Can elevated prolactin levels cause or make gynecomastia worse, even though all other hormone tests are normal?

I'm 30 years old. Had gyno since 11. I have a soft tissue gland in my left pec. In 2009 my gyno got more prominent and last year it seemed to get even worse. The gland in my left pec has gotten larger. I have puffy nipples in both pecs. I workout and stay lean year round. My prolactin is 37. My endocrinologist wants me to start taking cabergoline next week. Can elevated prolactin levels make pre-existing gyno worse? I don't want to get surgery until my prolactin levels are normal? Thanks

Doctor Answers 3

Causes of Gynecomastia

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The male breast is composed of glandular tissue and fatty tissue. An excess in either type of tissue can cause the chest to take on the look of gynecomastia. Gynecomastia can affect #men of all different body types. There are different types of #gynecomastia.

According to official statistics, 36% of adult young men and 57% of older #adult men in the United States have this medical condition in one of the four grades. 
About 200,000 to 3 million cases of #gynecomastia are being reported every single year. So if you have #breast #enlargement and you feel you're an exception, please understand that 1 in 3 young adult #men and 1 in 2 older adult men are just like you and have breast #enlargement.
Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.
There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. 
The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate. 

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Elevated prolactin levels and gynecomastia

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Yes. These are the most common causes of elevated prolactin levels:

Causes of Hyperprolactinemia
  • Prolactinomas
  • Medications (phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors, estrogens, verapamil)
  • Stress
  • Pregnancy
  • Hypothyroidism
  • Kidney disease
  • Chest trauma
Unless you are taking one of the medications, or your thyroid level is very low, you probably have a Prolactinoma, which is a growth in the Pituitary gland in your brain. Your prolactin levels should start to lower within a few weeks though they may take a few months to normalize. You will probably always have to take the Cabergoline or the high prolactin will likely return. Once your prolactin level has normalized, you can consider gynecomastia surgery. Since the actual breast gland is removed with the surgery, the gynecomastia should not return, or perhaps minimally, even if your Prolactin level should rise again. Good luck.

Can elevated prolactin levels cause or make gynecomastia worse, even though all other hormone tests are normal?

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Your prolactin level and gynecomastia can be intimately related. Please follow up with your doctor as these issues require the attention of a plastic surgeon. Seek a plastic surgeon with specialty training in gynecomastia surgery.

Ron Hazani, MD, FACS
Beverly Hills General Surgeon
4.9 out of 5 stars 318 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.