Here in Manhattan, gynecomastia patients tend to be fairly savvy about their condition. Many are aware that hormones almost always play a role in man boobs. That’s why some people we work with ask whether it would be a good idea to see an endocrinologist and have their hormone levels tested.
We understand the logic behind the question, but we usually find a hormonal workup to be unnecessary prior to male breast reduction surgery. Let us explain.
The many decisions we make together with our patients start with an open, honest discussion and a complete medical history. In most cases, the men who consult us report noticing signs of gynecomastia during puberty, when hormone levels can swing widely. But while other aspects of sexual development proceeded normally, with male characteristics falling into place eventually, moobs did not disappear in time for these men.
This is a very common scenario. Over the years we’ve found that these patients who do elect to have their hormones evaluated discover the levels are normal.
Some patients’ hormones may be out of whack due to drug use. This is another topic we cover in our medical history conversation. Whether a patient has been using prescription drugs that can trigger gynecomastia – such as Propecia – or street drugs like marijuana and anabolic steroids, it’s important that we talk about the matter frankly, including the patient’s future plans. In most cases, gynecomastia surgery can produce a very satisfying outcome. But patients need to understand the implications of using certain drugs.
Occasionally we see patients with an underlying medical condition that interferes with hormone levels, thereby contributing to gynecomastia. We evaluate these cases with care, working with other physicians when needed to determine whether male breast reduction can be performed safely and effectively.
Rarely, we meet a patient whose history indicates hormone levels may indeed be awry. An example could be a man who sailed through adolescence with no evidence of man boobs, then suddenly developed gynecomastia in his 20’s or 30’s for no apparent reason. We would likely refer a case like this to an endocrinologist.
In fact, we never discourage our Manhattan gynecomastia patients from having their hormone levels tested if they so desire. Medicine is one field in which you rarely hear someone complain about “too much information.”

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