Enlarged Breasts in Men (Gynecomastia)
Medikoe Health Expert
Koramangala, bengaluru, karnataka, india, Bengaluru Feb 9, 2017
What is Gynecomastia?
Gynecomastia is an enlargement of breast tissue in boys or men due to imbalance of the hormones estrogen and testosterone. It can affect both breasts, sometimes unevenly.
Following are the symptoms of gynecomastia:
Swollen breast tissue
The cause of Gynecomastia is a decrease in the amount of the hormone testosterone compared with estrogen. There are several things which can upset the hormone balance such as:
Natural Hormone Changes
Sex characteristics in men and women are controlled by hormones testosterone and estrogen. Testosterone controls male traits, such as muscle mass and body hair while estrogen controls female traits such as the growth of breasts.
Men also produce estrogen but in small quantities. When estrogen levels are too high in male or are out of balance with testosterone levels, it causes gynecomastia.
Gynecomastia in Infants
More than half of the male babies are born with enlarged breasts due to the effects of their mother’s estrogen. Usually, the enlarged breast tissue goes away within two to three weeks after birth.
Gynecomastia during puberty
Gynecomastia during puberty is very common but it goes away within six months to two years without treatment.
Gynecomastia in adults
The frequency of gynecomastia peaks again between the ages of 50 to 69. In research, it was found that at least 1 in 4 men in this age group is affected.
There are several medicines which can cause gynecomastia such as:
Anti-androgens which are used to treat an enlarged prostate and other conditions.
Anabolic steroids and androgens which are used illegally by athletes to build muscle and enhance performance.
Gynecomastia can occur in HIV-positive men who are receiving a treatment regimen called highly active antiretroviral therapy.
Street drugs and alcohol
Substances that can cause gynecomastia to include:
There are different health conditions which can cause gynecomastia by affecting the normal balance of hormones. The conditions are:
Hypogonadism- It is the condition that interferes with normal testosterone production such as pituitary insufficiency.
Ageing- Ageing results in hormonal changes which can cause gynecomastia, especially in men who are overweight.
Tumours- Some tumours which involve the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.
Hyperthyroidism- In this condition, the thyroid gland produces too much thyroxine hormone.
Kidney failure- People treated with dialysis experience gynecomastia due to hormonal changes.
Liver failure and cirrhosis- Changes in hormone levels related to liver problems are associated with gynecomastia.
Malnutrition and starvation- When you didn’t get adequate nutrition, your testosterone levels drop while estrogen levels remain the same.
The doctor will ask you about your medical conditions and about your family history. The doctor will also perform a physical examination that may include evaluation of breast tissue, abdomen and genitals.
The doctor may order several tests to determine the cause of gynecomastia:
Blood tests- To detect the signs that might be affecting your hormone levels.
Mammograms- Mammogram is an X-ray of your breast to look for signs of cancer.
Computerized tomography (CT) scans
Magnetic resonance imaging (MRI) scans
Most cases of gynecomastia treat over time. But, if it caused by a condition such as hypogonadism, cirrhosis then it may need treatment.
The doctor may advise surgery if enlarged breasts are significant even after treatment. Two options of gynecomastia surgery are:
In this surgery, the surgeon removes the breast fat without touching the breast gland tissue.
In this surgery, the surgeon removes the breast gland tissue. It is a minimal scar surgery done using only small incisions. It requires less recovery time.
There are a few things you can do that may reduce the risk of gynecomastia:
Avoid using drugs such as steroids and androgens, amphetamines, heroin, and marijuana.
Avoid drinking alcohol.
Ask your doctor if any medication is known to cause gynecomastia. Stop those medicines and take substitutes of them.
In kids with no apparent cause of gynecomastia, the doctor may recommend periodic re-evaluations every three to six months to see if the condition improves on its own. Generally, Gynecosmatia goes away on its own in less than two years.
Some medicines which are used to treat breast cancer may be helpful for some men with gynecomastia. Although the medications are approved by the Food and Drug Administration, they have not been approved for use in people with gynecomastia.
Coping and Support
For men, enlarged breasts are stressful and embarrassing. You can’t hide gynecomastia and it is a challenge to romantic relationships. You may feel like your body has betrayed you and you may feel unhappy with yourself. To feel like this is very normal, but to cope with this you can:
Counselling may help you in avoiding anxiety and depression caused by gynecomastia. It can also help you communicate with your family members.
Try to talk to your family and friends
Explaining your situation to your family members and friends will strengthen your relationships and reduce stress.
Talk to others who have gynecomastia
Talk to other people who have had the same condition. It will help you cope.
When to See a Doctor
Generally, gynecomastia is not a very serious problem, it may go away on its own. But it can be difficult to cope with the condition. Consult a doctor if the condition doesn’t resolve, also consult a counsellor to help you cope with the condition.