About: Charing Cross Hospital / General surgery St George's Hospital (Tooting) / General surgery

(as the patient),

I was diagnosed with Gynecomastia back in August 2008 but knew I had the condition a few years before that. I had tried extremely hard to lose the weight around my chest for three years. It is important that I mention that my BMI is 22; I am 6ft 2inches tall and weigh 12 stone. First I tried just going to the gym, then a combination of gym workouts and running. All of this was combined with a reasonably healthy diet but I was still unable to move the fat from my chest. Then I stopped the gym work and running in my final year of university and adopted indoor rock climbing instead. This did wonders for my body. I started losing fat around my stomach and love handles rapidly. Not to mention that my arms, shoulders, back and legs became more toned and continue to develop. I also cut out dairy products (milk, ice cream, pastries etc.) from my diet. Now I am climbing at an advanced intermediate level and continue to grow stronger after each session. I can see my abs (they aren’t washboard abs yet, but it’s nice to know I have them). But somehow, after all my hard work, the fat around my chest remains. It’s not an insane amount of fat and breast tissue but it is enough to make me feel self-conscious about taking my shirt off or wearing a fitted T-shirt (as the T-shirt hangs awkwardly on my body). The Gynecomastia is noticeable because I have a very slim waistline, so they literally stand out (as opposed to if I was over weight). My girlfriend was the first person to really notice the lumps and since then I can’t let her anywhere near my chest because it hurts and I feel so bloody insecure about it. We’ve lost our previous level of intimacy as a result. The GP (who was very helpful) was very straightforward and actually wanted to help me with my condition. He confirmed (after I had gone for an ultrasound) that it was mostly breast tissue and that there was more on the left side than the right. The reason for me going to the GP in August 2008 was because the breast tissue and area around my nipples had become painful. I would have waves of pain (centred right under the nipples) and they would hurt if any pressure was applied to them. Even if someone gives me a hug they will inadvertently apply pressure to the nipples and cause me to wince in pain. The pain is almost chronic, sometimes even keeping me up for a couple of hours at night.

When I was sent to a specialist by my GP (in December), the lady doctor who saw me was a junior doctor and inexperienced with male Gynecomastia and was frequently leaving the screening room to confer with her consultant or superior. I was sent to a breast clinic, which as we all know, has the prime function of diagnosing and treating women with breast cancer. I am, by no means, insinuating that she was a bad doctor. Just that she is used to treating women (with or without breast cancer) predominantly. Therefore someone in my condition is not seen as a priority. She did not even request that I undergo a mammogram or ultrasound, after she remarked that she could not find any lump on the right breast. I did not want to insult her by asking her if I should go and have another ultrasound, but in retrospect I should have (as the condition had changed). I told her that I used to smoke marijuana; she then explained that that could have caused the Gynecomastia although there is no conclusive proof. Prior to seeing the specialist I smoked marijuana once, maybe twice a month ( as a ritual with friends from university). Since she asked me to stop, I have done so and haven’t had any for over a month. But I also told her about my healthy lifestyle, diet and how I exercised (rock climbing) 3 times a week. At this point she left the room to consult with her superior. She came back with the verdict that I should come back in 6 months. Two nights before New Year’s Eve, the lump on my right breast (which the specialist could not find), caused me a great deal of pain so I couldn’t go to sleep.

I am still waiting to hear from the specialist. I was told I would receive a letter and that my GP would receive one too in two-three weeks. It has been over a month and the GP and I have not received anything. The breast clinic is almost impossible to contact and I do not have all day to sit in front of my telephone to make calls. Anyways, my suggestion is that the NHS should set up a clinic or a walk-in, or create some type of speciality that is specifically catered towards Gynecomastia. I believe that 6 months is too long for me to wait. I respect that there is a waiting period to see if it is actually marijuana that is causing it but surely someone as active as myself and someone who only smoked once or twice a month should not have to wait that long. The component of marijuana THC is supposed to store itself in the fat cells, but if you smoke infrequently, then the THC should leave your body in 3 – 6 weeks. I have stopped smoking marijuana, I am continuing with my healthy lifestyle. But slowly my self confidence is being chipped away, along with my sexual confidence. I cannot afford to go private. Not a lot of men feel comfortable talking about this and it took me some time to write this letter. But here it is. The NHS should have better guidelines in treating this condition because it is not a cosmetic issue for the men who suffer from Gynecomastia.

Thank you to my GP and to anyone who takes time out to read this.

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