Overview Of Gynecomastia
When abnormally large breasts develop in males, it is called gynecomastia. It is due to the excess growth of breast tissue, not excess fat tissue.
Causes Of Gynecomastia
Normal hormone changes are the most common cause of breast development in newborns, boys, and men. There are other causes as well.
HORMONE CHANGES
Breast enlargement is usually caused by an imbalance of estrogen (female hormone) and testosterone (male hormone). Males have both types of hormones in their body. Changes in the levels of these hormones, or in how the body uses or responds to these hormones, can cause enlarged breasts in males.
In newborns, breast growth is caused by being exposed to estrogen from the mother. About one-half of boy babies are born with enlarged breasts, called breast buds. They usually go away in 2 to 6 months, but can last longer.
In preteens and teens, breast growth is caused by normal hormone changes that occur in puberty. More than one-half of boys develop some breast enlargement during puberty. Breast growth often goes away in about 6 months to 2 years.
In men, hormone changes due to aging can cause breast growth. This may occur more often in overweight or obese men and in men age 50 and older.
HEALTH CONDITIONS
Certain health problems can cause breast growth in adult men, including:
- Chronic liver disease
- Kidney failure and dialysis
- Low testosterone level
- Obesity
Rare causes include:
- Genetic defects
- Overactive thyroid or underactive thyroid
- Tumors (including benign tumor of the pituitary gland, called prolactinoma)
MEDICINES AND MEDICAL TREATMENT
Some medicines and treatments that can cause breast growth in men include:
- Cancer chemotherapy
- Hormone treatment for prostate cancer, such as flutamide (Proscar), or for enlarged prostate, such as finasteride (Propecia) or bicalutamide
- Radiation treatment of the testicles
- HIV/AIDS medicines
- Corticosteroids and anabolic steroids
- Estrogen (including those in soy products)
- Heartburn and ulcer medicines, such as cimetidine (Tagamet) or proton pump inhibitors
- Anti-anxiety medicines, such as diazepam (Valium)
- Heart medicines, such as spironolactone (Aldactone), digoxin (Lanoxin), amiodarone, and calcium channel blockers
- Antifungal medicines, such as ketoconazole (Nizoral)
- Antibiotics such as metronidazole (Flagyl)
- Tricyclic antidepressants such as amitriptyline (Elavil)
- Herbals such as lavender, tea tree oil, and dong quai
- Opioids
DRUG AND ALCOHOL USE
Using certain substances can cause breast enlargement:
- Alcohol
- Amphetamines
- Heroin
- Marijuana
- Methadone
Men who have enlarged breasts may have an increased risk for breast cancer. Breast cancer in men is rare. Signs that may suggest breast cancer include:
- One-sided breast growth
- Firm or hard breast lump that feels like it is attached to the tissue
- Skin sore over the breast
- Bloody discharge from the nipple
- Home Care
- For swollen breasts that are tender, applying cold compresses may help. Ask your health care provider if it’s OK to take pain relievers.
Other tips include:
- Stop taking all recreational drugs, such as marijuana
- Stop taking all nutritional supplements or any medicines you are taking for bodybuilding
Exams & Tests
Your provider will take a medical history and perform a physical examination.
You may not need any tests, but the following tests may be done to rule out certain diseases:
- Blood hormone level tests
- Breast ultrasound
- Liver and kidney function studies
- Mammogram
Treatment Of Gynecomastia
Often no treatment is needed. Breast growth in newborns and young boys often goes away on its own.
If a medical condition is causing the problem, your provider will treat that condition.
Your provider will talk with you about medicines or substances that may cause breast growth. Stopping their use or changing medicines will make the problem go away. DO NOT stop taking any medicines before talking to your provider.
Breast growth that is extreme, uneven, or does not go away may be embarrassing.
Treatments that may be used in rare situations are:
- Hormone treatment that blocks the effects of estrogens
- Breast reduction surgery or liposuction
