Enlarged breasts in men (gynecomastia)
June 27, 2024
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Enlarged breasts in men (gynecomastia)
Gynecomastia is an increase in the amount of breast gland tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly.
Pseudogynecomastia refers to an increase in fat but not glandular tissue in male breasts. Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.The causes of gynecomastia can result as a side effect of numerous medications and drugs of abuse.The problem also is associated with certain medical conditions and treatments, for example, Hyperthyroidism, Chronic kidney failure, Cirrhosis of the liver, Low testosterone levels, Obesity.
Medications and surgical treatments can be used to treat the problem.
Symptoms
Most adult men with gynecomastia report no symptoms. Signs and symptoms of the condition may include:
- Pain, particularly in adolescents
- Swollen breast tissue
Gynecomastia can be seen as a button-sized growth underneath the nipple. You may be able to see this as a breast lump or feel it when you press on the area. The lump may move easily within the breast tissue and may be tender to touch.
- Breast tenderness
- Nipple sensitivity with rubbing against clothes
When to see a doctor?
See your doctor if you have:
- Swelling
- Pain or tenderness
- Nipple discharge in one or both breasts
Gynecomastia Causes
Hormone imbalance
Gynecomastia can be caused by an imbalance between the sex hormones testosterone and estrogen. Estrogen causes breast tissue to grow. While all men produce some estrogen, they usually have much higher levels of testosterone, which stops the estrogen from causing breast tissue to grow.
If the balance of hormones in the body changes, this can cause a man’s breasts to grow. Sometimes, the cause of this imbalance is unknown.
Obesity
Being very overweight (obesity) is a common cause of gynecomastia – this is because being overweight can increase levels of estrogen, which can cause breast tissue to grow. If you’re overweight you’re also more likely to have excess fat that can enlarge the breast tissue. For some people losing weight or doing more exercise can help but this may not always improve the condition.
Newborn baby boys
Gynecomastia can affect newborn baby boys, because estrogen passes through the placenta from the mother to the baby. This is temporary and will disappear a few weeks after the baby is born.
Puberty
During puberty, boys’ hormone levels vary. If the level of testosterone drops, estrogen can cause breast tissue to grow. Many teenage boys have some degree of breast enlargement. Gynecomastia at puberty usually clears up as boys get older and their hormone levels become more stable.
Older age
As men get older, they produce less testosterone. Older men also tend to have more body fat, and this can cause more estrogen to be produced. These changes in hormone levels can lead to excess breast tissue growth.
Other causes
Other rare causes of gynecomastia include:
- illegal drugs – such as cannabis or anabolic steroids
- alcohol misuse
- a health condition – such as kidney failure or liver disease
- Klinefelter syndrome (a rare genetic disorder)
- lumps or infection in the testicles
- side effects of medicines:
Some types of medicines can lead to gynecomastia, such as:
Anti-androgens. These are drugs that treat an enlarged prostate or prostate cancer.
Anabolic steroids and androgens. Athletes sometimes use these drugs illicitly in an effort to improve their athletic performance. The drugs also have legitimate uses for certain conditions.
HIV drugs. Gynecomastia can sometimes be a side effect of an HIV treatment called “highly active antiretroviral therapy.”
Anti-anxiety drugs. Medicines such as diazepam (Valium) can sometimes cause gynecomastia.
Heart medications. Drugs such as digoxin and calcium channel blockers can lead to gynecomastia sometimes.
Medicines used to empty your stomach. For example, metoclopramide can have gynecomastia as a side effect.
How is gynecomastia diagnosed?
our healthcare provider will assess symptoms, perform a physical exam and review your medical and family history. A blood test may also be recommended to check hormone levels.
Because both gynecomastia and breast cancer cause breast lumps, your provider may order a:
- Breast ultrasound to view detailed images of breast growths.
- Mammogram to examine unusual growths or changes in breast tissue.
What are the complications of gynecomastia?
Studies suggest that men with gynecomastia have a slightly higher risk of breast cancer. You should see your healthcare provider anytime you feel or notice unusual breast changes.
Gynecomastia Treatment
Most cases slowly get better on their own without treatment.
When you have gynecomastia, your doctor might refer you to a specialist known as an endocrinologist, who treats problems related to hormones and how they affect your body.
If a medication or other substance is causing breasts to enlarge, you may need to stop using the drug or switch to a different one. If a disease is the cause, swelling should go away with disease treatment.
How your condition is treated may depend on your age, your health, how long your condition may last, and how well you respond to certain drugs.
If gynecomastia happens during puberty, it usually goes away on its own. This might take anywhere from 6 months to 3 years.
If it turns out your hormones are out of balance because of another health problem, you’ll want to treat that underlying condition.
You might be given medication to address the hormone imbalance that’s causing breast growth
Liposuction (removal of extra breast fat)
Mastectomy (removal of breast gland tissue).
