Gynecomastia: Causes, Symptoms, and Treatment

Gynecomastia is a medical condition characterized by the development of enlarged breast tissue in males. While not typically harmful, it can cause physical discomfort and emotional distress. Let’s delve into the details of gynecomastia, including its causes, symptoms, and available treatment options.

High natural testosterone production in men is associated with blood clots and heart disease

Analysis of two major Mendelian randomization studies revealed that endogenous testosterone production in men is positively correlated with blood clots, heart attack, and heart failure. Data from at least 200,000 participants were included in the analysis. A proposed mechanism for such a risk is the testosterone conversion into estrogen, in turn contributing to thromboembolism. Testosterone can also increase platelet aggregation via the thromboxane A2 pathway.

Data from these “natural experiments” overall follow the observed increased risk of deep venous thrombosis and heart disease in men who are over-supplemented with exogenous testosterone. On the contrary, low Testosterone levels are also associated with visceral adiposity, low muscle mass, and insulin resistance.  From a cardiovascular perspective, future clinical research is needed to identify the balancing point of how much or little testosterone men should have.


New FDA Approval: Subcutaneous Testosterone Pen

The FDA has now approved the first subcutaneous testosterone auto-injector pen (Xyosted) for symptomatic patients with low testosterone levels. It is self-administered once weekly and is available in three doses: 50 mg, 75 mg, and 100 mg. The recommended starting dose is 75 mg per week.