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What is Gynecomastia (Enlarged Breasts in Men)?

By Dr. Raghav Mantri in Aesthetic And Reconstructive Surgery

May 27 , 2015 | 6 min read

Gynecomastia is a condition in which breast tissue swells in boys and men. It can happen when two hormones in your body are out of balance.

If you have enlarged breasts due to fatty deposits, you have another condition called "pseudo gynecomastia." Just like men, women are all children born with a small amount of breast tissue.

Most boys' bodies produce a hormone called testosterone, which controls sexual growth during puberty. But men also produce some estrogen, the hormone that drives sexual growth in girls.

When a boy hits puberty or an older man's body produces less testosterone, the balance of the two hormones changes. Sometimes, in this case, the higher estrogen levels cause male breast tissue to swell.

Gynecomastia is an enlargement of the glandular tissue of the male breast. Gynecomastia may occur during infancy and puberty from an imbalance in the hormonal environment in the body.

It is common during infancy, puberty, and in middle-aged to older men. It is an enlargement of glandular tissue rather than fatty tissue.

All individuals possess female hormones (estrogen) and male hormones (androgen). During puberty, levels of these hormones may fluctuate and rise at different levels, resulting in a temporary state in which estrogen concentration is relatively high.

A number of medical conditions may also result in gynecomastia

  • Disorders of the male sex organs (testes) can result in decreased testosterone production and relatively high estrogen levels, leading to gynecomastia.
  • Other conditions that may be associated with gynecomastia are cirrhosis of liver, chronic renal failure, and hyperthyroidism.
  • The side effect of a number of medications like spironolactone (Aldactone), Calcium channel blockers, ACE inhibitor drugs, etc
  • The hormonal preparation taken by bodybuilders has also become a common cause of gynecomastia in young adults.

About half of adolescent boys and up to two-thirds of men over 50 have this level of problem and know what it is gynecomastia?

Symptoms of Gynecomastia

  • Enlargement of the male breasts.
  • It is typically symmetrical in location and may have a rubbery or firm feel.
  • It usually occurs on both sides but can be unilateral in some cases.
  • The enlargement may be greater on one side even if both sides are involved.
  • Tenderness and sensitivity may be present, although there is typically no severe pain.

In most cases, gynecomastia can be diagnosed by a physical examination. In certain cases, medical history and tests may be recommended to help establish the cause of gynecomastia such as blood tests to examine liver, kidney, and thyroid function. Measurement of hormone levels in the bloodstream may also be recommended in some cases.

Causes of Gynecomastia

Gynecomastia is caused by a reduction in the level of testosterone in comparison to estrogen. The decrease can be caused by conditions that block the effects of testosterone, lower testosterone, or increase your estrogen levels.

Miscellaneous things alter hormone balance, including:

  • Natural hormonal changes

    Both men and women are controlled by the hormones testosterone and estrogen. Testosterone is in charge of male features including muscular mass and body hair. Estrogen regulates female features such as breast growth.

    Most people think of estrogen as a female-only hormone, but men also produce it, usually in small amounts.

    Gynecomastia can be caused by male estrogen levels that are too high or out of equilibrium with testosterone levels...

  • Gynecomastia in children

    More than half of all boys are born with enlarged breasts due to the effects of their mother's estrogen. Swollen breast tissue usually disappears two to three weeks after childbirth.

  • Gynecomastia during puberty

    Gynecomastia, which is caused by hormonal changes during puberty, is relatively common. In most cases, swollen breast tissue will go away without treatment within six months to two years.

  • Gynecomastia in adults

    Researchers have estimated the prevalence in men aged 50 to 80 to be between 24% and 65%. However, most men with this condition have no symptoms.

  • Medications

    Several medications can cause gynecomastia. These include:

    • AntiandrogensIt is used to treat enlarged prostate, prostate cancer, and other conditions.

      Examples include flutamide, finasteride, and spironolactone.

    • Anabolic steroids and androgens are used to treat hormone deficiencies, delayed puberty, or loss of muscle mass due to another disease.AIDSMedications.
    • The estrogen-like properties of some HIV drugs can cause gynecomastia, particularly efavirenz.ADHD medications that contain amphetamines.AnxiolyticsDrugs such as diazepam.Tricyclic antidepressants.
    • Medicines for ulcers, such as the over-the-counter drug cimetidine. Chemotherapy to treat cancer.
    • Cardiac drugs such as digoxin and calcium channel blockers.
    • Drugs used to empty the stomach, such as metoclopramide.
  • Recreational drugs, illegal drugs and alcohol

    Substances that can cause gynecomastia include:

    • Alcohol
    • Anabolic drugs to increase muscle mass and athletic performance
    • Methadone
  • Health problems

    Various health conditions can cause gynecomastia by affecting hormone balance. These include:

    • Hypogonadism

      Gynecomastia may be associated with conditions that limit testosterone production, such as Klinefelter syndrome or pituitary insufficiency.

    • Aging

      Hormonal changes that occur with age can lead to gynecomastia, especially in overweight men.

    • Tumors

      Some tumors, such as those affecting the testicles, adrenal glands, or pituitary glands, can produce hormones that alter the hormonal balance between men and women.

    • Hyperthyroidism

      In this condition, the thyroid produces too much thyroxine hormone.

    • Kidney failure

      About half of dialysis patients suffer from gynecomastia due to hormonal changes.

    • Liver failure and cirrhosis

      Changes in hormone levels linked to liver problems and cirrhosis medications linked to gynecomastia.

    • Malnutrition and starvation

      When your body is deprived of proper nutrition, testosterone levels drop while estrogen levels remain the same, leading to hormonal imbalance. Gynecomastia can also occur when normal eating is resumed.</p

  • Herbal products

    Plant oils such as tea tree or lavender have long been used in shampoos, soaps or lotions related to gynecomastia. This is most likely due to its low estrogenic action.

Risk Factors of Gynecomastia

Risk factors for gynecomastia include:

  • Adolescence
  • Advanced age
  • Use of anabolic steroids for performance improvement
  • Athletic performance
  • Some medical diseases, including as liver and renal illness, thyroid disease, hormonally active malignancies, and Klinefelter syndrome

Diagnosis of Gynecomastia

If your doctor suspects you have gynecomastia, he or she will likely examine you to make sure there are no hard lumps, fluid leakage, or skin problems that could be signs of cancer.

Doctor will also likely ask you questions about your medical history, including

  • Have you suffered diseases like mumps, kidney disease, or liver disease?
  • Drugs have you taken were legal or illegal?

You could also run tests. This could include:

  • blood Test
  • Urine Test
  • MammogramBiopsy
  • Testicle Ultrasound

Gynecomastia Treatment

Medications

Non-surgical treatments a doctor may recommend include:

  • Off-Label Drugs. As an off-label treatment for gynecomastia, your doctor may give the breast cancer medications raloxifene or tamoxifen.
  • Changing medication. If a doctor suspects that a medication you are taking is causing your gynecomastia, they may change your medication or reduce your dose.
  • Testosterone therapy. TRT (replacement therapy) in the form of injections, skin gels, or patches can increase your testosterone levels
  • Treat underlying health problems. Treating an underlying health condition, such as an overactive thyroid or malnutrition, can improve symptoms of Gynecomastia.

Surgery

If the enlarged breasts are significant and bothersome even after initial treatment or observation, your doctor may recommend surgery.

Two options for gynecomastia surgery are:

  • Liposuction

    Liposuction surgery removes breast fat but not the breast Glandular tissue itself.

  • Mastectomy

    In this type of surgery, tissue is removed from the mammary gland. The operation is often performed with only small incisions. This type of less invasive surgery means less recovery time.

  • Reduction mammoplasty

    This also known as male breast reduction surgery is done in cases of severe gynecomastia.

Gynecomastia Prevention

There are some controllable factors that can reduce the risk of gynecomastia:·

  • Avoid using drugs. Anabolic steroids, amphetamines, heroin, and marijuana are a few examples.
  • Stay away from alcohol. Consume alcohol in moderation.

Outlook for people with gynecomastia

Enlarged male breasts often go away over time or with changes in medication. Some men become self-conscious about their appearance, which can lead to depression and anxiety.

But these problems should get better once the patient understands what is gynecomastia and when gynecomastia is over.