The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management
Identifieur interne : 003587 ( Istex/Corpus ); précédent : 003586; suivant : 003588The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management
Auteurs : Richard J. Wassersug ; John L. OliffeSource :
- The Journal of Sexual Medicine [ 1743-6095 ] ; 2009-04.
Abstract
Introduction. Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise.
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DOI: 10.1111/j.1743-6109.2008.01053.x
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<front><div type="abstract">Introduction. Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise.</div>
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<profileDesc><abstract xml:lang="en" style="main"><head>ABSTRACT</head>
<p><hi rend="bold">Introduction. </hi>
Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise.</p>
<p><hi rend="bold">Aims. </hi>
Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT.</p>
<p><hi rend="bold">Methods. </hi>
We draw on academic literature, media accounts, and web‐based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues.</p>
<p><hi rend="bold">Main Outcome Measures. </hi>
By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress.</p>
<p><hi rend="bold">Results. </hi>
The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy.</p>
<p><hi rend="bold">Conclusion. </hi>
Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of gynecomastia is made available through psychosocial support programs. For example, PCa patients may learn to accept gynecomastia through reconceptualizing their breasts as autoerotic. Support programs modeled on those of the breast cancer community, including Encore and dragon boat racing, may also help to build communities to serve patients with gynecomastia while defending individuals against shame, isolation, and loss of self‐esteem. <hi rend="bold">Wassersug RJ, and Oliffe JL. The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management. J Sex Med **;**:**–**.</hi>
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<abstractGroup><abstract type="main" xml:lang="en"><title type="main">ABSTRACT</title>
<p><b>Introduction. </b>
Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise.</p>
<p><b>Aims. </b>
Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT.</p>
<p><b>Methods. </b>
We draw on academic literature, media accounts, and web‐based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues.</p>
<p><b>Main Outcome Measures. </b>
By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress.</p>
<p><b>Results. </b>
The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy.</p>
<p><b>Conclusion. </b>
Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of gynecomastia is made available through psychosocial support programs. For example, PCa patients may learn to accept gynecomastia through reconceptualizing their breasts as autoerotic. Support programs modeled on those of the breast cancer community, including Encore and dragon boat racing, may also help to build communities to serve patients with gynecomastia while defending individuals against shame, isolation, and loss of self‐esteem. <b>Wassersug RJ, and Oliffe JL. The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management. J Sex Med **;**:**–**.</b>
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<mods version="3.6"><titleInfo lang="en"><title>The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management</title>
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<titleInfo type="abbreviated" lang="en"><title>Psychological Distress from Gynecomastia</title>
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<titleInfo type="alternative" contentType="CDATA" lang="en"><title>The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management</title>
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<name type="personal"><namePart type="given">Richard J.</namePart>
<namePart type="family">Wassersug</namePart>
<namePart type="termsOfAddress">PhD</namePart>
<affiliation>Dalhousie University—Anatomy & Neurobiology, Halifax, Nova Scotia, Canada;</affiliation>
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<name type="personal"><namePart type="given">John L.</namePart>
<namePart type="family">Oliffe</namePart>
<namePart type="termsOfAddress">PhD</namePart>
<affiliation>University of British Columbia—School of Nursing, Vancouver, Canada</affiliation>
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<dateIssued encoding="w3cdtf">2009-04</dateIssued>
<copyrightDate encoding="w3cdtf">2009</copyrightDate>
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<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<abstract>Introduction. Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise.</abstract>
<abstract>Aims. Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT.</abstract>
<abstract>Methods. We draw on academic literature, media accounts, and web‐based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues.</abstract>
<abstract>Main Outcome Measures. By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress.</abstract>
<abstract>Results. The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy.</abstract>
<abstract>Conclusion. Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of gynecomastia is made available through psychosocial support programs. For example, PCa patients may learn to accept gynecomastia through reconceptualizing their breasts as autoerotic. Support programs modeled on those of the breast cancer community, including Encore and dragon boat racing, may also help to build communities to serve patients with gynecomastia while defending individuals against shame, isolation, and loss of self‐esteem. Wassersug RJ, and Oliffe JL. The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management. J Sex Med **;**:**–**.</abstract>
<subject lang="en"><genre>keywords</genre>
<topic>Prostate Cancer</topic>
<topic>Gynecomastia</topic>
<topic>Psychosocial Oncology</topic>
<topic>Sexuality and Cancer</topic>
<topic>Treatment Alternatives</topic>
<topic>Support Groups</topic>
</subject>
<relatedItem type="host"><titleInfo><title>The Journal of Sexual Medicine</title>
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<genre type="journal">journal</genre>
<identifier type="ISSN">1743-6095</identifier>
<identifier type="eISSN">1743-6109</identifier>
<identifier type="DOI">10.1111/(ISSN)1743-6109</identifier>
<identifier type="PublisherID">JSM</identifier>
<part><date>2009</date>
<detail type="volume"><caption>vol.</caption>
<number>6</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>4</number>
</detail>
<extent unit="pages"><start>989</start>
<end>1000</end>
<total>12</total>
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<identifier type="DOI">10.1111/j.1743-6109.2008.01053.x</identifier>
<identifier type="ArticleID">JSM1053</identifier>
<accessCondition type="use and reproduction" contentType="copyright">© 2008 International Society for Sexual Medicine</accessCondition>
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<recordOrigin>Blackwell Publishing Inc</recordOrigin>
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