{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:41:51Z","timestamp":1764290511734,"version":"3.46.0"},"reference-count":29,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Gynecomastia is defined as an enlargement of the male breast. Although it is commonly seen during puberty, it is often overlooked by many physicians. As adolescent medicine specialists, we believe there is a gap in the literature concerning both the etiology and maybe more importantly the care of these adolescents. Thus, we have been dedicated to conducting research on this topic. The aim of this review article was to evaluate the studies concerning pubertal gynecomastia that took place at the Division of Adolescent Medicine, Hacettepe University, published between the years 2003 and 2016. The review covers in detail both the short- and long-term effectivity and safety of tamoxifen used for the treatment of pubertal gynecomastia. As the exact basis for the pathogenesis of gynecomastia remains unknown, we also evaluate three studies that aimed to answer this question. We additionally review a study that aimed to assess the psychological distress and effect on body image that gynecomastia may have on the adolescent male. An important contribution this review article adds to the literature is as a conclusion to all the studies performed, we present the \u2018Hacettepe indications for tamoxifen treatment for pubertal gynecomastia\u2019. These indications will aid physicians when considering treating these patients.<\/jats:p>","DOI":"10.1515\/ijamh-2017-0011","type":"journal-article","created":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T11:39:40Z","timestamp":1497008380000},"source":"Crossref","is-referenced-by-count":2,"title":["Pubertal gynecomastia: years of progress \u2013 the Hacettepe experience"],"prefix":"10.1515","volume":"31","author":[{"given":"Sinem","family":"Akg\u00fcl","sequence":"first","affiliation":[{"name":"Division of Adolescent Medicine , Department of Pediatrics , Hacettepe University Faculty of Medicine , Ankara , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orhan","family":"Derman","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine , Department of Pediatrics , Hacettepe University Faculty of Medicine , Ankara , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuray","family":"Kanbur","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine , Department of Pediatrics , Hacettepe University Faculty of Medicine , Sihhiye , 06100 Ankara , Turkey , Tel.: 0312-3051160"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2017,6,9]]},"reference":[{"key":"2025112800361561836_j_ijamh-2017-0011_ref_001_w2aab3b7b4b1b6b1ab1b5aAa","doi-asserted-by":"crossref","unstructured":"Akg\u00fcl S, Kanbur N, Derman O. A different training model for adolescent medicine: a PhD program in Turkey, where adolescent medicine is not currently a sub-specialty at this stage. Int J Adolesc Med Health. 2016;28(3):269\u201372.2611549510.1515\/ijamh-2016-5008","DOI":"10.1515\/ijamh-2016-5008"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_002_w2aab3b7b4b1b6b1ab1b5b1Aa","doi-asserted-by":"crossref","unstructured":"Carlson HE. Gynecomastia. N Engl J Med. 1980;303(14):795\u20139.10.1056\/NEJM1980100230314056997736","DOI":"10.1056\/NEJM198010023031405"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_003_w2aab3b7b4b1b6b1ab1b5b2Aa","doi-asserted-by":"crossref","unstructured":"Braunstein GD. Gynecomastia. N Engl J Med. 2007;357(12):1229\u201337.1788175410.1056\/NEJMcp070677","DOI":"10.1056\/NEJMcp070677"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_004_w2aab3b7b4b1b6b1ab1b5b3Aa","doi-asserted-by":"crossref","unstructured":"Boljanovic S, Axelsson C, Elberg J. Surgical treatment of gynecomastia: liposuction combined with subcutaneous mastectomy. Scand J Surg. 2003;92(2):160\u20132.10.1177\/14574969030920020912841558","DOI":"10.1177\/145749690309200209"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_005_w2aab3b7b4b1b6b1ab1b5b4Aa","doi-asserted-by":"crossref","unstructured":"Lawrence SE, Arnold Faught K, Vethamuthu J, Lawson ML. Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia. J Pediatr. 2004;145(1):71\u20136.10.1016\/j.jpeds.2004.03.05715238910","DOI":"10.1016\/j.jpeds.2004.03.057"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_006_w2aab3b7b4b1b6b1ab1b5b5Aa","doi-asserted-by":"crossref","unstructured":"Riepe FG, Baus I, Wiest S, Krone N, Sippell WG, Partsch C-J. Treatment of pubertal gynecomastia with the specific aromatase inhibitor anastrozole. Horm Res. 2004;62(3):113\u20138.15273427","DOI":"10.1159\/000079882"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_007_w2aab3b7b4b1b6b1ab1b5b6Aa","doi-asserted-by":"crossref","unstructured":"Lapid O, van Wingerden JJ, Perlemuter L. Tamoxifen therapy for the management of pubertal gynecomastia: a systematic review. J Pediatr Endocrinol Metab. 2013;26(9-10):803\u20137.23729603","DOI":"10.1515\/jpem-2013-0052"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_008_w2aab3b7b4b1b6b1ab1b5b7Aa","doi-asserted-by":"crossref","unstructured":"Wood AJ, Osborne CK. Tamoxifen in the treatment of breast cancer. N Engl J Med. 1998;339(22):1609\u201318.10.1056\/NEJM1998112633922079828250","DOI":"10.1056\/NEJM199811263392207"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_009_w2aab3b7b4b1b6b1ab1b5b8Aa","doi-asserted-by":"crossref","unstructured":"Derman O, Kanbur N\u00d6, Kutluk T. Tamoxifen treatment for pubertal gynecomastia. Int J Adolesc Med Health. 2003;15(4):359\u201364.14719418","DOI":"10.1515\/IJAMH.2003.15.4.359"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_010_w2aab3b7b4b1b6b1ab1b5b9Aa","doi-asserted-by":"crossref","unstructured":"Derman O, Kanbur N, K\u0131n\u0131\u00e7 I, Kutluk T. Long-term follow-up of tamoxifen treatment in adolescents with gynecomastia. J Pediatr Endocrinol Metab. 2008;21(5):449\u201354.18655526","DOI":"10.1515\/JPEM.2008.21.5.449"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_011_w2aab3b7b4b1b6b1ab1b5c10Aa","doi-asserted-by":"crossref","unstructured":"Derman O, Kanbur N, Tokur TE. The effect of tamoxifen on sex hormone binding globulin in adolescents with pubertal gynecomastia. J Pediatr Endocrinol Metab. 2004;17:1115\u201320.15379424","DOI":"10.1515\/JPEM.2004.17.8.1115"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_012_w2aab3b7b4b1b6b1ab1b5c11Aa","doi-asserted-by":"crossref","unstructured":"Kilic M, Kanbur N, Derman O, Akg\u00fcl S, Kutluk T. The relationship between pubertal gynecomastia, prostate specific antigen, free androgen index, SHBG and sex steroids. J Pediatr Endocrinol Metab. 2011;24(1-2):61\u20137.21528817","DOI":"10.1515\/jpem.2011.112"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_013_w2aab3b7b4b1b6b1ab1b5c12Aa","doi-asserted-by":"crossref","unstructured":"Durmaz E, \u00d6zmert EN, Erkeko\u011flu P, Giray B, Derman O, H\u0131ncal F, et al. Plasma phthalate levels in pubertal gynecomastia. Pediatrics. 2010;125(1):e122\u20139.2000841910.1542\/peds.2009-0724","DOI":"10.1542\/peds.2009-0724"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_014_w2aab3b7b4b1b6b1ab1b5c13Aa","doi-asserted-by":"crossref","unstructured":"Pehlivant\u00fcrk K\u0131z\u0131lkan M, Akg\u00fcl S, Akb\u0131y\u0131k F, Derman O, Kanbur N. Evaluation of serum vitamin D levels in adolescents with pubertal gynecomastia. Breast Care. 2016;11:333\u20137.10.1159\/000451074","DOI":"10.1159\/000451074"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_015_w2aab3b7b4b1b6b1ab1b5c14Aa","doi-asserted-by":"crossref","unstructured":"Akg\u00fcl S, Kanbur N, G\u00fc\u00e7er \u015e, \u015eafak T, Derman O. The histopathological effects of tamoxifen in the treatment of pubertal gynecomastia. J Pediatr Endocrinol Metab. 2012;25:753\u20135.23155705","DOI":"10.1515\/jpem-2012-0105"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_016_w2aab3b7b4b1b6b1ab1b5c15Aa","doi-asserted-by":"crossref","unstructured":"Akg\u00fcl S, Derman O, Kanbur N. The effect of tamoxifen on pubertal bone development in adolescents with pubertal gynecomastia. J Pediatr Endocrinol Metab. 2016;29:77\u201383.26353169","DOI":"10.1515\/jpem-2015-0200"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_017_w2aab3b7b4b1b6b1ab1b5c16Aa","unstructured":"Esenbo\u011fa S, Akg\u00fcl S, Kanbur N, T\u00fcz\u00fcn Z, Derman O. The effect of gynecomastia on body image perception and gender roles in adolescents. Turk J Pediatr. 2015;57:60\u20137.26613222"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_018_w2aab3b7b4b1b6b1ab1b5c17Aa","doi-asserted-by":"crossref","unstructured":"Love RR. Tamoxifen therapy in primary breast cancer: biology, efficacy, and side effects. J Clin Oncol. 1989;7(6):803\u201315.10.1200\/JCO.1989.7.6.8032654333","DOI":"10.1200\/JCO.1989.7.6.803"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_019_w2aab3b7b4b1b6b1ab1b5c18Aa","unstructured":"Sawka CA, Pritchard KI, Paterson AH, Sutherland DJ, Thomson DB, Shelley WE, et al. Role and mechanism of action of tamoxifen in premenopausal women with metastatic breast carcinoma. Cancer Res. 1986;46(6):3152\u20136.3084082"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_020_w2aab3b7b4b1b6b1ab1b5c19Aa","doi-asserted-by":"crossref","unstructured":"Selby C. Sex hormone binding globulin: origin, function and clinical significance. Ann Clin Biochem. 1990;27(6):532\u201341.10.1177\/0004563290027006032080856","DOI":"10.1177\/000456329002700603"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_021_w2aab3b7b4b1b6b1ab1b5c20Aa","doi-asserted-by":"crossref","unstructured":"Hammond GL. Diverse roles for sex hormone-binding globulin in reproduction. Biol Reprod. 2011;85(3):431\u201341.2161363210.1095\/biolreprod.111.092593","DOI":"10.1095\/biolreprod.111.092593"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_022_w2aab3b7b4b1b6b1ab1b5c21Aa","doi-asserted-by":"crossref","unstructured":"Kim M, Gupta M, Travers S, Rogers D, Van Lente F, Faiman C. Serum prostate specific antigen, sex hormone binding globulin and free androgen index as markers of pubertal development in boys. Clin Endocrinol. 1999;50(2):203\u201310.10.1046\/j.1365-2265.1999.00636.x","DOI":"10.1046\/j.1365-2265.1999.00636.x"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_023_w2aab3b7b4b1b6b1ab1b5c22Aa","doi-asserted-by":"crossref","unstructured":"Vieira J, Nishida S, Pereira A, Arraes R, Verreschi I. Serum levels of prostate-specific antigen in normal boys throughout puberty. J Clin Endocrinol Metab. 1994;78(5):1185\u20137.7513717","DOI":"10.1210\/jcem.78.5.7513717"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_024_w2aab3b7b4b1b6b1ab1b5c23Aa","doi-asserted-by":"crossref","unstructured":"Zoeller RT, Brown T, Doan L, Gore A, Skakkebaek N, Soto A, et al. Endocrine-disrupting chemicals and public health protection: a statement of principles from The Endocrine society. Endocrinology. 2012;153(9):4097\u2013110.10.1210\/en.2012-142222733974","DOI":"10.1210\/en.2012-1422"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_025_w2aab3b7b4b1b6b1ab1b5c24Aa","doi-asserted-by":"crossref","unstructured":"Shea KM. Pediatric exposure and potential toxicity of phthalate plasticizers. Pediatrics. 2003;111(6):1467\u201374.10.1542\/peds.111.6.146712777573","DOI":"10.1542\/peds.111.6.1467"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_026_w2aab3b7b4b1b6b1ab1b5c25Aa","doi-asserted-by":"crossref","unstructured":"Sibonga JD, Evans GL, Hauck ER, Bell NH, Turner RT. Ovarian status influences the skeletal effects of tamoxifen in adult rats. Breast Cancer Res Treat. 1996;41(1):71\u20139.893287810.1007\/BF01807038","DOI":"10.1007\/BF01807038"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_027_w2aab3b7b4b1b6b1ab1b5c26Aa","doi-asserted-by":"crossref","unstructured":"Kinsella C, Landfair A, Rottgers SA, Cray JJ, Weidman C, Deleyiannis FW, et al. The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg. 2012;129(1):1\u20137.2191508410.1097\/PRS.0b013e3182361efd","DOI":"10.1097\/PRS.0b013e3182361efd"},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_028_w2aab3b7b4b1b6b1ab1b5c27Aa","unstructured":"Alagaratnam T. Treating puberty gynecomastia. JR Coll Gen Pract. 1987;37(297):178."},{"key":"2025112800361561836_j_ijamh-2017-0011_ref_029_w2aab3b7b4b1b6b1ab1b5c28Aa","doi-asserted-by":"crossref","unstructured":"Atabek ME. Gynecomastia in puberty is usually asymptomatic and regresses spontaneously. J Pediatr Endocrinol Metab. 2013;26(5-6):605.23412861","DOI":"10.1515\/jpem-2012-0403"}],"container-title":["International Journal of Adolescent Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/ijamh.2019.31.issue-3\/ijamh-2017-0011\/ijamh-2017-0011.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/ijamh-2017-0011\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/ijamh-2017-0011\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:37:16Z","timestamp":1764290236000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/ijamh-2017-0011\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,9]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,1,25]]},"published-print":{"date-parts":[[2019,6,26]]}},"alternative-id":["10.1515\/ijamh-2017-0011"],"URL":"https:\/\/doi.org\/10.1515\/ijamh-2017-0011","relation":{},"ISSN":["2191-0278","0334-0139"],"issn-type":[{"type":"electronic","value":"2191-0278"},{"type":"print","value":"0334-0139"}],"subject":[],"published":{"date-parts":[[2017,6,9]]},"article-number":"20170011"}}