genitourinary disorders
Gynecomastia
Evaluation of Gynecomastia
 should help clarify the duration of breast enlargement, whether secondary sexual characteristics are fully developed, the relationship between onset of gynecomastia and puberty, and the presence of any genital symptoms (eg, Libido , Review of systemsshould seek symptoms that suggest possible causes, such as Weight loss and fatigue ( Cirrhosis , Skin discoloration (chronic kidney disease, cirrhosis) Hair loss and frequent infections (undernutrition) Fragility fractures (undernutrition, hypogonadism) Mood and cognitive changes (hypogonadism) Tremor, heat intolerance, and diarrhea (hyperthyroidism) Past medical historyshould address disorders that can cause gynecomastia and include a history of all prescribed and over-the-counter drugs. 