However, these are general alpha adrenergic antagonists and therefore have a much broader action than is needed and some unwanted side effects. Infertility Male fertility is dependent on the quantity of semen ejaculated, the number of sperm per mililiter, and the motility and morphology of the sperm. On average some 400 million sperm are ejaculated in a fluid volume of 3 ml. Autoimmune disturbances, ejaculation disturbances and anatomic abnormalities are much less common causes. Proposed mechanisms for this disorder involve an imbalance between estrogen and androgen concentration or an abberation in response at the mammary gland level.
Chronic gynecomastia is usually asymptomatic.
Acute gynecomastia often presents with nipple or breast pain and tenderness, enlarged breasts and sometimes a discharge. Patients may be more at risk for breast cancer . Treatment is by removing the underlying cause or drug. Antiestrogens are useful for relieving pain and reversing gynecomastia in some patients. For cosmetic reasons, surgical reduction may be considered.