Gynecomastia: Causes, Symptoms, Diagnosis & Treatment
What Is Gynecomastia?
Gynecomastia is a condition that affects a large number of men, and boys. It makes the breasts swell and grow out of proportion. In simple words, gynecomastia causes abnormal enlargement or overdevelopment of male breast tissues. Both genders have breast glands, but they are typically not visible in males.
Males of all ages, including newborns, adolescents during puberty, and older adults, may develop gynecomastia. It is caused by extra breast tissue instead of fat. In gynecomastia, exercising or losing weight will not reduce breast tissue.
Pseudogynecomastia is a separate condition in which a person develops breast fat, possibly as a result of being overweight or obese.
An imbalance between testosterone and estrogen hormones is frequently the cause of gynecomastia. Male breast tissue can also swell and become larger due to certain diseases and medications. Although estrogen is typically present at low levels, testosterone, and estrogen are both produced by the male body. If a man's testosterone levels are particularly low in contrast with estrogen, or on the other hand assuming that there is an overabundance of estrogen action compared with testosterone, it results in the overdevelopment of breasts.
Gynecomastia may develop in boys when they reach puberty and the body experiences a noticeable change in the activity of hormones. However, it might go away on its own without treatment over time. Either both breasts have the same amount of excess tissue, or one breast has more than the other.
Gynecomastia may develop and persist unless treated, as testosterone levels fall in older men. According to research, approximately one in four men between the ages of 50 and 80 suffer from gynecomastia. Typically, the condition is not serious or harmful. But it can bring about irritated or sore breast tissue. If this condition is causing you discomfort, breast reduction surgery might be an option for you.
What Causes Gynecomastia?
Male breast growth can be triggered by a variety of factors, the exact cause of which is frequently unknown.
Gynecomastia frequently results from an imbalance in the hormones estrogen and testosterone. While testosterone and estrogen are both produced by the male body, estrogen is typically present at low levels. If a man's testosterone levels are particularly low in comparison to estrogen, or if, on the other hand, there is an excess of estrogen activity in comparison to testosterone, it causes his breasts to grow too much.
Gynecomastia and low testosterone are both caused by aging. Low testosterone is usually just a sign of aging. Additionally, certain diseases and medications can cause male breast tissue to swell and expand.
Low levels of testosterone may also be caused by some underlying medical conditions. For example, damage to the cells in the testes that make testosterone, an accident, inflammation, testicular cancer, cancer chemotherapy, and radiology, and diseases that affect parts of the brain, like the hypothalamus and pituitary gland.
Problems with the thyroid, some cancers, such as tumors of the lungs, pituitary gland, or adrenal glands, obesity, which can lead to an increase in estrogen, illegal drugs, such as anabolic steroids, marijuana, and heroin, kidney failure, liver disease can also cause gynecomastia in some cases.
Because of the effects of their mother's estrogen, more than half of male infants are born with enlarged breasts. The swollen breast tissue typically subsides within two to three weeks of birth.
Medicines
In some cases, gynecomastia is caused by taking some medication such as,
- Anti-androgens
- Anabolic steroids and androgens
- AIDS medicines
- Anti-anxiety medications
- Tricyclic antidepressants
- Antibiotics
- Ulcer medications
- Cancer chemotherapy
- Medications used for treating heart diseases like digoxin and calcium channel blockers
- Stomach-emptying medications (metoclopramide)
Some underlying medications are also responsible for the abnormal development of breast tissues in males. The most common health issues are listed below,
- Hypogonadism
- Aging
- Tumors
- Hyperthyroidism
- Kidney failure
- Liver failure and cirrhosis
- Malnutrition and starvation
Alcohol, recreational drugs & illegal drugs are all substances that can cause gynecomastia.
- Liquor
- Anabolic steroids
- Amphetamines
- Heroin
- Marijuana
- Methadone
- Opioids
Lavender oil, and tea tree oil present in shampoos, soaps, and lotion can also cause the overdevelopment of male breast tissues in some cases. This is because of their low estrogenic activity.
What Are The Symptoms Of Gynecomastia?
The majority of adult men with gynecomastia don't have any symptoms. One or both of your breasts may be affected by gynecomastia. It may begin as a sore lump or fatty tissue beneath the nipple. Frequently, the breasts expand unevenly.
Gynecomastia may display the symptoms of swollen breast tissue, especially in adolescents; breast tenderness; nipple sensitivity when rubbing against clothing.
Gynecomastia symptoms may resemble those of other medical conditions or issues. Always seek a diagnosis from your healthcare provider.
How Is Gynecomastia Diagnosed?
Your doctor will look over your symptoms, do a physical examination, and look at your medical and family history. For hormone levels to be checked, a blood test may also be recommended. Because breast lumps are caused by both gynecomastia and breast cancer, your healthcare professional can also order some other tests such as,
- Magnetic resonance imaging (MRI) scans
- Mammograms (For diagnosing unusual changes or growths in the breast tissue)
- Computerized tomography (CT) scans
- Testicular ultrasounds
- Tissue biopsies
How Is Gynecomastia Treated?
Gynecomastia improves gradually without treatment in most cases. If you have gynecomastia, your doctor may recommend an endocrinologist, a doctor who treats issues with hormones and how they affect your body.
The treatment of gynecomastia depends upon your age, health, the duration of your condition, and how well you respond to particular medications.
When it occurs during puberty, gynecomastia typically resolves on its own. This could take six months to three years.
If a substance or medication is making your breasts bigger, you may need to stop taking it or switch to another one. If a disease is causing gynecomastia, treatment for the disease should reduce swelling. Your doctor may prescribe medication to fix the imbalance of hormones that is making your breasts grow.
Some men with gynecomastia may benefit from taking medications that are used to treat breast cancer and other conditions. For example, Aromatase inhibitors like anastrozole (Arimidex) and tamoxifen (Soltamox). However, they are not specifically approved for the treatment of gynecomastia.
Surgery to remove excess breast tissue If your enlarged breasts persist despite treatment or observation, your physician may recommend surgery. The two options for gynecomastia surgery are:
Liposuction: Breast fat is removed during this procedure, but the breast gland tissue is not.
Mastectomy: In a mastectomy, the breast gland tissue is removed. Most of the time, the surgery only requires a few small cuts. The recovery period for this less invasive type of surgery is shorter.
How To Prevent Gynecomastia?
Many of the hormonal changes that lead to gynecomastia cannot be avoided. Switching medications or seeking treatment for a substance use disorder may, if necessary, lower your risk of breast enlargement.
You must avoid certain drugs such as heroin, marijuana, anabolic steroids, and amphetamines. You should avoid drinking alcohol or drink in moderate amounts.