Definition
Gynecomastia is an enlargement of the breasts in men. This condition is not the same as having a fatty breast area from obesity. The breast tissue is firm in men with gynecomastia.
This may occur in up to one-third of men. More than half of boys will develop some degree of breast enlargement during puberty. This is normal and usually goes away by age 18.
Causes
All men produce male and female hormones. Normally, men produce much more male hormones than female hormones. Gynecomastia is caused by an imbalance in the female and male hormones. The hormone imbalance can be caused by:
- Adolescent puberty changes
- Aging, especially in association with low testosterone levels
- Certain genetic disorders causing low levels of testosterone
- Certain medications, such as
digoxin,
spironolactone,
cimetidine, and many others
-
Anabolic
steroids
used to enhance athletic performance in sports
Risk Factors
Gynecomastia is more common in adolescents or in men over age 50.
Factors that may increase your risk of gynecomastia include:
- Obesity
-
Excess
alcohol consumption
leading to liver
cirrhosis
- Chronic liver or kidney disease
-
Presence of a condition or medication that decreases androgen or
estrogen
production
- Family history
- Marijuana use
- Hyperthyroidism—overactive thyroid gland
- Tumors of the testicles, lung, stomach, liver, kidney, or pituitary gland
Symptoms
Symptoms of gynecomastia include:
- Enlargement of the breasts with firm tissue, usually starts on one side and go on to affect both breasts
- Tenderness
Diagnosis
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will focus on your weight, breast exam, testicular exam, and any other signs of a hormone problem. You may be referred to a doctor who specializes in hormone disorders.
Other tests may be done if you have prolonged or large gynecomastia.
Your body's fluids and tissues may be tested. This can be done with:
Images may be taken of your chest. This can be done with:
Treatment
Treatment for gynecomastia is rarely needed. However, it is important to find and treat the underlying cause of the gynecomastia. If a medication is causing gynecomastia, you will be asked to stop taking it or to switch medication. If a tumor is causing the problem, your doctor will make a treatment plan for the tumor.
Medications may be used if needed to treat the gynecomastia. However, they can produce unwanted side effects. Surgery may also be used to remove breast tissue.
Prevention
Some gynecomastia may be prevented by avoiding known risk factors. This includes avoiding:
- Excessive alcohol consumption
- Steroids
- Marijuana
Gynecomastia. Family Doctor—American Academy of Family Physicians website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/gynecomastia.html. Updated January 18, 2018. Accessed March 20, 2018.
Gynecomastia. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T116259/Gynecomastia. Updated June 15, 2017. Accessed March 20, 2018.
Johnson RE, Kermott CA, et al. Gynecomastia: evaluation and current treatment options.
Ther Clin Risk Manag. 2011;7:145-148.
Wollina U, Goldman A. Minimally invasive esthetic procedures of the male breast.
J Cosmet Dermatol. 2011;10(2):150-155.
Last reviewed March 2018 by
EBSCO Medical Review BoardKari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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