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

### input:
hi,i am 21 years old male and a medical student. 7 months ago i developed gynecomastia. initially it was unilateral but now it is bilateral. i have palpated it, its glandular. my height is 5,10 and weight is 80kg.i have lumps in my scrotum for 5 years, which are not tender. is my gynecomastia due to obesity (i have gained 7 kgs in last 2 years)?? or it is due to scrotal lumps?? please.

### output:

HI, Dear,Welcome to Chat Doctor. Based on the facts and data of your query, You seem to be having complex hormonal imbalances, the cause of which could be in the scrotal lumps, as the lumps are for 5 yrs and are painless. Being at 21 yr-a younger and active age group, possibility of Seminoles need to be ruled out by CXR and by Scrotal Doppler Studies. Painless lumps lead to the possibility of Varicocele as TH cause of Scrotal Lumps. In this scenario, as there are no chest complaints and as Gynecomastia followed after 5 yrs of bilateral scrotal swellings, a slow process of testicular damage, leads the cause to Bilateral Varicocele with Gynecomastia lately in last 6-7 myths time, which was unilateral and later involving other testes also. Dopplere study of the Scrotal swellings would fix the Varicocele, as its cause. Early age of the Gynecomastia with bilateral tumors indicates more of Bilateral Varicocele, as Seminoles occur in 30-40 yrs mostly. Get checked from Surgeon, who could grade it by Valhalla maneuver. Besides this hypothyroidism with high TSH levels/Low testosterone with high LH levels/ High prolactinemia would indicate SOL of the Sell Turkic, mostly of Prolactin, would need to be ruled out before the Gynecomastia is evaluated for the Scrotal lumps. In the above scenario, you need to be very cautious and take the needful treatments for the varied unknown health issues you may have, which requires thorough evaluation of your case. Hope this reply would help you to resolve your sever anxiety. Welcome for any further query in this regard Will appreciate writing your feedback review comments, to help the needy patients like you at Chat Doctor. Good Day!! Chat Doctor. S. Genl-CVTS