Gynecomastia: What Is It? Who Does It Affect? Is It Treatable?

Gynecomastia is a condition that makes it difficult for a man to live his life without being extremely self-conscious of his physique. This article will discuss the symptoms, causes, and treatments for gynecomastia.

What is Gynecomastia?

Gynecomastia

Gynecomastia, often called gyno for short, is a condition used to describe breast tissue hypertrophy or enlargement in males. You might even hear it be referred to as “man boobs” or “moobs.” So how does this enlargement of the breast tissue? It can occur for a variety of reasons, including hormonal changes or imbalances; this may occur during puberty due to the naturally occurring hormonal changes, but it can also occur from birth to older adulthood.

Most people tend to misunderstand this condition simply as breast hypertrophy in men, but there are other cases in which this symptom can occur. Another similar condition called lipomastia manifests in larger breasts in men due to the excess fat accumulation in the breasts for obese men. Additionally, as previously mentioned, the tissue hypertrophy may occur from hormonal imbalances.

Although it may have negative social implications due to the stigma surrounding masculinity and the resulting self-consciousness, gynecomastia is not usually cancerous and is therefore not necessarily a dangerous health concern. It can also be treated and resolved within a relatively short period of time.

How Common is Gynecomastia?

Although you might not have been aware of it, gynecomastia is fairly common. Research studies have demonstrated that it is the most common reason behind male breast evaluations, and furthermore, it is the most prevalent benign male breast disorder. It tends to affect newborns, males going through puberty, and men over the age of 50 years old more than other age groups.

Symptoms

The main symptom of gynecomastia is the enlargement of male breasts, and this may occur in one or both breasts. One common misunderstanding is that people think that it only affects the fat tissue; this is incorrect, as it also affects the glandular tissue.

Secondary symptoms may include breast tenderness, which is worse upon palpation. You may also notice the development of chest asymmetry and an increase in the size of the areola, the dark ring surrounding the nipple.

Hormonal Causes

One of the main causes of gyno is changes in various hormone levels and an imbalance between the male and female hormones, testosterone and estrogen, respectively. Males and females have both hormones; however, the proportion of each varies with males having higher levels of testosterone compared to estrogen and females having the opposite ratio.

So, how does gyno develop? Essentially, it results from an increase in estrogen and other female hormone levels. This causes changes in various biochemical pathways, leading to the further suppression of testosterone production. As previously mentioned, this hormonal imbalance then leads to the enlargement of breast glandular and fat tissues and even the skin.

Medication-related or Medical Condition-related Causes

A variety of different medications can increase your risk of developing gynecomastia, and it can also be a side effect of various drugs including, anti-ulcer medications, human growth hormone, steroids, cardiac medications, cancer treatment medications, anti-anxiety medications or antidepressants, and even some antibiotics.

However, one of the most well-known drugs that can lead to gyno is the use of anabolic steroids. These exogenous hormones can aromatize into estrogen and lead to the development of gyno.

Various health conditions may result in the development of gynecomastia, including but not limited to malnutrition, kidney failure or chronic kidney disease, obesity, liver problems, and even tumors. All of these can affect hormone levels and production, whether it is increasing estrogen levels, suppressing testosterone levels, or both.

Diagnosis

Diagnosis of gynecomastia is not as simple as identifying breast growth. Medical professionals take a patient’s entire medical history into consideration in addition to a comprehensive physical exam. This will be further supplemented with various laboratory tests used to identify the levels of various blood markers to better identify potential causes of gyno. In some rare cases, a physician may utilize imaging modalities, including mammograms, although this is much rarer and typically used if there is suspicion for cancer.

Treatment

There are two major routes for treatment of gynecomastia. The first is the use of medications, which can include a single or combination of hormone regulators. These medications include testosterone, selective estrogen receptor modulators (SERMs), and aromatase inhibitors (AIs). Obviously, the use of exogenous testosterone will increase your body’s level of testosterone, but as previously noticed, this use of exogenous hormones can lead to aromatization into estrogen which will actually make the condition worse. SERMs have been found to be able to reduce breast volume for men suffering from gyno; however, it is typically used in severe cases or if a patient is experiencing pain. AIs have also been found to work for some men. Regardless of which medication treatment you may choose, results have been shown to be more favorable the earlier treatment is started.

The second option is surgical intervention. This is typically only considered in cases where drug treatment has been ineffective or there has been noticed scarring of the tissue. There are multiple surgical options, although these can lead to various complications and are not as affordable as compared to other treatment methods.

So What Can You Do?

Gynecomastia is a misunderstood condition, often being incorrectly thought of as the enlargement of the breasts in men. It involves more than the increase of just fatty tissue and involves glandular breast tissue growth. If you think that you might have this condition, please seek the consultation of your primary care provider to properly diagnose the condition and discuss possible treatment methods.