What is gynecomastia in men?

What is gynecomastia in men?

An embarrassing occurrence for any male having it is the condition of gynecomastia.  Gynecomastia is when a male may have an overdevelopment of breast tissue of either one or both breasts. From newborns, boys going through puberty to older men, gynecomastia can affect any male as a result of normal changes in hormone levels, though other causes may also exist.

Usually, gynecomastia is not considered a serious problem but emotionally and socially it can be hard for boys or men to cope with.  Some males may also experience pain in their breasts. 

It is estimated that up to sixty percent of males worldwide have some degree of gynecomastia.  There is also another condition very similar called Pseudogynecomastia which is a condition characterized by excess fat in the chest. 

Symptoms and causes of gynecomastia

The primary symptom is enlargement of the breasts.  Males may notice tenderness or even a slight bump or lump behind the nipple area.  Other symptoms can include:

·      Moveable, fibrous tissue beneath the nipple in one or both breasts

·      Tissue that feels hard, distinct from softer fatty tissue

·      Changes in mood and sex drive

The main cause of gynecomastia is a change in hormones.  The times of a man’s life this is more likely to occur is at birth, puberty, or as a part of aging:

·      Gynecomastia in infants. More than half of male infants are born with enlarged breasts due to too much estrogen which the mother transfers to their babies in the womb.  Generally, the swollen breast tissue goes away within two to three weeks after birth.

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

·      Gynecomastia in men. The prevalence of gynecomastia peaks again between the ages of 50 and 69. At least 1 in 4 men in this age group are affected.

The sex hormones of testosterone and estrogen have strong control over the development and maintenance of sex characteristics in both men and women.  The characteristics of muscle mass and body hair more prevalent in men are controlled by testosterone.  Estrogen controls the growth of breasts which is a more female trait. 

Even though estrogen is thought of as an exclusively female hormone, men also produce it but in much smaller amounts.  If a man’s estrogen levels are too high or are out of balance with testosterone levels, this could lead to gynecomastia.

Besides hormonal imbalances, there can be other causes of gynecomastia which include:

·      Tumors of the adrenal gland, pituitary gland, or testes

·      Hyperthyroidism (overactive thyroid)

·      Hypothyroidism (underactive thyroid)

·      Hypogonadism (low testosterone)

·      Kidney disease

·      Liver disease

·      Medications such as HIV/AIDS meds, chemotherapy and radiation, and anti-anxiety meds

·      Drugs such as opioids, anabolic steroids, amphetamines, heroin, and marijuana

·      Lifestyle factors such as obesity and overconsumption of alcohol

Seeing a doctor for gynecomastia

Any male who has overdevelopment of his breasts needs to make an appointment with his primary care physician.  They will ask about symptoms, how long the tissue growth has been there, if the area is tender and what medications a man takes.

The most common test a doctor will most likely perform is a blood test to check hormone levels. If there is any suspicion of a disease, then they may order an ultrasound, mammogram, and/or biopsy.

Can it be treated?

In most case of gynecomastia, there is no treatment needed.  However, a doctor may want to monitor the condition of the breast tissue every few months. 

If it is determined that a certain medication or using drugs is causing gynecomastia, then they need to be stopped.  Lifestyle changes such as losing weight if overweight or obese, is another effective treatment.  If hormonal imbalances are found to be at the root of the cause, then taking medications to even our hormonal levels will be another option for treatment. 

Male breast reduction surgery is the most effective known treatment for gynecomastia.  This cosmetic surgery procedure removes excess fat and glandular tissue to restore a flatter, firmer and more masculine contour to the chest.   A plastic surgeon that specializes in this type of procedure should be consulted with to determine eligibility for the procedure.