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Introduction
  • Benign breast enlargement in males secondary to increased effective estrogen
    • can be increased production or decreased degradation
    • also result of decrease in androgens leaving estrogens unopposed
  • May occur naturally throughout male life
    • newborn
      • secondary to high maternal estrogen
    • puberty
    • elderly
      • secondary to androgen decrease
  • Associated conditions
    • cirrhosis
    • genetic diseases
      • Klinefelter syndrome
        • increased aromatizing activity of Leydig cells
        • high estrogen results in increased male breast cancer risk
      • testicular feminization
    • cancer
      • choriocarcinoma of testis
        • high production of hCG (an LH analogue)
    • drugs
      • estrogen
      • marijuana
      • flutamide
        • blocks androgen receptors
      • leuprolide
        • blocks androgen production
      • psychoactive drugs
      • "Some Drugs Create Awesome Knockers"
        • Spironolactone
          • block androgen receptors, displaces estrogen from SHBG
        • Digitalis
          • intrinsic estrogen activity
        • Cimetidine
        • Alcohol
        • Ketoconazole
          • displaces estrogen from SHBG

 

 

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