Causes and Metabolic Consequences of Gynecomastia in Adult Patients

Table 1

Causes for gynecomastia in different patients and hormonal characteristics in the investigated group. Data are presented as median (n), min–max. low prolactin levels in patients already treated with dopamine agonists or transsphenoidal surgery. The minimal prolactin level at the time of prolactinoma diagnosis was 1088 mIU/l. One of the patients was with somatoprolactinoma. indicates normal testosterone levels in patients with already started testosterone therapy. All hypogonadal patients had initial testosterone levels under 11 nmol/l and additional tests to prove hypogonadism. In one patient with panhypopituitarism, the testosterone level was very low but measured in other laboratory/not included/.

Causes for GM	N	%	Categories	Age (years)	Testosterone (nmol/l)	LH (IU/l)	FSH (IU/l)	Prolactin (mIU/l)	TSH (mIU/l)	Estradiol (pmol/l)
Persistent pubertal GM	18	16.4	Persistent pubertal GM	22.00 (18) 18–40	20.90 (15) 9.70–30.60	2.85 (12) 0.60–9.70	2.30 (13) 1.40–7.60	308.00 (14) 91.00–652.00	1.80 (15) 0.87–26.80	394.00 (11) 112.00–633.00
Idiopathic postpubertal GM	22	20.0	Idiopathic postpubertal GM	28.00 (22) 19–66	18.60 (21) 11.40–40.20	2.55 (16) 0.47–7.70	4.04 (15) 0.53–8.30	214.00 (21) 82.00–430.00	2.45 (20) 0.62–6.90	282.00 (14) 23.00–960.00
Secondary hypogonadism	18	16.4	Secondary hypogonadism	28.00 (18) 18–69	2.60 (17) 0.60–17.90	1.02 (14) 0.47–3.50	1.45 (14) 0.60–3.40	160.00 (15) 108.00–559.00	2.30 (15) 1.00–15.80	304.00 (6) 178.00–761.00
Prolactinoma	12	10.9	Prolactinoma	31.50 (12) 23–53	12.50 (11) 3.20–35.10	0.80 (5) 0.60–2.10	2.40 (5) 1.20–6.00	474.00 (12) 82.00–10561.00	2.00 (8) 0.51–4.20	248.00 (1)
Primary hypogonadism	14	12.7	Primary hypogonadism	33.00 (14) 21–67	5.05 (14) 0.60–10.80	12.65 (14) 6.70–29.00	25.71 (14) 13.50–56.50	191.00 (14) 72.00–667.00	1.80 (13) 0.95–4.40	467.50 (6) 110.20–631.00
Medication-induced GM	20	18.2	Medication-induced GM	60.00 (20) 33–91	14.30 (13) 4.50–44.20	3.30 (9) 2.00–29.90	6.70 (9) 2.00–47.00	286.00 (11) 137.00–602.00	2.10 (16) 0.90–4.80	332.50 (6) 129.00–1171.00
Testicular tumor	2	1.8	Other causes	34.00 (6) 18–44	8.50 (5) 1.40–22.90	2.10 (4) 0.80–3.50	4.35 (4) 1.30–7.40	309.00 (5) 110.00–1030.00	0.39 (4) 0.03–1.40	997.00 (2) 747.00–1247.00
Hepatic injury	1	0.9
Thyreotoxicosis	1	0.9
Anabolic steroid abuse	2	1.8
All	110	100.0	Referent ranges		8.5–42	2–8	3–12	<350	0.3–4.0	<180