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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Oliffe</name><affiliation><mods:affiliation>University of British Columbia—School of Nursing, Vancouver, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Journal of Sexual Medicine</title><title level="j" type="alt">JOURNAL OF SEXUAL MEDICINE</title><idno type="ISSN">1743-6095</idno><idno type="eISSN">1743-6109</idno><imprint><biblScope unit="vol">6</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="989">989</biblScope><biblScope unit="page" to="1000">1000</biblScope><biblScope unit="page-count">12</biblScope><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2009-04">2009-04</date></imprint><idno type="ISSN">1743-6095</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1743-6095</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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. 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Management</title></titleStmt><publicationStmt><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><availability><licence>© 2008 International Society for Sexual Medicine</licence></availability><date type="published" when="2009-04"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management</title><title level="a" type="short">Psychological Distress from Gynecomastia</title><author xml:id="author-0000"><persName><forename type="first">Richard J.</forename><surname>Wassersug</surname><roleName type="degree">PhD</roleName></persName><affiliation>Dalhousie University—Anatomy & Neurobiology, Halifax, Nova Scotia, Canada;<address><country key="CA"></country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">John L.</forename><surname>Oliffe</surname><roleName type="degree">PhD</roleName></persName><affiliation>University of British Columbia—School of Nursing, Vancouver, Canada<address><country key="CA"></country></address></affiliation></author><idno type="istex">7336342DD1CF51D6E5CE52F8ED16BB394F8A8D6E</idno><idno type="DOI">10.1111/j.1743-6109.2008.01053.x</idno><idno type="unit">JSM1053</idno><idno type="toTypesetVersion">file:JSM.JSM1053.pdf</idno></analytic><monogr><title level="j" type="main">The Journal of Sexual Medicine</title><title level="j" type="alt">JOURNAL OF SEXUAL MEDICINE</title><idno type="pISSN">1743-6095</idno><idno type="eISSN">1743-6109</idno><idno type="book-DOI">10.1111/(ISSN)1743-6109</idno><idno type="book-part-DOI">10.1111/jsm.2009.6.issue-4</idno><idno type="product">JSM</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">6</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="989">989</biblScope><biblScope unit="page" to="1000">1000</biblScope><biblScope unit="page-count">12</biblScope><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2009-04"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><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></p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">Prostate Cancer</term><term xml:id="k2">Gynecomastia</term><term xml:id="k3">Psychosocial Oncology</term><term xml:id="k4">Sexuality and Cancer</term><term xml:id="k5">Treatment Alternatives</term><term xml:id="k6">Support Groups</term></keywords><classCode scheme="tocHeading1">ORIGINAL RESEARCH</classCode><classCode scheme="tocHeading2">PSYCHOLOGY</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/7336342DD1CF51D6E5CE52F8ED16BB394F8A8D6E/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Inc</publisherName><publisherLoc>Malden, USA</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1743-6109</doi><issn type="print">1743-6095</issn><issn type="electronic">1743-6109</issn><idGroup><id type="product" value="JSM"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF SEXUAL MEDICINE">The Journal of Sexual Medicine</title></titleGroup></publicationMeta><publicationMeta level="part" position="04104"><doi origin="wiley">10.1111/jsm.2009.6.issue-4</doi><numberingGroup><numbering type="journalVolume" number="6">6</numbering><numbering type="journalIssue" number="4">4</numbering></numberingGroup><coverDate startDate="2009-04">April 2009</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="14" status="forIssue"><doi origin="wiley">10.1111/j.1743-6109.2008.01053.x</doi><idGroup><id type="unit" value="JSM1053"></id></idGroup><countGroup><count type="pageTotal" number="12"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL RESEARCH</title><title type="tocHeading2">PSYCHOLOGY</title></titleGroup><copyright>© 2008 International Society for Sexual Medicine</copyright><eventGroup><event type="firstOnline" date="2008-10-20"></event><event type="publishedOnlineFinalForm" date="2009-03-25"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.17 mode:FullText source:FullText result:FullText" date="2010-09-07"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-01"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="989">989</numbering><numbering type="pageLast" number="1000">1000</numbering></numberingGroup><correspondenceTo>Richard Wassersug, PhD, Dalhousie University—Anatomy & Neurobiology, 5850 College Street, Halifax, Nova Scotia B3H 1X5, Canada. Tel: (902) 494‐2244; Fax: (902) 494‐1212; E‐mail: <email>tadpole@dal.ca</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JSM.JSM1053.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="1"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="95"></count><count type="wordTotal" number="8215"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management</title><title type="shortAuthors">Wassersug and Oliffe</title><title type="short">Psychological Distress from Gynecomastia</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Richard J.</givenNames><familyName>Wassersug</familyName><degrees>PhD</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>John L.</givenNames><familyName>Oliffe</familyName><degrees>PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="CA"><unparsedAffiliation>Dalhousie University—Anatomy & Neurobiology, Halifax, Nova Scotia, Canada;</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CA"><unparsedAffiliation>University of British Columbia—School of Nursing, Vancouver, Canada</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">Prostate Cancer</keyword><keyword xml:id="k2">Gynecomastia</keyword><keyword xml:id="k3">Psychosocial Oncology</keyword><keyword xml:id="k4">Sexuality and Cancer</keyword><keyword xml:id="k5">Treatment Alternatives</keyword><keyword xml:id="k6">Support Groups</keyword></keywordGroup><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></p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Psychological Distress from Gynecomastia</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>The Social Context for Psychological Distress from Iatrogenic Gynecomastia with Suggestions for Its Management</title></titleInfo><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><role><roleTerm type="text">author</roleTerm></role></name><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><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Inc</publisher><place><placeTerm type="text">Malden, USA</placeTerm></place><dateIssued encoding="w3cdtf">2009-04</dateIssued><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">1</extent><extent unit="references">95</extent><extent unit="words">8215</extent></physicalDescription><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></titleInfo><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></extent></part></relatedItem><identifier type="istex">7336342DD1CF51D6E5CE52F8ED16BB394F8A8D6E</identifier><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><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Inc</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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