restart scenario whatsoever, and simply referring to the STRICK use of SERMS to combat gyno and for reasons unspecified. Right?? So then tracking the timelines you were simply stating how long GYNO Reduction was holding from SERM use I now see.

    Thanks and your contribution is greatly appreciated (So now more when you have the foresight or time:D)

  7. BBC3

    BBC3 Member

    It is a very interesting post so I have read it again. The post within its self is very misleadiing to the layman because the word "gyno" being visible in the context SUPERCEDES clearvoyance.. LOL

    IN SHORT, I had to zoom in on the word "Pseudo". Hence:
    The prefix pseudo- (from Greek ?????? "lying, false") is used to mark something as false, fraudulent, or pretending to be something it is not.

    So basically the activle is discerning between guys with FAT Titties and guys with Real Gyno. Hence the liposuction being effect as a reduction technique for "Pseudo-gyno". In short, true pseudogyno could be alleviated by weight loss alone. Gyno can not...

    So my first interpretation of the article kinda mislead me into thinking "glandular" may have referred to "duct like". It was a brief incorrect assumption on my part that was never publicizd and remained in my head.

    I am doing no more wiki-ing today so I am going to take a guess that "glandular" in normal womens breasts refers to all tissue that can generate, sustain, retain, or expell milk or lactate. Thats my guess for now without further differentialtion between the DUCTs and the Resevoirs so to speak. We will have to further examine NORMAL breast development in WOMEN to see what propensities exist in normal nature with regard to breasts. But there is no question that womens breast sizes increase with additional body fat or general size increases with women for that matter. So a good question to a physician would be, when a woman puts on ADIPOSE TISSUE, or FAT, does it BLEND in with the normal breast glands, or simply sit ATOP...? My suspicion, and having fondled so many of them, is that increases in adipose tissue tend to blend in to the normal glandular breast development in women. If that is correct then it only further complicates what is the true definition of "Breast tissue", can could it be indeed roughly defined as "boobs" or "whatever is growing ona womans sternum", LOL - but seriously..

    So to the poster who produced the pics of the man who had lyposuction (I think I read, or am I generating my own horse shit?), I believe the question you asked was did we think that was GYNO or FAT on his cheszt?? Just looking at the pics, I would have on first glance said thats just a big boy who had become so overweight that he now even has fat on his chest. Then you look closer and see the way around the nipple the tissue has a slightly different appearance and wonder. But I am going to assume this is a normal hazzard of this much MASS toward to pinnacle of a FOLD of body tissue and assume fat only. STILL - You dont see Body fat peaking to a point like that on a belly roll!! This all brings us back to the nature of breast area tissue and how it should normally grow.

    We also have to give consideration to the NORMAL GENETIC DESIGN of a given individual and where he or she is intended to HOLD weight. Further, is there a predisposition to which type (adipose, breast, muscle, etc...). I have always been one to quickly assume that the kids with high fat levels on the chest/pec area tissue were the ones with a blessing to grow a massive chest in the gym if they wanted simply due to their inclination to hold weight there. But I wonder now...

    So to be sure this thread has not "left the building" and hijacked its-self. The point is that gyno may have several social definitions. The real and distinct definition of gyno is the development of "Glandular" breast related tissue. Glandular I speculate being milk/lactate retaining, generating, expelling(duct). So "Fat Cheszt" is NOT Gyno. And the further point one point of the thread being to further investigate what society is doing by unleasing mass hormone dosing in males and thus the NATURAL UNNOTICED curve of breast tissue development in men being artificially bolstered - mole hills potentially becomming mountains given the seeming exponential rate of growth now begun or accerlerated much earlier SOCIALY than in days past. What will be the price?

    What is the real implication of develping gyno as a steroid user - and to ANY degree....? Clearly tissue has a life of its own via its own tissue receptor composition. Clearly even gyno that APPEARS minor is having a considerable impact on males, even if only recognized as the dreaded "BB". And to clarify I am referring to a small nodule in the aereola - which I interpret as duct development. I found it amazing that after developing this "BB", I can not longer take wellbutrin due to the drugs Dopamine/prolactin relations - which is COMPLETELY IGNORED by the medical community. I have been reading lately about the effects of the dopamine agonizing drugs Bromo, Caber, etc. And how the can produce dramatic changes in the abiltiy to have an erection, or even cause SPONTANEOUS orgasms. And this is because of the clearly poorly documented relation between Dopamine and Prolactin. Prolactin is a facet of Breast tissue. So now you really have to ask yourself, to what degree due I have gyno going on and even on just an unnoticeable cellular level, what kind of prolactin is this GENERATING at the RECEPTORS. How is this impacting dopamine? And just HOW LITTLE does it take in terms of breast development to render a mans LIBIDO damaged, to cause poor erections, to cause premature orgasm thus leading to "impotence". How little Breast tissue development does it take?

    You can take counts in serum ALL DAY LONG. The proof is going to be IN THE PUDDING - or whats actually physically present...!

    Last edited: Mar 17, 2012
  8. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Ustun I, Rifaioglu EN, Sen BB, Inam MU, Gokce C. gynecomastia: a rare complication of isoretinoin? Cutan Ocul Toxicol. Gynecomastia: a rare complication of isoretinoin?, Cutaneous and Ocular Toxicology, Informa Healthcare

    Isotretinoin is a retinoic acid derivative mostly used in the treatment of cystic acne vulgaris. The adverse effects of isotretinoin are well defined being the major limitation factor for its usage. The decrement of testosteron during isoretinoin treatment is defined in literature. We present a case with 20 years old man who developed gynecomastia after treatment with isotretinoin. To the best of our knowledge, this is the third report of the development of gynecomastia after isotretinoin treatment.
  9. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Deepinder F, Braunstein GD. Drug-induced gynecomastia: an evidence-based review. Expert Opin Drug Saf. Drug-induced gynecomastia: an evidence-based review, Expert Opinion on Drug Safety, Informa Healthcare

    Introduction: Drugs are estimated to cause about 10 – 25% of all cases of gynecomastia. Over the course of several decades, multiple medications have been implicated in the development of gynecomastia mostly in the form of case reports and case series. However, these reports suffer from a multitude of deficiencies, including poor quality of evidence.

    Areas covered: Studies were selected for this review by performing an extensive electronic and hand-search using BIOSIS, EMBASE and Medline, from 1940 to present, for all reported drug associations of gynecomastia and their possible pathophysiology. Quality of evidence was assessed on a three-point scale: good, fair and poor, and each of the drugs reported to cause gynecomastia was assigned a level of strength. The pathophysiology of gynecomastia is also discussed in detail for each of the drugs found to have a good or fair evidence of association with gynecomastia.

    Expert opinion: Most of the reported drug–gynecomastia associations were based on poor quality evidence. The drugs definitely associated with the onset of gynecomastia are spironolactone, cimetidine, ketoconazole, hGH, estrogens, hcg, anti-androgens, GnRH analogs and 5-? reductase inhibitors. Medications probably associated with gynecomastia include risperidone, verapamil, nifedipine, omeprazole, alkylating agents, HIV medications (efavirenz), anabolic steroids, alcohol and opioids.
  10. BBC3

    BBC3 Member

    On the subject of drugs that cause gyno, I see they have alcohol there and it done shit fer me since I quit....:drooling:

    On a serious note. I suspect a whole thread should be devoted to Wellbutrin. My wife recently dosed herself with some of mine I had laying around, and she noted some leakage within two weeks. There is no question that the prolactin based action (whatever it may be) is off the charts with this med. I find it very interesting that this is still the most they have posted at the manufacturer website considering you can go our on the web and see COUNTLESS womens reports of their breast growing as much as a cup size when taking this med..! And interestingly enough, obviously it may not even be a bad thing, as we dont know what the effect is really doing... But I hazzard to speculate - Their AINT a single guy here with any gyno that could take this stuff and not have a blow up... Something has got to give and they need to start talking. Their IS NO DAMN WAY they have not been motivated to do a post marketing study to follow up with this...?!??????

    Endocrine: Infrequent was gynecomastia; rare were glycosuria and hormone level change.
    Gastrointestinal: Infrequent were dysphagia, thirst disturbance, and liver damage/jaundice; rare were rectal complaints, colitis, gastrointestinal bleeding, intestinal perforation, and stomach ulcer.
    Genitourinary: Frequent was nocturia; infrequent were vaginal irritation, testicular swelling, urinary tract infection, painful erection, and retarded ejaculation; rare were dysuria, enuresis, urinary incontinence, menopause, ovarian disorder, pelvic infection, cystitis, dyspareunia, and painful ejaculation.

    But with all that said. I would not dispute the TECHNICAL LANGUAGE. As I dont feel that the drug CAUSES gyno, but it will sure as hell get a SET-O-TITTIES milkin..... They should be using megadoses to primer a set a tits in premature delivery scenarios, etc, i wonder....

    Further it really highlights the relationship between dopamine and the hormones I think....
  11. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Lee JH, Kim IK, Kim TG, Kim YH. Surgical Correction of gynecomastia with Minimal Scarring. Aesthetic Plast Surg. Surgical Correction of Gynecomastia wit... [Aesthetic Plast Surg. 2012] - PubMed - NCBI

    BACKGROUND: Gynecomastia is a benign, excessive development of the male breast that occurs at an overall incidence of 32-36 %. The authors effectively removed peripheral fat tissues with power-assisted liposuction (PAL) and periareolar glandular tissues with a cartilage shaver in a series of patients. The small periareolar incisions were not easily recognized.

    METHODS: Between February 2010 and April 2012, the charts of 15 patients (28 breasts) treated with PAL and a cartilage shaver were retrospectively reviewed.

    RESULTS: The mean volume of fat tissue removed with liposuction was 319 mL, and the mean volume of glandular tissue removed with the cartilage shaver was 70 mL. The mean follow-up period was 11.2 months. No infection, nipple-areola complex necrosis, nipple retraction, or saucer deformity was encountered in this series. Intraoperative bleeding occurred in one patient. Mild asymmetries developed in three patients.

    CONCLUSIONS: Use of PAL and a cartilage shaver for the treatment of gynecomastia allows for effective removal of both the fat and the glandular tissue of the breast through a minimal periareolar incision. This technique can achieve excellent aesthetic results with inconspicuous scarring.
  12. BBC3

    BBC3 Member

    So what u r saying is that there is breast reduction without poopin the nip. Hmmm.
  13. BBC3

    BBC3 Member

    Disregarding the previous reply and mid-spelling. Lol I would like a refresher course on how prolactin comes into play. Especially in TRT or steroid users who only take excess testosterone, yet reap the yields of prolactin as the dreaded "juicy-tit". Lol. So how exactly does excess testosterone summize to enough prolactin to generate breast milk precursors?
  14. Sworder

    Sworder Member

    TRT or supra testosterone levels doesn't directly correlate to elevated prolactin levels. Throw an SSRI in with elevated estrogen and fun things start happening though :)
  15. BBC3

    BBC3 Member

    I was kinda thinkin back myself down the metabolism trail and kinda sorta came up a little confused too. However, I am here to tell you - THEY DO.... The only thing I have supped in last two months is synT-cyp. And not all that massive a dose. The verdict IS..... Juicy tit.... They have to relate... Now that I have a single "bb" type gyno occurring under one areola, I can not dose TRT above 100-150mgs/week with the gyno flaring up. It materializes in TWO ways. Both tits get a little sensative/sore, and the one with the bb starts its general fluid retention and oil substance can be expressed if really SQUEEEYUUUZD....:drooling: No SSRIs, No DA drugs, No Alcohol, No psyche meds of any kind. Only current meds being amphetamines, nicotine, hydrocodne minor, and nuthin... And all those have been daily for many years...

    I would offer that perhaps the recent addition of DAA and some other minor OTC health supps like the Erase I tried could have contributed. But this has been the story ever since I earned my "bb" a few years ago. The erase actually dont do jack shit - IMHO. But it definitely did not agonize...

    Perhaps the elevated Estrogen conversion from the excess Syn-T on an overweight person like myself is all the enabling (whatever my standard prolactin level are) I needed to effect prolactin related breast type fluids, where otherwise no. This could be the case I am sure. I guess I may have drawn lines that EXCESS prolactin was require for breast tissue fluid generation?? And no - I do not believe its illness related. Its just like a clear oily substance at best. Removal of the exogenous hormones, or back down to 100mgs/wk or less completely resolves the situation with the exception of the "deflated bb" which you can feel if you really try. At that point it always appears pretty much inert and completely void of growth or activity...

    And FYI, its not the SSRIs that I have found to cause the issue, as more like DA drugs especially Welbutrin. I guess the SSRI drugs could alter Dopa profile as a secondary - perhaps...

    Last edited: Sep 21, 2012
  16. Sworder

    Sworder Member

    Why do you believe it is the prolactin which is being increased rather than estrogen?

    This cycle I have taken some trazodone for insomnia and my estrogen has been through the roof. 2mg of letrozole/day isn't keeping the "bb" at bay. 5mg one day helped bring my estrogen down to the point where I noticed a decrease in bloat. But these are extraordinary doses of letrozole. My typical 1mg/day letrozole is high as well but that just hasn't been enough as both nipples flared with the bbs. Trying to get control of my right one now as that one is being persistent. I think there is some synergy between estrogen and prolactin. I don't really know how it could be explained but I do know that with the latest addition of trazodone I have been ramping my letrozole high. Are you currently using an aromatase inhibitor?

    Trazodone treatment increases plasma prolactin concentration... : International Clinical Psychopharmacology
    m-Chlorophenylpiperazine (m-CPP), which is a metabolite of trazodone, is a serotonin agonist. To examine for the possibility that m-CPP is involved in biochemical effects during treatment with the parent compound, prolactin response to trazodone treatment (150 mg at bedtime for 3 weeks) was studied in 12 depressed patients. The means +/- S.D. of plasma prolactin concentrations before treatment, 12 h. and 1,2 and 3 weeks after initiation of treatment were 9.1 +/- 5.6, 14.7 +/- 9.1, 15.3 +/- 8.5, 13.2 +/- 7.0 and 13.0 +/- 7.0 ng/ml, respectively. The mean prolactin concentrations at 12 h(p < 0.01), 1 week(p < 0.001) and 2 weeks (p < 0.05) were significantly higher than that before treatment. The present study thus shows that trazodone treatment increases prolactin concentrations, suggesting that m-CPP is involved in biochemical effects during treatment with the parent compound.
  17. BBC3

    BBC3 Member

    I have taken Trazadone. I think its a tryciclic class antidepressant with minimal Serotonin effects. Or at least they tried if for AD use and the effects were very limited. At the higher doses required for antidepressant I think the priapism risk goes up. And FIY, I have experienced the Trazadone LOAFER and it is amazing. LOL

    I SUSPECT the study as you are reading it does not neccesarily relate the serotonin DIRECTLY to the prolactin, but as a concomitant moreso. There is also no telling how the overall action of the drug is affecting the S/DA balance (poorly said). My only point was that I have seen Prolactin associated with Dopa moreso than serotonin to my recollection. I would like to see the whole article if you have. And by the way, dont take it with Prozac (you wont find that in writing much). Dont know why and never found.. May have to do more with the point that I think Trazadone is a Mild MOAI (or whatever its called)... I could be wrong there..

    I think headdoc lightly address the issues of the prolactin with the psyche drugs once, but remained somewhat vague.

    Still more of my direction of thought is from my experience with Welbutrin, which has presented incredible gyno activity, which I again assumed was prolactin based.
    Still prolacting is a neuron type drug I think, moreso than and agonist or antagonist for receptor production (I THINK). If so, then bla bla. But I do note that Dopamine agaonists like Caber suppress prolactin.

    An exerpt from somewhere/anywhere:
    This is the main hormone involved in the formation and production of milk. It is secreted by the anterior pituitary (the part of the brain that regulates hormones) and the release is prompted by delivery of the placenta. Prolactin levels rise during pregnancy and drop for a short period just before birth, then they rise once again a few hours after delivery, or immediately when the baby is put to the breast. The levels should be approximately 150 to 200 ng/ml at term; they double during a breastfeeding session. Prolactin levels during lactation slowly drop over time after birth until the baby is weaned. (The standard range for a non-pregnant woman is 2.8 to 29.2 ng/ml. It is recommended that, for optimal health, women maintain prolactin levels no higher than 7.3 ng/ml).

    Breast development and breast milk production are two different things, yet cross paths clearly. I have not doubt that estogen is essential for breast tissue development, as well as prolactin to what ever degree, but the prolactin has to rise to make the milk.. So this is my logic that prolactin is in play when gyno QUICKLY FLARES. Tissue development is not an ovenight game. Quick changes are usually associated with inflection/temp related inflammation, or cancer (as abnormal growth rate which is still much slower that gyno stocking with fluid in a week). This is not to say that general rises in estrogen can not create general inflammation site specific unclear. But This is why I go with prolactin with I apply a drug/stimulus, and get gyno activity. You can also clearly feel the difference is not a new growth, the the expansion of the previously "deflated" breast type Gland or duct. Again I lean toward prolactin.

    You further point out YOUR BB. The reason exactly your BB is not at bay is because you are using an AI, which inhibits estrogen activity. Your BB is probably again Prolactin related which in that case the only way to stop is Caber, Bromo, or remove the Trazadone. One stop short of the Caber would be a SERM. This can help as it will block estrogen at the breast tissue effectively, and thus inhibit prolactin activity somewhat. Further, I dont believe in AIs, as while the cut down circulating estrogen, who is to say that the end tissues are not getting every bit as much estrogen as they want.? Also who is to say that perhaps it may ENCOURAGE them to cling on to the estrogens that the are interacting with currently whilst they further cannibalize into E3 and become a carcinogen its self.

    Just thoughts.:)

  18. Michael Scally MD

    Michael Scally MD Doctor of Medicine

    Kakisaka Y, Ohara T, Tozawa H, et al. Panax ginseng: a newly identified cause of gynecomastia. Tohoku J Exp Med 2012;228(2):143-5. https://www.jstage.jst.go.jp/article/tjem/228/2/228_143/_pdf

    Gynecomastia or benign proliferation of the male breast glandular tissue is not uncommon for adolescent males. Its pathogenesis has been attributed to a transient imbalance between estrogens and androgens. Ginseng is a popular herb with a long history of medicinal use. Oriental folk medicine describes it as both a tonic for restoring strength and a panacea. The term "ginseng" generally refers to a plant, Panax ginseng. Based on estrogen-like actions of Panax ginseng due to its structural similarity with estradiol, this agent could be speculated to cause gynecomastia. Here we report a 12-year-old Korean-Japanese boy with bilateral enlargement of the breasts with tenderness in the right breast, which was noticed about 1 month before his first visit to our outpatient clinic. He was diagnosed with gynecomastia based on physical, laboratory, and ultrasound examinations. Detailed questioning about his medications and supplements revealed that he had been given red ginseng extract daily to enhance his performance for 1 month before his clinical presentation. He wanted to make his body stronger as an athlete. He was recommended from his grandmother to take Panax ginseng for his purpose. After stopping this, there was no further growth of the masses and no pain when his right breast was pressed. In conclusion, physicians should consider ginseng in the investigation of gynecomastia.
  19. BBC3

    BBC3 Member

    Very interesting point about genseng and the similarity to the estrogen molecule. I was not aware, not ever had any reason to look. It should, of course, be noted that ginseng is in everything from diet supps, to energy drinks, to general drinking teas around the house. My one question would be that they make reference the the PANAX ginsing, which I believe refers to the plant common to asian cultures. There are many variations. From Wiki:

    Besides Panax ginseng, there are many other plants which are also known as or mistaken for the ginseng root. The most commonly known examples are Xiyangshen, also known as American Ginseng ??? (Panax quinquefolius), Japanese ginseng ??? (Panax japonicus), crown prince ginseng ??? (Pseudostellaria heterophylla), and Siberian ginseng ??? (Eleutherococcus senticosus). Although all have the name ginseng, each plant has distinctively different functions. However, true ginseng plants belong to the Panax genus.[3

    So they acknowledge a difference and further indicate the Panax type Korean ginsing is the only one with "true" or initially identified as herbal ginseng for health purposes. I for one have had different experiences with Ginseng, and perhaps compllicated by this, as well as all the concomitant ingredients in many of these products that render you not knowing what really caused the reaction.

    Perhaps an entire thread should be devoted to Ginseng to help differentiate the different kinds. And maybe some of these touted positive sexual and energy benefits have some real merit if the kind taken could actually be correctly qualified in buyers...

    Foremost, my reply was based on the question as to whether or not ALL of these different types of ginseng are as estrogen similar..??

    Further, and again as wiki continues to impressively develop:

    I did not note anywhere any heavy connotation or mention of the estrogen similarity, and I find that funny. You have to wonder if perhaps the sexual "Boost" touted by some varieties of Ginseng are related to the estrogen similarity, and perhaps its indeed acting as a serm interacting with certain estrogen receptors, but antagonizing as inert in the ways that bolster sex drive and erections. Finally, it would be interesting to see if it is indeed the SAME one which MAY cause gyno, that is the best one for sexual disorder. Because clearly you would have the classic catch-22 where as if it were bolstering sex drive, it would seem to be AGONIZING E activity at the breast tissue.:(

    Last edited: Sep 28, 2012