Gynecomastia is a condition that refers to the enlargement of the breast tissues (glandular proliferation) in males. Only accumulation of fatty tissue is not regarded as gynecomastia. One or both breasts may be affected either symmetrically or unevenly. Gynecomastia can affect males during any age group, infancy, puberty, and middle-aged to older men. Often the mothers’ estrogen hormone can cross the placenta and lead to the enlargement of the male babies' breasts, but that condition resolves on its own within 2-3 weeks.
About 1 in 4 men are affected by gynecomastia between the ages of 50 and 69. The condition itself is not usually harmful or serious, but it can lead to low self-esteem and psychological problems in males. In some cases, it is accompanied by pain or soreness, swelling, and nipple discharge. Immediate medical care is required if one experiences any of these symptoms.
Gynecomastia is caused by an imbalance in the sex hormones, which are estrogen and testosterone. These hormones usually determine the sexual characteristics of males and females. In males, testosterone is in greater amount than estrogen and is responsible for muscle mass, distribution, and quality of body hair, sex drive, and mood. Any condition that can alter this balance of hormones can lead to gynecomastia. It can either be caused by natural hormone alterations during puberty or due to some pathological conditions or adverse effects of some medicines.
Disorders that can result in gynecomastia include;
Medications that may result in the development of gynecomastia include;
You may have increased chances of getting gynecomastia if you have one of the following;
The condition can be classified as functional gynecomastia, in which no pathological cause is present, and it occurs due to normal imbalance at different age peaks like infancy, puberty, and very old age.
The other type is pathological, in which the gynecomastia is due to some abnormal condition or disease.
Gynecomastia is quite a common condition. Temporary gynecomastia affects around 60 – 90% of infants due to the high estrogen state of pregnancy. The second peak of functional gynecomastia occurs during puberty and affects approximately 4-69% of boys about the age of 12 years. The third peak affects 24-65% of older men. 25% of people are diagnosed with persistent pubertal gynecomastia. In 8%, the condition is due to cirrhosis or malnutrition, 3% are due to testicular tumors, while no abnormality is detected in 25% of the patients.
The condition may not result in any particular symptoms except for the enlargement of the breast. Other symptoms may include;
If you have bothersome symptoms or notice any change in the size, shape, or pain of the breasts, consult your doctor. Diagnosis is made based on the following;
Several conditions may need to be excluded to make efficient progress towards treating the disorder like;
In most cases, especially in pubertal males, the condition resolves over time with no treatment. If the patient's condition is caused by an underlying medical condition such as malnutrition or cirrhosis, those conditions may need treatment. The doctor may ask to stop or change medication in cases where it is caused by the adverse effects of a medicine. Breast cancer medication such as aromatase inhibitors (Arimidex) Tamoxifen (Soltamox ) may be helpful for some, but these medications are approved by the FDA to treat breast cancer, not gynecomastia.
If significant breast enlargement still exists after initial treatment, the doctor may suggest surgery. Liposuction or mastectomy are two gynecomastia surgical options. The liposuction procedure involves removing the breast fats and not the breast gland tissue. In a mastectomy, the breast gland tissue is removed.
One may go for counseling and support to cope, talk to friends and family, or connect with people with the condition.
Following medication are used for gynecomastia ;
Gynecomastia is a benign condition. It is not known to cause long-term complications. Pubertal gynecomastia resolves spontaneously within months or years. In other cases, the only treatment is removing breast tissue which requires surgery. Gynecomastia is sometimes associated with breast cancer which needs to be treated accordingly.
Besides medicines, some modifications of the habits can be made to cope with the condition;
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 20, 2023.
Gynecomastia: Etiology, Diagnosis, and Treatment - Endotext - NCBI Bookshelf (nih.gov)
What is gynaecomastia? - NHS (www.nhs.uk)