Gynecomastia is the enlargement of glandular tissue in one or both of the breasts in boys or older men. The condition is benign (non-cancerous) and very common: 30 to 65 percent of men experience it, depending on age. While it’s not life-threatening, it can be uncomfortable and can affect someone’s self-esteem.
This article will review the causes of gynecomastia, possible symptoms, and treatments.
According to breast surgeon Susan Love, the first recorded breast surgery was performed on a man with gynecomastia in AD 625. Breast surgery was not performed on women until more than 1,000 years later, in 1897.
The main symptom of gynecomastia is breast enlargement. It usually starts as a slight bump or lump behind the nipple. This enlargement is usually painless, but some men experience tenderness. Although it usually occurs in both breasts, it can only occur in one breast.
There are many causes of gynecomastia, but the most common cause is a hormonal imbalance.
In breast tissue, there are receptors that can cause breast tissue to grow (estrogen receptors) or not grow (androgen receptors). If men’s estrogen levels are higher than normal, their breast tissue grows.
Certain periods of men’s lives do have higher estrogen levels, including:
- Birth: Many newborn boys have enlarged breasts due to estrogen transferred from the mother in the womb. Neonatal gynecomastia usually resolves on its own after about a month.
- Puberty: Half of all adolescent boys experience gynecomastia, usually around age 13 or 14. It usually goes away on its own within six months to two years, but it can persist into adulthood.
- Older adults: Decreased levels of the hormone testosterone may lead to a peak incidence of gynecomastia in men over the age of 50.
Gynecomastia can be caused by chronic diseases such as:
- Cirrhosis (chronic liver damage that causes scarring and liver failure)
- hypogonadism (The gonads hardly produce any hormones)
- Hyperthyroidism (hyperthyroidism)
- poor kidney function
- Testicular or adrenal tumor (rare)
- Klinefelter syndrome (an inherited condition caused by an extra copy of the X chromosome)
Understanding Klinefelter Syndrome
The use of certain medicines may also cause breast enlargement in men. E.g:
- CaroSpir (spironolactone), heart medication
- Nizolar (Ketoconazole), an antifungal drug
- Heartburn and Ulcer Medicines
- certain supplements
- Recreational drug use, including marijuana, heroin, and amphetamines
Anabolic steroid use also frequently leads to irreversible gynecomastia. Injections of external testosterone suppress the natural production of testosterone, which cannot be recovered quickly between steroid injection cycles to prevent estrogen dominance.
Gynecomastia can also be caused by treatment for prostate cancer, as typical treatments given block testosterone production.
Lifestyle and environmental factors for gynecomastia include:
- using heavy alcohol
- exposure to estrogen
To diagnose gynecomastia, a health care provider will perform a physical exam of the breast as well as the entire body to assess any areas of concern.
It’s important to make sure that men’s large breasts are due to overgrowth of glandular tissue that has a network of ducts that can be felt, and not excess fatty tissue.is called pseudogynecomastiawhich occurs when breasts in overweight boys and men grow due to increased fat rather than real breast tissue.
Blood tests may also be done to check hormone levels. Imaging tests, such as a mammogram or ultrasound, may also sometimes be needed to confirm the diagnosis.
While breast cancer is rare in men, accounting for less than 1 percent of all disease cases, people with gynecomastia often become anxious and seek medical care, according to the Mayo Clinic report of the results of a five-year survey. Only 1% of male mammograms show breast cancer.
If it is determined to be pseudogynecomastia, your breasts will not shrink on their own. A combination of diet and exercise can help reduce body fat percentage and possibly reduce breast size.
In contrast, there are several possible treatment options for gynecomastia, and the one that’s best for you depends on several factors.
wait and watch
Treatment may not be needed at all. In a wait-and-see approach, no specific treatment is prescribed. If breast tissue continues to increase or other symptoms develop, further treatment may be recommended at a later date.
When gynecomastia is the result of an underlying health problem or the use of medications that can cause breast growth, treating the problem or stopping the medication usually improves the condition. Of course, this should be done on the advice of your healthcare provider.
Pain is more common in patients with newly developed or rapidly progressing gynecomastia. If your breasts are tender, you can use a cold compress. Over-the-counter (OTC) pain relievers (pain relievers) are also available.
In cases where the condition persists or causes discomfort, a healthcare provider may prescribe a brief (three to six-month) course of an estrogen-blocking medication called tamoxifen or Evista (raloxifene). This is most often attempted during adolescence.
Adult men can also take a short course of one of these drugs. However, this treatment is only effective in men whose breast tissue is tender and who have had the disease for less than a year.
Which drugs will interfere with tamoxifen?
Breast reduction surgery
Surgery is a common treatment for gynecomastia. Surgery is usually not recommended for teens until puberty is complete to ensure that breast tissue stops growing.
There are many surgical techniques used to reduce breast tissue, including removal of glandular tissue and excess skin. The areola can also be reduced or repositioned. Liposuction (a surgical technique that uses suction) removes excess fat.
Coping with Gynecomastia
For some men, having gynecomastia can be difficult to deal with. They may feel embarrassed or insecure about their bodies. Young men going through puberty have a particularly tough time.
If you experience any symptoms of depression, embarrassment, or any other negative emotions, it is important to remember that you are not alone. Gynecomastia is fairly common and gets better over time.
It can be helpful to talk about your feelings with a supportive family member or friend. If needed, it may be necessary to speak with a counselor or therapist to learn about body receptivity and how to deal with these feelings.
Although gynecomastia (enlargement of breast tissue in men) is not life-threatening, it can cause discomfort or insecurity in men. There are many possible causes of gynecomastia, and it is important to seek medical care to determine the cause and the best course of treatment, if any.
Gynecomastia is a common problem in boys and men, and it is important to see your healthcare provider to rule out any medical causes for the condition. While it resolves on its own without treatment, gynecomastia can cause feelings of anxiety, embarrassment, and even depression. If your condition persists and is causing you discomfort, treatments such as lifestyle changes, medications, and surgery can help reduce the size of your breasts.
Frequently Asked Questions
How can you get rid of gynecomastia?
The cause of gynecomastia needs to be found before the best treatment can be determined. For example, if it is caused by a drug, stopping the drug can resolve it.
Can gynecological diseases go away on their own?
Gynecomastia can go away on its own, especially if it occurs at a certain time in a man’s life, such as birth or puberty, when the hormonal imbalance is temporary.
What happens if gynecomastia is not treated?
There is no danger in untreated gynecomastia. In some cases, the recommended treatment is to wait and see if it progresses or causes symptoms.
Can exercise reduce gynecomastia?
Will not. Exercise and reducing body fat may improve breast size only if obesity (called pseudogynecomastia) causes breast enlargement.