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Gynecomastia and me.

23:17 / 01.08.02

I have never had a discussion about gynecomastia. I think that I've actually had conversations about it with three or four people in my life. Which is odd, given the enormous impact it has had on me. For those of you who don't know, which I suspect is a lot of you, gynecomastia is a condition where men develop breasts. It affects a surprisingly large proportion of males, about a third. See here.

I was reminded of it, having just been to Barcelona, where I exerienced a good deal of anxiety when facing the prospect of meeting people at a swimming pool. I was reminded of my adolescence and my time at school. Although I had an operation about ten years ago it wasn't as successful as I'd have liked and now I am clinically obese, which doesn't help matters.

I've worked hard to come to terms with my body - my involvement with fetish and SM has been incredibly positive - but now that I'm starting to feel more at ease, I can't help thinking about how little I shared my problem. I'm wondering about a sort of chicken and egg question here. In terms of male health issues, does the reluctance of men in seeking help and support set the tone? Or is there a genuine lack of support due to gender stereotypes?

Also, given that the statistics say I'm really not alone, why have I never spoken to someone else with the condition? I couldn't, of course. But in retrospect, I find this deeply disturbing.

00:30 / 02.08.02

In my medical finals, I was asked to examine a man with 'true gynaecomastia', and explain how the condition differed from 'normal' male adipose development. More actual fibrous/glandular breast tissue - and quite evident on examination.

I think it remains a smirksome 'titter ye not' subject, even amongst doctors. 'Course, the single commonest cause of gynaecomastic (certainly at the time I was studying for my finals) was as part of liver damage secondary to alcohol abuse - so men tended to present with a whole range of symptoms, of which gynaecomastia was relatively low-priority (ie. distressing but not life-threatening or even 'unhealthy' as such) compared to addressing the numerous physical, psychological and social problems associated with their alcoholism. In restrospect, we probably saw the fairly severe end of the scale. I'm certainly rather surprised to hear that a full third of men are apparently classed as having gynaecomastia.

I think men don't go to see doctors - or, for that matter, anyone else - about it, precisely because there's that puerile, faintly Carry On element to the situation. That and men's general reluctance to discuss their health.

For what it's worth, Lurid, I tend to register even mild gynaecomastia and, when we went to Torture Garden that time, I didn't notice anything out of the ordinary (and I did look

). Then again, I didn't think you were obese either, m'dear...

07:53 / 02.08.02

Yeah, but I tend to choose clothes that are flattering. In fact, this seems to be a large component of men's experience with the condition.

And the obesity thing I find a bit wierd. I know I'm overweight, but obese? My doctor assures me that I'm at the "edge" of obesity by some scale or other.

STOATIE LIEKS CHOCOLATE MILK

07:58 / 02.08.02

I had it- only one tit, though. It took me years to go to the doctor- not out of embarrassment (it wasn't all that visible) but because I thought it was cancer or something and figured I'd rather not know (dumb reaction, I know). When I had the operation (about 6 years ago), they neglected to tell me that I might lose the nerves in that nipple. Bastards. (Funnily enough, it hurt when I had it pierced, whereas the one with the intact nerves didn't hurt half as much.)

But yeah, it's not really the kind of thing I talk about very often.

08:25 / 02.08.02

Oh, bloody hell, Lurid, we're all obese by some scale or other! With the rise of 'health promotion' (ie. nagging), some GPs tend to focus on weight issues, while others decide to aggressively target smokers, social drinkers, blah blah blah. Best way to balance this is to actively attempt to meet some 'obese' people from the US: that should help recalibrate your internal scales...

08:52 / 02.08.02

So the scale used was the Body Mass Index, I believe. Doesn't this represent a fair indication of health risk? I know that there are people a lot heavier than me, but I also know that I'm heavier than many. Of course, my feeling is that doctors are more insensitive in dealing with men and body image. But though I've had a fair few doctors, at least 10, I'm not sure that I could say my experiences have been representative. And its hard to compare, except via second hand accounts.

Maominstoat: Yeah, no one told me about the nipple thing either.

09:11 / 02.08.02

The Body Mass Index is pretty mainstream, yeah (although my own direct experience with it is generally at the other end of the scale, assessing whether or not anorexics are dangerously under weight) but terminology such as 'obese' is rather imprecise - it's like saying a woman who drinks more than fourteen units of alcohol a week is automatically an 'alcoholic'.

09:34 / 02.08.02

Yeah - Lurid, don't worry too much if you can help it. My BMI is 'fine' according to my psychiatrist, but I'm fantastically unhealthy nevertheless because of the whole eating disorder thing - I also used to be considered 'obese' by some chart or other, and found that enormously depressing - however, I was actually a lot healthier then, and that matters a lot more, you know...

11:48 / 02.08.02

Adding my voice to Ganesh and Cholister... as I have said elsewhere (Head Shop thread on Fat) I have been classed as verging on the obese, and have been told by doctors that I should be trying to lose weight, when I think that I am basically fine (albeit slightly chubby, but not unhealthily so). The indicators they use seem to give a 'normal' weight range of about two stone, which is a little limited given all the different body types out there. I wouldn't worry about the classification you've been given, just about how you feel about your body...

13:22 / 02.08.02

I went to a health fair, at a hospital. I was told that I should weigh 110 pounds. I have never in my adult life weighed that little, and I have gone a long period of time without eating enough. I am firmly convinced that were I to attempt that weight I would most likely have to go via organ failure

and yet this is the crap they teach us. and aside from a better education of the whole thing, health professionals are no less fallible and not much less prone to the vagaries of societies body image perceptions

14:05 / 02.08.02

Thats all true but obesity is a problem and I know that I for one do need to take more care with my health, as well as examining the way I deal wirth food. It is hard finding a balance between that and adopting unneccssary stereotypes.

14:10 / 02.08.02

Well, to be fair, it's not entirely bollocks: there's plenty of broad statistical evidence to show that being X amount overweight significantly increases one's chances of developing Y or Z disease. With an increasing emphasis on illness prevention, doctors aren't actually wrong to advise weight loss, generally. It's only one risk factor among many, though, and attempting to be overly specific ("you must weigh 110 pounds") makes for a rather limited approach. It also makes general assumptions with regard to one's life priorities (eg. 'normal weight' = 'health' = 'happiness').

Jack The Bodiless

11:17 / 04.08.02

Obesity is certainly a problem... it's also a scare word. 'Fat' is a playground insult, 'overweight' is generally either used as a euphemism or as a subjective attack on your own weight... 'obese' is the extreme, and adding the word 'clinically' adds verisimilitude and... well, weight.

Lurid, regardless of whether your doctor would describe you as obese, you simply don't look obese - if you were huge, no amount of clever dressing could hide it. This should take the power out of the phrase right away - reducing it to the level of medical diagnosis. The more important thing to focus on, as say, is your health and your relationship with what you eat. I liked my body more when I was horribly unhealthy (existing on a diet of Doritos, scotch and cigarettes), and now that I'm eating properly, I'm getting a wee bit porky...

As regards discussion of the gynaecomastia - you're right, doctors display less empathy with men. So does the rest of society... and that's mostly because we don't talk about our mental and physical health (I generalise, obviously). Case in point - provided everything with me and miss spooky continues as swimmingly as it has to date, when I turn thirty I intend to have a vasectomy. I suggested it, we've discussed it, and we agreed that for us, with the lifestyle and sexual habits that we have, it's a sensible idea. And despite the fact that me and spooks talk about everything, I still haven't talked to her about the fact that I've started having bad dreams about it, or about the fact that I know that my reaction to being circumcised during puberty is responsible. The idea of 'Little Jack' going under the knife again terrifies me. But I've not mentioned it to her once, and I have no idea why...

I have no idea now whether that's in any way similar to what you're referring to Lurid... have a sneaking suspicion I've just coopted your thread. Felt good to get it off my chest, though...

11:28 / 04.08.02

(Side point: 'Little Jack' won't be harmed at all, during vasectomy; they don't go anywhere near the penis itself or, for that matter, the testes. It's such a simple little snipping of the vas deferens on each side that it can be safely carried out in around twenty minutes under a local anaesthetic. I would however advise storing sperm samples just in case you change your minds re: future offspring and there are problems with reversing the procedure.)

Lurid: if you weren't advised that pectoral/breast operations typically result in decreased nipple sensitivity, then that probably does reflect underlying assumptions/stereotyping on the part of doctors. It's something that is routinely discussed with women (including transwomen) attending for breast surgery, so I'd have to wonder whether the concept of men deriving pleasure from their nipples ever crosses surgeons' minds at all...

18:59 / 04.08.02

Jack: I think that your experiences are precisely the kind of things we should be talking about. As you say, we don't talk enough about our health. When I had my breast op, the consultant explained that the incision would under the "swell", due to the size. As it turned out, the incision was made under the nipples and about half the breast tissue was removed. Moreover, one of my nipples ended up a bit folded (not sure how to explain that), though it has straightened over the years. The point is that, as an 18 year old, I was too scared to talk about any of this and I just accepted what had happened. Also, when the psychological problems didn't go away with the op, it didn't occur to me that I might seek help.

Now I was particularly inept at dealing with the situation, but I feel that there was something "male" about my behaviour. Anyway, the title was intended to confront my own anxiety, not to limit the discussion. Vasectomies, as I understand it, are a source of anxiety for many men. And talking about them also seems to involve giggles and scare stories. I'm glad you feel a bit better, Jack, and I hope that Ganesh info helps some.

22:03 / 04.08.02

There's probably quite a good head shop topic to be started about how men relate to health professionals, something that has been explored in the female context... I've certainly had a lot of contact with the wonderful world of healthcare, and even in the simplest and best explored cases (flu, broken bones etc) I've felt a "you've come here, so stop whinging and do what we tell you" subtext. Patients are very sensitive to this sort of thing. If they feel the doctor isn't treating a condition very seriously they will often think that they're over-reacting, making too much of a fuss etc.

I say this partly because I realise I've had GERB for five years and nothing really has been done about it, besides being told "it's stress, calm down, have you tried these breathing exercises?" Which, if there really is no other solution known to medical science, is fair enough, but I'm not convinced every avenue has been explored.

The masculine role as perceived by patient vs doctor is, I feel, a very important thing to explore, and it's conditions like gynecomastia that challenge gender roles through physical symptoms that can help explore these things. I wouldn't want to make you (Lurid) feel like a test case, but you have a condition that can make people think.

22:49 / 04.08.02

This may well be an example of poor health-related communication but... what's "GERB"? It's not an acronym I know, and Google isn't helping.

We spent a little while discussing the many difficulties of the doctor-patient relationship (and I suspect that many cases of subjectively 'not being taken seriously' are indicative of a generational change in the expectations of the patient - and a general failure on the part of medical training establishments to reflect that change) but not specifically from the male viewpoint. The general cliche is that men are, broadly speaking, less likely to visit their doctors or assume the sick role - but when they do, they really go for it...

23:00 / 04.08.02

er, sorry, GERB is... a typo. I meant GERD
(gastro-eosophogial reflux disease to those unfamiliar)

I think to be honest that there is a specific gender-ID-related issue to be examined here. It's clear that there is very different gender behaviour with respect to medical services, I think that's undeniable. I'd be interested to hear what differences you have observed, Ganesh, on the sharp end... but it's also a question of what people perceive as gender-based expectations as patients. After all, patients don't come into the doctor-patient relationship as pure consumers.

I think I'll start a head shop topic on this...

23:10 / 04.08.02

the head shop topic is here

23:55 / 04.08.02

The general cliche is that men are, broadly speaking, less likely to visit their doctors or assume the sick role - but when they do, they really go for it... Ganesh

Do you think that this second part holds some truth? Or is it an extension of the view that real men don't complain and certainly don't cry.

00:36 / 05.08.02

I think the second part is an extension of the 'men don't get trivial illnesses' assumption. Men's attitude to health, within western society, is tinged with silent (supposedly stoical) machismo - as exemplified, off the top of my head, by that appalling Beechams advert, 'Lemsip separates the men from the boys' or whatever - so when we do decide we're ill, our male pride requires that the illness be 'serious'. We cannot, therefore, ever have 'a touch of 'flu'; it's undoubtedly pneumonia...

08:22 / 11.08.02

I have a slight tendency to gain weight like a girl, which doesn't go together well with being slightly overweight. The thing that pisses me off about my breasts is that they change in size without warning or consistency. So, I'll look in the mirror and be within normal range, then I'll come back two minutes later and they've decided to spread out a bit, making me look very silly.

This isn't a big issue for me though, since I will be losing more weight than I really want to over the next few years for reasons completely seperate from body image.