### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am a 35 y.o. male with painful gynecomastia like symptoms. I have been seen by my PCP and had testosterone/estrogen/thyroid levels taken and all have been within the normal ranges and breast cancer has been ruled out. This started about 7 years ago with my left breast being markedly larger than my right with a painful to touch center and within the last year my right breast has caught up with my left and also is painful to touch in the center. My wife states that I would be a B cup as far as size goes. My PCP stated that the only abnormal thing she could find was that my breast tissue was dense. I am overweight but other than that I am healthy. I weigh 187 lbs and I stand 5 11 ; am a nonsmoker and the only meds I take are OTC Claritin for allergies and Paxil for anxiety. Please help me to find out why this is happening and/or what I can do to get rid of this burden. (FYI-I was not overweight when this started 7 years ago).

### output:

Hi, although your above-mentioned hormone level are normal, but you should go for Prolactin level estimation as it is a major cause of gynecomastia, for how long duration you are taking pail as it can also cause gynecomastia if taken for very long duration, so you should get its dose adjusted, or even you can replace it, for this it is better to consult a psychiatrist. Also try to lose weight as obesity leads to increased formation of estrogen. After all if not received by above process then you can consult specialist for its surgical management. Wish you all the best.