Gynecomastia: Symptoms, Causes and Treatment

Gynecomastia can occur in newborns, adolescents, and older adults. Find out what this condition consists of, what are its symptoms, causes and possible treatments.
Gynecomastia: Symptoms, Causes and Treatment

Written by Daniela Andarcia, 25 June, 2021

Last update: 25 June, 2021

Both men and women have mammary glands. The difference is that in males they’re less developed and tend to be small. However, there’s a pathology that reverses this condition. It’s known as gynecomastia and is characterized by the increase in the volume of these glands.

What’s gynecomastia?

Consequences of gynecomastia
This condition is often associated with mood and self-esteem problems.

Gynecomastia is defined as the ‘enlargement of the mammary glands in men’. It can affect one or both breasts and usually occurs in older adults, adolescents, children, or newborns.

Many people have the belief that when a man has pronounced mammary glands, it can only be related to being overweight. However, this condition is known as pseudogynecomastia, and it’s very different from gynecomastia. Losing weight or having an intense exercise routine won’t solve the problem.

Many cases of gynecomastia don’t need treatment. However, it’s a condition that men feel not to be very aesthetic, and, as a result, it ends up affecting the self-esteem of those who suffer from it. Some specialists prescribe a specific treatment or even perform surgery.

What are the symptoms of gynecomastia?

If you’re a man and have any of these signs, it’s important that you go to see your doctor so that they can diagnose the cause of the condition:

  • Swollen breasts
  • Areolas that have increased in diameter
  • Tender breasts, although most cases are usually painless
  • Any type of secretion from the breast

What causes gynecomastia?

It’s usually associated with an increase in the hormone estrogen and a decrease in the hormone testosterone. As men grow or go through the different phases of life, they can suffer from hormonal fluctuations.

In andropause

In women, this stage is known as menopause, but in men when the production of male sex hormones decreases, we say that they are facing andropause. If the hormonal balance changes, a man can suffer from gynecomastia, as well as loss of sleep and hair.

In adolescence

It may be difficult to understand, but boys also produce female hormones, although to a lesser extent than male sex hormones.

When a boy goes through puberty, the balance is disturbed and more estrogens (female hormone) are produced than androgens (male hormone). This imbalance can lead to gynecomastia, although it usually disappears when hormone levels return to their normal levels.

According to a study published in the medical journal Seminars in Plastic Surgery, 10% of children who are undergoing puberty transformation suffer from gynecomastia.

In babies

When children are breastfed, the mother transfers some estrogen to them. This can alter the levels of this hormone in babies and cause gynecomastia.

According to a study published in American Family Physician, 1 in 9 newborn boys have noticeable breast tissue.

Narcotic substances

A study published in Canadian Family Physician revealed that drugs can also affect hormonal balance and cause estrogen levels to rise more than necessary. So, steroids and amphetamines can cause gynecomastia.

Other conditions

Some other rare conditions are associated with gynecomastia, and these are testicular tumors, chronic kidney failure, hyperthyroidism, and cirrhosis.

How is gynecomastia diagnosed?

Laboratory diagnosis of gynecomastia
Several complementary studies may be necessary to determine the cause of gynecomastia.

The doctor often asks routine questions, such as your medical history or if there’s anyone in your family who has suffered from inflammation in the breasts. Also, at this point, your doctor will likely examine your genitals and breasts. Gynecomastia is considered to be possible when the breast tissue has increased by at least 0.5 centimeters (0.2 inches) in diameter.

Other tests to perform are blood tests, to evaluate hormone levels, and an ultrasound to look at breast tissue. They may also ask for an x-ray, biopsy, MRI or CT scan.

Risk factor’s

Experts suggest that between 10 and 20% of gynecomastia cases are due to the abuse of herbal medications and 25% are unknown. Some risk factors could be the following:

  • Alcohol abuse
  • Radiation treatment to the testicles
  • Anabolic steroids
  • Having kidney or liver disease
  • Klinefelter syndrome
  • Hyperthyroidism
  • Tumors in the testicles
  • Consuming certain antibiotics
  • Chemotherapy
  • Treatment for ulcers
  • Certain HIV medications
  • Consuming diazepam

Treatment for gynecomastia

If gynecomastia is caused by a medical condition, causes severe pain, or affects the patient’s self-esteem, then the doctor will usually proceed with surgery or prescribe treatment. However, you should bear in mind that in most cases this pathology disappears when hormonal levels return to normal.

Surgery

To remove much of the glandular tissue, the expert often suggests performing a mastectomy. This only happens when gynecomastia is psychologically affecting the person, to the point of diminishing their public or social relationships.

Medicines

In order to block estrogen, they often prescribe tamoxifen. This is often used in breast cancer patients, however, according to research published in the Clinical Trial, it may also relieve pain and inflammation in men with large breasts.

Another treatment that might be used is raloxifene. However, according to some studies, it may produce unfavorable results in aromatase inhibitors, drugs used to treat postmenopausal women and breast cancer.

Mental therapy

Gynecomastia can affect men psychologically, to such an extent that they withdraw from the social life they were used to. Attending support groups or a psychologist can help you find mental stability.

Gynecomastia, an aesthetic problem

Gynecomastia can affect men’s social life. The abnormal growth of their breasts can embarrass them to the point of withdrawing from their friends or the places they frequented.

In general, this condition can occur in infants, adolescents, and older adults when there’s an imbalance in the levels of male and female hormones.

However, the consumption of some drugs and medications can increase the risk, so you should consult with your doctor if you observe an increase in the size of your breasts.

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  • Dickson, G. (2012). Gynecomastia. American family physician, 85(7), 716–722.
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