Evidence map›Paper›PMID 42258023›Full record

GuidelineJournal of endocrinological investigation2026

Management of gynecomastia in adolescence and adults: the clinical practice guidelines from the Italian Society of Andrology and Sexual Medicine (SIAMS).

Carlotta Pozza, Riccardo Selice, Arcangelo Barbonetti, Valeria Hasenmajer, Francesco Lotti, Davide Menafra, Daniela Pasquali, Andrea Sansone, Andrea M Isidori, Vincenzo Rochira

Abstract readPractice GuidelineSystematic Review
In one paragraph

Guideline in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Carlotta PozzaDivision of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy. carlotta.pozza@uniroma1.it.ORCID http://orcid.org/0000-0002-1147-6114
Riccardo SeliceUnit of Andrology and Reproductive Medicine, Department of Systems Medicine, University Hospital of Padova, Padova, 35100, Italy.
Arcangelo BarbonettiAndrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Valeria HasenmajerDivision of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy.ORCID http://orcid.org/0000-0003-4301-6662
Francesco LottiDepartment of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
Davide MenafraDepartment of Clinical Medicine and Surgery, Section of Endocrinology, Diabetology, Andrology and Nutrition, Federico II University of Naples, Naples, Italy, Unit of Andrology and Male and Female Reproductive and Sexual Medicine, Federico II University of Naples, Naples, Italy.
Daniela PasqualiDepartment of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
Andrea SansoneChair of Endocrinology and Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.ORCID http://orcid.org/0000-0002-1210-2843
Andrea M IsidoriDivision of Endocrinology and Andrology, Department of Experimental Medicine, Sapienza University, Rome, Italy.ORCID http://orcid.org/0000-0002-9037-5417
Vincenzo RochiraEndocrinology Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGynecomastia, defined as the benign proliferation of male breast glandular tissue, is a common condition in both adolescence and adulthood, often associated with physical discomfort and psychological distress. Despite its high prevalence, clinical management is frequently inconsistent and lacks standardized, evidence-based recommendations.

methodsThe Italian Society of Andrology and Sexual Medicine (SIAMS) convened a multidisciplinary expert panel to develop updated clinical practice guidelines for the evaluation and management of gynecomastia. Recommendations were formulated based on a systematic review of the available literature and developed through expert consensus according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. The document was critically reviewed and approved by the SIAMS Executive Committee.

resultsThe guidelines address physiological, pharmacological, pathological, congenital, and genetic forms of gynecomastia, providing a structured diagnostic and therapeutic approach. Clinical assessment, including detailed history and examination, is the cornerstone of diagnosis, and should be complemented by targeted hormonal and imaging investigations when appropriate. Observation is recommended for physiological or recent-onset cases. Pharmacological therapy may be considered in selected idiopathic or painful forms, whereas testosterone replacement should be restricted to men with proven hypogonadism. Surgery is indicated for long-standing fibrotic gynecomastia or significant psychological distress. Psychological support is also advised, especially for adolescents.

conclusionsThese SIAMS Guidelines provide an evidence-based, standardized framework for the diagnosis and management of gynecomastia, promoting individualized, multidisciplinary care and identifying priorities for future research.

Indexed as

AndrologyGynecomastiaAdolescentAdultDisease ManagementHumansItalyMaleSocieties, MedicalTestosteroneTestosteroneAdolescenceAdultEstradiolGynecomastiaHypogonadismMale breast disordersProlactinTestosterone

Identifiers

PMID42258023
PMCPMC13627163

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.