Gynecomastia: When is treatment indicated?
This algorithmic approach can simplify your clinical evaluation and help you decide whether intervention or watchful waiting is appropriate.
CASE Mr. J had a pituitary prolactin-secreting microadenoma causing secondary hypogonadism and gynecomastia. He was started on cabergoline (a dopamine agonist) 0.5 mg orally once a week. Four months later, his total testosterone level was 291 ng/dL, and prolactin was 9.3 ng/mL. His headaches and gynecomastia had significantly decreased. He continued to do well on the same regimen and, 6 years later, his prolactin level was 1.4 ng/mL, indicating that treatment had been effective.
CORRESPONDENCE
Roy N. Morcos, MD, Department of Family Medicine, St. Elizabeth Health Center, 1044 Belmont Avenue, Youngstown, OH 44501; roymorcos@gmail.com
