What is gynaecomastia?
Dr. Sahana K P
Basaveshwara nagar, Bengaluru Feb 9, 2017
Gynaecomastia (now and again known as "man boobs") is a common condition that results in enlargement of the breast tissue in males. It is more common in young children (around 5-7years) and older men.
What are the reasons for Gynaecomastia?
One of the most common cause for Gynaecomastia is Obesity. Sudden gain in weight or loss of weight results in gynaecomastia.
Gynaecomastia can also be physiological occurring in a newborn child and adolescent men who frequently experience transient enlargement of breasts due to the effect of maternal hormones and hormonal modifications all through puberty, respectively. This gradually improves with age, and usually does not require any treatment. However, thorough evaluation by a physician is necessary to rule out any other pathological cause for this condition.
Gynaecomastia results from an imbalance in hormone levels in which ranges of estrogen (female hormones) are multiplied relative to levels of androgens (male hormones). Gynaecomastia as a result of transient changes in hormone levels in a newborn, usually disappears on its own within six months to two years. Sometimes, gynaecomastia that develops in puberty persists beyond two years and is referred to as Continual Pubertal Gynaecomastia.
Some of clinical situations may additionally result in gynecomastia:
•Malnutrition and re-feeding (recovery from malnutrition) have both been proven to create a hormonal environment that can lead to gynecomastia.
Cirrhosis of the liver alters normal hormone metabolism and might result in gynecomastia.
•Disorders of testes can bring about reduced testosterone production and relatively high estrogen stages, leading to gynecomastia. Those problems can be genetic, which include Klinefelter's syndrome, or obtained because of trauma, contamination, decreased blood flow, or ageing. Testicular cancers might also secrete hormones that cause gynecomastia.
•Other conditions which can be associated with an altered hormonal surroundings in the body and can be related to gynecomastia are chronic renal failure and hyperthyroidism.
Rarely, cancers other than testicular tumors might also produce hormones that may cause gynecomastia.
Gynecomastia can also occur due to the effect of a number of medications like Cimetidine, Ketoconazole, etc. It can also result from excess intake of anabolic steroids, Cannabis, and Alcohol .
New born baby boys
Gynaecomastia can have an effect on new born baby boys, due to the fact that oestrogen passes through the placenta from the mother to the child. This is temporary and could disappear in a few weeks to months after birth.
As men become older, they produce less testosterone. Older men generally tend to have more body fat, and this can cause extra oestrogen to be produced. These modifications in hormone tiers can result in excess breast tissue growth.
Generally, no treatment is required for physiologic gynecomastia. Pubertal gynecomastia resolves spontaneously within several weeks to 3 years in approximately 90% of patients. Breasts greater than 4 cm in diameter may not completely regress.
Identifying and managing an underlying primary disorder often alleviates breast enlargement. If hypogonadism (primary or secondary) is the cause of gynecomastia, parenteral or transdermal testosterone replacement therapy is instituted. However, testosterone does have the potential to exacerbate gynecomastia through the aromatization of the exogenous hormone into estradiol.
For patients with idiopathic gynecomastia or with residual gynecomastia after treatment of the primary cause, medical or surgical treatment may be considered.