Patient: I am a 25 year old male and I have prominent female breasts, and I also don’t really grow facial hair or chest hair and my pubic hair grows in the triangular female pattern rather than up to the belly button, with no hair on the scrotum. I first started developing breasts at around age 12 or 13, but I didn’t grow facial or pubic hair or even become sexually active until i was around 17 or 18 years old, like i had a second puberty almost. I’m sure I have some kind of hormonal imbalance but none of my doctors have ever talked to me about it or mentioned it and I feel embarrassed to mention it to them. I do have chronic upper back pain though and poor posture because of the weight of my breasts but I’m not sure what to do about that. What should I do?
Symptoms: Hormonal imbalance, back pain
Doctor: Hello,Thanks for the query.Gynecomastia is a manifestation in itself without any other associated causes or it could be a part of a spectrum of diseases. In your case, it seems that it may be a part of a spectrum of diseases like a hormonal deficit of androgen and its receptor in the body, called androgen insensitivity syndrome. It presents with breasts appearing like females, lack of pubic hair, absence of secondary sexual characters like beard, etc and they generally appear feminine. Apart from this, there are many more such chromosomal mismatches and hormonal disorders which needs to be investigated in you to pick up the right one.Do not hesitate to see an andrologist or a physician. The doctor will need to do a head to toe examination and also send a few blood and hormonal investigations and an ultrasound of abdomen and pelvis as well may be needed. Based on the above, we can come to a conclusion on what is the actual concern for the symptoms. Hormonal supplements throughout life, surgeries and lifestyle changes may be treatment options. Kindly discuss regarding the above with your doctor and proceed further. The back pain may be associated with skeletal abnormalities and reduced calcium and vitamin B12. Get your calcium levels checked and supplements of calcium and vitamin B 12 with physiotherapy and back exercises will help youHope this helpedRegards