Gynecomastia

What Is Gynecomastia (Enlarged Breasts in Men)?

Gynecomastia is a condition that makes breast tissue swell in boys and men. It can happen when the balance of two hormones in your body is thrown off. If you have enlarged breasts because of fat deposits, you have a different condition called "pseudogynecomastia."

Although breasts don't develop in men the way they do in women, all boys are born with a small amount of breast tissue.

Boys' bodies mostly make a hormone called testosterone, which guides their sexual growth during puberty. But males also make some estrogen -- the hormone that steers sexual growth in girls.

When a boy is going through puberty, or when an older man's body makes less testosterone, the balance of the two hormones changes.

Sometimes when that happens, a higher percentage of estrogen causes male breast tissue to swell. About half of adolescent boys and as many as two-thirds of men older than 50 will have this to some degree.

Gynecomastia Symptoms

Your first sign of gynecomastia may be a lump of fatty tissue under the nipple. Sometimes this lump is tender or sore.

This might make you worry that you have breast cancer, which does occur in a small number of men. Gynecomastia is not necessarily a sign of cancer, but your doctor may run some tests to rule it out.

Swelling of the breasts may happen unevenly, with one becoming larger than the other. You may also have breast tenderness.

See your doctor if you notice that your breasts have swelling, are painful or tender, or there is a discharge from the nipple of one or both breasts.

Gynecomastia Causes

A lot of things can trigger the hormone imbalance that causes male breast growth, and many times the exact cause isn't known.

In addition to body changes such as puberty and aging, some things that can cause gynecomastia are:

• Injury or diseases that affect the testicles, which make testosterone
• Thyroid problems, since hormones from that gland control growth and sexual development
• Some cancers, including tumors of the lungs, pituitary gland, or adrenal glands
• Obesity, which can result in more estrogen
• Illegal drugs, including anabolic steroids, marijuana, and heroin
• Kidney failure (when they can no longer clean and filter your blood)
• Liver disease

Some infant boys may get gynecomastia briefly while hormones from their mother are still in their bodies.

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 asdigoxin (Lanoxin) and calcium channel blockers can lead to gynecomastia sometimes.

Medicines used to empty your stomach. For example, metoclopramide (Reglan) can have gynecomastia as a side effect.

Ulcer drugs. Some medicines that you buy over the counter for ulcers can lead to gynecomastia, such as cimetidine (Tagamet HB).

Some antibiotics can also cause gynecomastia. So can tricyclic antidepressants and some cancer treatments.

Gynecomastia Diagnosis

If your doctor suspects you have gynecomastia, they will probably examine you to make sure there are no hard lumps, oozing fluid, or skin problems that could be signs of cancer.

They will also likely ask you questions about your medical history that might include:

• Have you had illnesses such as mumps, kidney ailments, or liver disease?
• What drugs have you taken -- legal or illegal?

You might also be given tests. They could include:

• Blood tests or urine samples
• Mammogram
• Biopsy
• CT scans
• MRI scans
• Testicular ultrasounds

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.

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.

In some cases, you might need surgery. Your doctor may recommend techniques such as:

• Liposuction (removal of extra breast fat)
• Mastectomy (removal of breast gland tissue)

Gynecomastia Prevention

There are steps you can take to lower your chances of having gynecomastia. They include things such as:

• Don't use illicit or recreational drugs, such as anabolic steroids, androgens, amphetamines, marijuana, or heroin.
• Don't drink alcohol, or drink moderately.
• Go over your medicine list with your doctor. If any of your medications can cause gynecomastia, ask if there are alternatives.

Gynecomastia Complications

Gynecomastia can have an impact on your mental health. You might feel embarrassed, or feel anxious or depressed. There are steps you can take to manage these feelings.

Talk to you doctor about how gynecomastia is making you feel. They can suggest a mental health professional who can help you manage any mental health problems you may get.

Also talk to your family and close friends. They know you best and can give you the emotional backing you need.

Support groups can also help. You'll get a chance to talk to others who understand what you're going through. Ask your doctor for help in finding groups that you can connect with.

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