A consecutive series of 4,023 men attending our Outpatient Clinic for SD was retrospectively studied.
RESULTS: After excluding
Klinefelter's syndrome patients, the prevalence of
gynecomastia was 3.1 %. Subjects with
gynecomastia had significantly lower
testosterone (T) levels; the association retained statistical significance after adjusting for age and life-style. However, only 33.3 % of subjects with
gynecomastia were hypogonadal.
Gynecomastia was associated with
delayed puberty, history of testicular or hepatic diseases, as well as
cannabis abuse. Patients with
gynecomastia more frequently reported sexual complaints, such as severe
erectile dysfunction [odds ratio (OR) = 2.19 (1.26-3.86), p = 0.006], lower sexual desire and intercourse frequency [OR = 1.23 (1.06-1.58) and OR = 1.84 (1.22-2.78), respectively; both p < 0.05], orgasm difficulties [OR = 0.49 (0.28-0.83), p = 0.008],
delayed ejaculation and lower ejaculate volume [OR = 1.89 (1.10-3.26) and OR = 1.51 (1.23-1.86), respectively; both p < 0.05].
Gynecomastia was also positively associated with
severe obesity, lower testis volume and LH, and negatively with
prostate-specific antigen levels. The further adjustment for T did not affect these results, except for
obesity. After introducing body mass index as a further covariate, all the associations retained statistical significance, except for
delayed ejaculation and ANDROTEST score. When considering
gynecomastia severity, we found a step-wise, T-independent, decrease and increase of testis volume and LH, respectively.
Gynecomastia was also associated with the use of several drugs in almost 40 % of our patients.
CONCLUSION: