Pubertal gynecomastia (PG) is a common condition characterized by the abnormal development and hyperplasia of unilateral or bilateral breast tissue in adolescent males, affecting up to 50% of appropriately aged adolescents and exhibiting rising prevalence over recent years. The etiology of PG is multifaceted, encompassing physiological, pharmacological, and pathological factors. This narrative review synthesizes evidence from a comprehensive selection of peer-reviewed literature, including observational studies, clinical trials, systematic reviews, and case reports, to explore the pivotal role of endocrine hormones in the pathogenesis of PG. Specifically, it examines the effects of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2), progesterone (P), prolactin (PRL), growth hormone (GH), insulin-like growth factor-1 (IGF-1), thyroid hormones (T3, T4), parathyroid hormone (PTH), anti-Müllerian hormone (AMH), human chorionic gonadotropin (hCG), and leptin. By synthesizing current insights, this review underscores the intricate hormonal dynamics underlying PG and their implications for diagnosis and treatment. Conclusively, the findings advocate for a personalized approach in the clinical management of PG, with particular emphasis on the hormonal milieu as a cornerstone of therapeutic strategy.
Keywords: adolescence; endocrinology; gynecomastia; puberty; sex hormones.