Abstract 130: Clinical and etiological aspects of gynecomastia in 270 patients presenting at a Tertiary care centre

Objectives: To evaluate the characteristics of presentation, biochemical profile, and etiology of gynecomastia in patients Methods: Medical records of 270 patients with gynaecomastia were evaluated Results: The medical records of 270 males presenting with symptoms of gynaecomastia were reviewed. Mean duration of symptoms at the time of presentation was 41 +- 53.31 months. Besides clinical examination, diagnosis of gynaecomastia was documented by sonomammography in 27.22% of patients. Based on BMI 20.2% patients were overweight and (6.9%) patients were Obese. Median age at the time of presentation was 19.0 years (range 10-72 years). Pain was associated in 57.4% patients. Bilateral gynaecomastia was seen in patients 76.23%. Associated erectile dysfunction along with loss of libido were observed in 10 patients (3.9%). In 43.3% patients etiology of gynaecomastia was idiopathic. Other common etiologies were Pubertal (37.0%), pharmaceutical drugs (6.6%), Anabolic steroids (2.2%), variococele (2.2%), Klinefelter syndrome and other causes of primary testicular failure (2.9%) and chronic alcoholism (1.48%). One patient was diagnosed with hypothyroidism. When compared to the idiopathic group patients presenting secondarily to pharmaceutical drugs were older (P = 0.0343) while those with pubertal gynaecomastia were younger (p = 0.0001). Patients with klinefelter syndrome (p = 0.001), other causes of primary gonadal failure (p = 0.0007) and chronicalcoholism (0.019) had mean testicular volume that was less when compared to idiopathic group. Patients with klinefelter syndrome and other causes of primary testicular failure had low testosterone values and higher FSH and LH values when compared to idiopathic group. Conclusions: Patients with gynecomastia presented more often with aesthetic concerns and breast pain. The most frequent diagnosis was idiopathic gynecomastia, whereas the most frequent identified etiologies were pharmaceutical drugs, anabolic steroids consumption, hypogonadism. Although other etilogies were less frequent, patients presenting with gynaecomastia should be subjected to thorough work up.