Description

Gynecomastia (guy-nuh-koh-MAS-tee-uh) is an increase in the amount of breast gland tissue in boys or men. An imbalance of the hormones estrogen and testosterone cause. Gynecomastia can affect one or both breasts, sometimes unevenly.

Pseudogynecomastia is an increase in fat but not the tissue of the gland in the male breast.

Newborns, boys going through puberty and older men may develop gynecomastia due to the natural changes in hormone levels. There are also other causes.

More often, gynecomastia is not a serious problem. But it can be hard to deal with the disease. People with gynecomastia sometimes have pain in their breasts. And they may feel embarrassed.

Gynecomastia may go away on their own. If you do not, the medicine or surgery can help.

Symptoms

Gynecomastia symptoms may include:

  • The pain, especially in teenagers.
  • Swollen breast tissue.
  • Tenderness in the breasts.
  • Nipples sensitive to the friction with your clothes.

When to see a doctor

See a member of your health care team if you have:

  • The swelling.
  • Pain or sensitivity.
  • Fluid coming out of one or both breasts nipples. This is called discharge from the nipple.
  • A company or a hard lump.
  • The dimpling of the skin of the breast.

Causes

In persons assigned male at birth, the body primarily makes the sex hormone testosterone. It also makes small amounts of the hormone estrogen. Gynecomastia can happen when the amount of testosterone in the body falls in comparison with estrogen. The decrease may be caused by conditions that decrease testosterone or block its effects. Or it can be caused by conditions that raise the level of estrogen.

Some of the things that can change the body's hormonal balance include the following:

Natural hormone changes

The hormones testosterone and estrogen control the sex of the features. Testosterone controls traits such as muscle mass and body hair. Estrogen controls of traits, including the growth of breasts.

Estrogen levels that are too high or are out of balance with testosterone levels can cause gynecomastia.

  • Gynecomastia in infants. More than half of male infants are born with enlarged breasts due to the effects of estrogens during pregnancy. The swelling of the breast tissue usually disappears within 2 to 3 weeks after birth.
  • Gynecomastia during puberty. Gynecomastia caused by hormone changes during puberty is common. Most of the times, the swelling of the breast tissue goes away without treatment within 6 months to 2 years.
  • Gynecomastia in adults. Around 24% to 65% of men ages 50 to 80 to get gynecomastia. But the majority of adults with the condition have no symptoms.

Medications

The following medications can cause gynecomastia:

  • Anti-androgens are used to treat conditions such as an enlarged prostate and cancer of prostate. Examples of these medications include flutamide, finasteride (Proscar, Propecia), and spironolactone (Aldactone, Carospir).
  • Anabolic steroids and androgens to treat delayed puberty, or the loss of muscle disease.
  • The antiretroviral drugs. The estrogen-like properties of some HIV medications can cause gynecomastia, especially efavirenz.
  • ADHD medications that contain amphetamines, such as Adderall.
  • Anti-anxiety medications, such as diazepam (Valium).
  • The tricyclic antidepressants.
  • Some antibiotics.
  • Opioids to treat chronic pain.
  • Ulcer medications, such as-the-counter drugs cimetidine (Tagamet HB) and omeprazole (Prilosec).
  • Chemotherapy to treat cancer.
  • Heart medications such as digoxin (Lanoxin) and calcium channel blockers.
  • Stomach-emptying of the drugs, such as metoclopramide

Drugs, illegal drugs and alcohol

Substances that can cause gynecomastia include:

  • The consumption of Alcohol.
  • The anabolic steroids used to build muscle and improve athletic performance.
  • Amphetamines.
  • Marijuana.
  • Heroin.
  • Methadone (Methadose).

Health conditions

Certain health conditions that affect the balance of hormones can cause or be associated with gynecomastia. They include:

  • The hypogonadism. Conditions that decrease the amount of testosterone that the body makes that may be associated with gynecomastia. Examples include Klinefelter's syndrome, and pituitary insufficiency.
  • Aging. The hormonal changes that occur with aging can cause gynecomastia, especially in overweight people.
  • Tumors. Some tumors may produce hormones that moving the body's hormonal balance. These are tumors that involve the testicles, the adrenal glands or the pituitary gland.
  • The hyperthyroidism. In this condition, the thyroid gland produces too much of the hormone thyroxine.
  • The renal failure. About half of the people receiving dialysis treatment, develop gynecomastia due to hormonal changes.
  • Liver failure and cirrhosis. Changes in hormone levels related to problems in the liver, and cirrhosis drugs are associated with gynecomastia.
  • Malnutrition and hunger. When the body does not get enough nutrition, testosterone levels drop. But the levels of estrogen in the same room. This causes an imbalance in the hormones.

Herbal products

Some vegetable oils used in shampoos, soaps, and lotions that have been associated with gynecomastia. These include the tea tree or lavender oil. This is probably due to the compounds in the oil that can mimic estrogen or affect the testosterone.

Risk factors

Risk factors for gynecomastia are:

  • Puberty.
  • Advanced age.
  • Obesity.
  • The use of anabolic steroids to improve athletic performance.
  • Certain health conditions. These include the liver, and kidney disease, thyroid disease, Klinefelter's syndrome, and some tumors.

Complications

Gynecomastia has few physical complications. But it can lead to mental health problems due to changes in how the breast looks.

Prevention

Several factors within your control, you can decrease the risk of gynecomastia:

  • Do not use drugs. Examples include anabolic steroids, amphetamines, heroin, and marijuana.
  • Limit or avoid alcohol. Helps not to drink alcohol. If you drink, do so in moderation. That means no more than two drinks per day for men.

Diagnosis

To find out if you have gynecomastia, a member of your health care team starts by asking you some questions. For example, you will probably ask about your symptoms and the medicines you take. It is given a medical examination to check your breast tissue, the stomach and the genitals.

Tests

Your health care team likely that the end of the tests. These can help to find a possible cause of gynecomastia, or search for conditions that can cause similar symptoms. Tests may be done to detect breast cancer. You may need tests such as:

  • Blood tests.
  • Mammograms — This is an x-ray of the breast.
  • The computed tomography (CT) — This is a series of X-rays taken from different angles.
  • Magnetic resonance imaging (MRI) — This imaging test uses a magnetic field and radio waves.
  • Testicular ultrasound — This uses sound waves to produce images of your testicles and the tissue around them.
  • Tissue biopsies — This procedure removes a small piece of tissue, which is examined in a laboratory.

The conditions that cause similar symptoms

Your health care team will want to make sure that your swelling of the breast is gynecomastia and not another condition. Other conditions that can cause similar symptoms include:

  • Fatty breast tissue. Another name for this is pseudogynecomastia. Some people, especially those with obesity, have the fat of the breast that is seen as gynecomastia. But it is not the same as gynecomastia. For the people diagnosed with this condition, the more evidence that is not necessary.
  • Breast cancer. Breast cancer is rare in men, but it can happen. The enlargement of one breast or the presence of a firm lump raises the concern for male breast cancer.
  • Mastitis. This inflamed the breast tissue that sometimes involves an infection.
  • Lipoma. This slow-growing, fatty lump is not cancer.

Treatment

Gynecomastia is usually disappear with time without treatment. But if gynecomastia is caused by a medical condition, you may need treatment.

If you take medicines that may be the cause of gynecomastia, ask your health care team about your options. Your doctor may ask you to stop the medication or try a different one.

Often, no treatment is necessary for adolescents with gynecomastia due to the natural hormonal changes during puberty. A young health care team may recommend revisions every 3 to 6 months to see if the condition is improving on its own. Gynecomastia in adolescents often goes away without treatment in less than two years.

The treatment may be necessary if gynecomastia doesn't get better on its own. The treatment can also help if the condition causes pain, tenderness, or shame.

Drugs

Drugs used to treat breast cancer and other conditions may be useful for some adults with gynecomastia. They include:

  • Tamoxifen (Soltamox).
  • Raloxifene (Evista).
  • Aromatase inhibitors, such as anastrozole (Arimidex).

In the united States, these drugs are approved by the Food and Drug Administration. But have not been specifically approved for use in people with gynecomastia.

The surgery to remove excess breast tissue

You can still have enlarged breasts after waiting for gynecomastia go away on its own account or after taking the medication. If your appearance or other symptoms that bother you, surgery may be a treatment option:

Two of gynecomastia surgery options are:

  • The liposuction. This surgery removes fat from the breast, but not the breast gland tissue itself.
  • The mastectomy. This type of surgery removes the breast gland tissue. With small amounts of tissue from the gland, the mastectomy can be performed through small incisions. This decreases the recovery time. Sometimes, liposuction and mastectomy are combined.

Coping and support

For people with gynecomastia, have enlarged breasts can be stressful and embarrassing. The condition can be difficult to hide. Sometimes, it can be a challenge to romantic relationships. During puberty, gynecomastia can do that teenagers with a target of ridicule from peers as well. You can do activities such as swimming or the change in the locker room traumatic.

Whatever your age, if you have gynecomastia, you may feel dissatisfied with their body. But you can take steps that can help you to deal with:

  • To get a checkup. Some people with gynecomastia are concerned that their symptoms are due to a more serious condition. It can be a relief to learn that the gynecomastia is the cause.
  • Get counseling. Psychotherapy can help manage the anxiety or the depression caused by gynecomastia. It can also help you to talk with your partner or family members, to understand what is going on.
  • Get your family and friends. You may feel embarrassed to speak about gynecomastia with the people that matter to you. But if you explain your situation and ask for help, which could strengthen their relationships, and relieve stress.
  • Connect with other people who have gynecomastia. It can feel good to talk to people that understand what is happening. Web sites, such as Gynecomastia.org it can help you to connect with other people who have the condition.
Symptoms and treatment of Enlarged breasts in men (gynecomastia)