Hormonal Changes during Puberty: V. Transient Pubertal Gynecomastia: Abnormal Androgen-Estrogen Ratios*

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Abstract
The plasma profiles of 8 hormones were followed over the course of prepuberty and puberty in 30 adolescent males who developed gynecomastia and 24 who did not. Throughout (puberty, ratios of Δ4-androstenedione to estrone (E1) and estra-diol (E2) were significantlylower in the gynecomastia group than in the control group. Similarly, ratios of dehydroepiandroster-one-sulfate to E1 and E2 were significantly lower in the gyneco-mastia group. In contrast, ratios of plasma testosterone to E1 and E2, as well as plasma progesterone and PRL concentrations, were similar in both groups. Because of the adrenal origin of dehydroepiandrosterone and its sulfate, and of peripheral conversion of adrenal androgens to E1 and to E2, it appears that either decreased adrenal production of androgens and/or increased conversion of dehydroepiandrosterone-sulfate and Δ4 androstenedione to estrogens cause transient gynecomastia in adolescent boys.