Automatic gain adjustments are necessary on the state-of-the-art ultrasound scanners to obtain optimal scan quality, while reducing the unnecessary user interactions with the scanner. However, when large anechoic regions exist in the scan plane, the sudden and drastic variation of attenuations in the scanned media complicates the gain compensation. This paper presents an advanced and automated gain adjustment method that precisely compensate for the gains on scans and dynamically adapts to the drastic attenuation variations between different media. The proposed algorithm makes use of several ultrasonic physical estimates such as scattering strength, focus gain, acoustic attenuation, and noise level to gain a more quantitative understanding of the scanned media and to provide an intuitive adjustment of gains on the scan. The proposed algorithm was applied to a set of 45 in-vivo movie sequences each containing 50 frames. The scans are acquired using a recently commercialized BK3000 ultrasound scanner (BK Ultrasound, Denmark). Matching pairs of in-vivo sequences, unprocessed and processed with the proposed method were visualized side by side and evaluated by 4 radiologists for image quality. Wilcoxon signed-rank test was then applied to the ratings provided by radiologists. The average VAS score was highly positive 12.16 (p-value: 2.09×10^-23) favoring the gain-adjusted scans with the proposed algorithm.