Increased Morbidity in Males Diagnosed with Gynecomastia: A nationwide register-based cohort study

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CONTEXT: Evidence on the long-term and general health of males with gynecomastia is entirely lacking.

OBJECTIVES: To assess health prior to and following a diagnosis of gynecomastia.

METHODS: A register-based cohort study of 140,574 males, of which 23,429 males were diagnosed with incident gynecomastia and age- and calendar-matched (1:5) to 117,145 males without gynecomastia from the background population. Males with gynecomastia were stratified into males without (idiopathic) or with a known pre-existing risk factor (disease/medication). Cox and logistic regression models investigated associations of disease risk according to ICD-10 chapters following and prior to gynecomastia diagnosis.

RESULTS: A total of 16,253 (69.4%) males in the cohort were identified with idiopathic gynecomastia. These males had a statistically significant higher risk of future disease across all included disease chapters (HR range: 1.19 to 1.89), with endocrine diseases representing the greatest disease risk (HR 1.89, 95% CI: 1.76 to 2.03). The highest sub-chapter disease risk was observed for disorders of endocrine glands (OR 7.27, 95% CI: 6.19 to 8.54). Similarly, the odds ratios of comorbidities were higher across all included disease chapters (OR range 1.05 to 1.51), except for psychiatric disease (OR 0.72, 95% CI: 0.68 to 0.78), with the highest association with musculoskeletal/connective tissue (OR 1.51, 95% CI: 1.46 to 1.57) and circulatory (OR 1.36, 95% CI: 1.29 to 1.43) diseases.

CONCLUSIONS: The presence of idiopathic gynecomastia is an important first clinical symptom of an underlying disease and a significant predictor of future disease risk. These findings should stimulate more awareness among health care providers to increase identification of gynecomastia and its causes in males.

TidsskriftThe Journal of clinical endocrinology and metabolism
Udgave nummer7
Sider (fra-til)e380–e387
Antal sider8
StatusUdgivet - 2023

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© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail:

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