Original Article

Clinical and Biochemical Phenotype of Adolescent Males with Gynecomastia


  • Milosz Lorek
  • Dominika Tobolska-Lorek
  • Barbara Kalina-Faska
  • Aleksandra Januszek- Trzciakowska
  • Aneta Gawlik

Received Date: 26.02.2019 Accepted Date: 17.05.2019 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub] PMID: 31117335


Gynecomastia is defined as benign proliferation of male breast glandular tissue. Its prevalence during puberty stands at 50-60% and this condition is common also in neonatal and elderly males. It develops mainly due to the disequilibrium between estrogen and androgen activity in breast tissue, where estradiol binds to estrogen receptor and stimulates ductal and glandular cells. The aim of this work was to find a relationship between the sex hormones alterations and the natural history (evolution) of gynecomastia. Furthermore, the work tries to indicate the importance of checking the E2/TTE ratio.

Materials and Methods:

Participants in this study were 93 male patients aged 9 to 18 (mean age 13.8 ± 2.6) referred to an outpatient clinic between January 2011 and February 2016 with breast enlargement.


In 63 of 93 boys the gynecomastia was confirmed and 28 of them were follow-up (median of 3 months). None of all observed boys have reduced the size of breast during the observation and there was no correlation between BMI Z-Score and size of breast (p>0.05). Breast enlargement progressed in 9 boys (32.1%). We have observed a positive correlation between E2/TTE Ratio and Tanner B stage (r=0.47; p=0.034).


The E2/TTE ratio may be a helpful tool in diagnosing gynecomastia. Altered E2/TTE ratio might be responsible for part of cases described previously as idiopathic. Additionally, weight loss does not imply reduction of breast size in boys, nonetheless it should be the first step before further treatment of prolonged gynecomastia.

Keywords: Pubertal, Gynecomastia, Estradiol, Testosterone, Ratio