Gynecomastia or Breast Enlargement in Men
Gynecomastia is a condition of breast enlargement or an increase in the amount of breast gland tissue in boys and men. This condition can increase the size of one or both the chests and can also lead to uneven growth. Gynecomastia is caused by abnormal changes in hormone levels that can occur in infants, boys going through puberty, older aged men, or men as they age.
In most cases, gynecomastia does not need treatment or medication as it disappears on its own. Even though it does not pose a serious health problem, gynecomastia can be difficult to live with and can affect the quality of life for boys and men with such conditions. Males with gynecomastia may experience pain in their chests and feel embarrassed along with low self-esteem which can lead to withdrawal from social settings. To address this problem when it persists, there are medications and surgeries available to treat the condition.
What are the symptoms of gynecomastia?
The symptoms of gynecomastia or breast enlargement in men include:
- Sore and swollen breasts
- uneven chest
- discharge from chest
- breast tenderness
The symptoms of gynecomastia can look like other health conditions or problems. If you experience these symptoms, you should see your healthcare provider for they can diagnose as well as determine the cause of your condition.
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What are the causes of gynecomastia?
Gynecomastia is a benign or noncancerous condition that usually occurs as a result of hormonal changes. When there is an increase in the female hormone estrogen and a decrease in the male hormone testosterone, it causes breast enlargement in men. However, other factors can also cause gynecomastia.
Just like women go through menopause when they age, men also undergo a similar stage called andropause when they reach middle age. During this phase, the production of male hormone testosterone declines leading to hormonal imbalance. It can cause gynecomastia or breast enlargement, which often peaks in men between the ages of 50 and 80.
Both boys and girls produce the female hormone, estrogen and the male hormone, androgen. When boys reach puberty, if they produce more estrogen than androgen, it can lead to gynecomastia. However, the imbalance in the hormones is usually temporary and the breast enlargement usually disappears in six months to two years after the start of puberty.
- Breast Milk
Newborn babies can also develop gynecomastia from the mother’s breast milk as the mother’s breast milk contains the hormone estrogen, which can lead to an increase in the babies’ estrogen level.
Certain medicines can lead to gynecomastia such as steroids, amphetamines, antidepressants, antibiotics, and prostate cancer medicines. In case a medication is the cause, the doctor will ask you to stop taking it or prescribe a different medication. Illegal drugs, such as anabolic steroids, marijuana, heroin, and alcohol can also result in breast enlargement in men or gynecomastia.
- Other health conditions
Other health conditions which can result in gynecomastia include kidney disease, testicular cancer, liver diseases or cirrhosis, lung cancer, thyroid disorders, congenital disorders, and obesity.
How is gynecomastia diagnosed?
To determine the cause of enlarged breasts, the doctor will go through the health and medical history and will give you a physical exam where the male breasts and genitals will be examined. The doctor may suggest the following tests to identify other health conditions such as:
- Blood tests to check hormone levels and liver function
- Urine tests
- A mammogram or X-ray of the breast and ultrasound to view breast tissue and check for any abnormal growths
- A biopsy where a small breast tissue sample is removed and checked for cancer cells
How is gynecomastia treated?
Gynecomastia is a condition that usually does not require any treatment as it disappears on its own. However, the condition may need treatment and medication if it causes severe pain, low self-esteem, and indicates other underlying health conditions.
Surgery may be used to remove extra tissue from the breast. In case of severe conditions such as swollen tissue and long-term gynecomastia, where medications are not likely to be effective, mastectomy or surgery to remove extra tissue may be suggested.
Medical treatments are available to treat gynecomastia. Medications such as tamoxifen and raloxifene can reduce breast volume in gynecomastia and balance the hormone levels.
Counseling may be recommended for males who find it difficult to cope with this condition. Since enlarged breasts can lead to embarrassment and low self-esteem, it is crucial to seek counseling. If not treated, it can lead to depression, anxiety, stress, and withdrawal from normal activities. Reaching out support groups with people who have similar experiences can help manage the condition.
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The doctor will decide the best treatment for you taking into consideration the following points:
- Your age
- Your health history
- The present health condition
- Your ability to undergo certain medicines, treatments, and therapies
- The duration of the condition
- Your preference for treatment
There are other health conditions which appear like gynecomastia but are not gynecomastia. These are:
- Breast cancer
Although it is a rare case, men can also suffer from breast cancer. Breast cancer usually affects a single breast, which is not tender to touch and one may feel a lump. The breast also looks enlarged due to an increase in the size of lymph nodes in the breast area. One can also experience a discharge or leakage of liquid from the nipple.
- Fatty breast tissue
This is a condition that occurs in overweight and obese men. The breast looks enlarged due to the accumulation of fats in the breast. Therefore, it is not gynecomastia.
Can gynecomastia be prevented?
Gynecomastia or breast enlargement in males caused by hormonal imbalance due to growing and aging are not preventable. However, gynecomastia conditions that emerge as a medical condition are prevented to a certain extent. You can also control certain things to reduce the risk of gynecomastia such as:
- Avoid taking drugs such as steroids and androgens, amphetamines, heroin, and marijuana.
- Avoid consuming alcohol which can help reduce the gynecomastia condition.
- Consult your doctor if you’re undertaking medication known to cause gynecomastia.
Meet the specialists at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad
Dr. (Col.) Mohammed Alam Parwaz is the Head of Plastic, Reconstructive, and Cosmetic Surgery at Yashoda Hospital & Research Centre, he is a skilled and experienced plastic surgeon with over 14 years in apex centers of the Indian Armed Forces. His expertise includes aesthetic and micro-vascular surgeries, hand and peripheral nerve surgeries, burns management, and conventional plastic surgery.
Dr. Shivam Dang, with Plastic Surgery training from the esteemed Army Hospital Research & Referral, New Delhi, brings extensive expertise in modern techniques. Proficient in aesthetic, body contouring, and facial surgeries, he also excels in onco-reconstructive, nerve, trauma, and pediatric surgeries.