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Does Gynecomastia Cause Pain In Left Breast Area?

Posted on Tue, 7 Jul 2015

Question: Hi, I am a Male, 46, Azospermic. My blood test shows Testosterone 1.76 ng/ml, LH 10.28 mlU/ml, FSH 23.03 mlU/ml, Estradiol 238.9 pg/ml, Beta HCG 0.10 mlU/ml. Following pain in left breast area the US scan impressions were Gynaecomastia??Inflammatory Changes. USG Abdomen Impressions are normal. My liver function tests are normal. Is pain due to hormonal imbalance? History of Tessa/Icsi procedure 12 years back with 4 quadrant testicular biopsy for unsuccessful IVF treatment. No BP, Cholesterol, Diabetes. Doctor suggests a US/CT scan to rule out testicular tumour before any hormone treatment. Should treatment be to inhibit estrodial or to supplement testosterone? Side effects? Thankfull for any suggestions in way forward.

Answered by Dr. Shehzad Topiwala (17 minutes later)

Brief Answer:
Hormones

Detailed Answer:
Sorry to learn about your hormone related conditions.

First I suggest a karyotype. This is a blood test to rule out a condition called Klinefelters syndrome.

I also recommend
CBC
Creatinine
Electrolytes
TSH
Free T4

None of these tests require any fasting and can be done at any time of the day.

Then treatment with testosterone supplementation should be considered.

And yes, the pain is the breast area is likely due to Gynecomastia

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shehzad Topiwala (31 minutes later)

Is estradiol inhibitor like Arimidex (anastrozole), an option to testosterone supplement? If not, Why? how is testosterone supplement administerd? Any side effects? Can I delay treatment or should immediately start? Thanks..

Answered by Dr. Shehzad Topiwala (12 hours later)

Brief Answer:
Follow up

Detailed Answer:
1 Arimidex is not an option. It is not relevant here because you have a hormonal imbalance mostly due to low testosterone. Once the levels of testosterone are restored towards normal, the imbalance will likely be taken care of.

2 So the main treatment approach is to supplement testosterone.

3 Testosterone supplements are available in various options depending from country to country.
Broadly there are

Injections
Gels
Patches
Buccal pellets

4 There are some side effects especially when blood testosterone levels rise too high. These include
Acne
Hair loss in male pattern
Breast enlargement
Swollen feet
Worsening of sleep apnea or heart failure
Prostate trouble

This is why it is important to receive testosterone related care from an Endocrinologist in person only who will closely monitor you.

Some tests need to be performed before starting testosterone such as
CBC
PSA
Lipids

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar