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Updated: Jan 11 2018


  • 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
      • 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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