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Breast enlargement with increased breast gland tissue in men is called gynecomastia. Gynecomastia can occur during early childhood, puberty, or older age (60 years and older), which can be a normal change. Men can also have gynecomastia due to hormonal changes, or medication side effects. It can happen to one or both breasts. Pseudogynecomastia will not be discussed here, but it is caused by obesity and by more fat in the breast tissue, but not increased gland tissue.
Most cases of gynecomastia don’t require treatment. However, for cosmetic reasons, the condition can affect self-esteem and cause someone to withdraw from public activities. Gynecomastia can be treatable with medication, surgery, or by stopping use of certain medications or illegal substances.
The symptoms of gynecomastia include:
Depending on the cause, there may be other symptoms as well. If you have symptoms of male breast enlargement, contact your doctor so they can determine the cause of your condition.
A decrease in the hormone testosterone usually with an increase in the hormone estrogen cause most cases of breast enlargement in men. These hormone fluctuations can be normal at different phases of life and can affect infants, children entering puberty, and older men.
Andropause is a phase in a man’s life that’s similar to menopause in a woman’s. During andropause, production of male sex hormones, especially testosterone, declines over several years. This usually occurs around middle age. The resulting hormone imbalance may cause gynecomastia, hair loss, and insomnia.
Although boys’ bodies produce androgens (male sex hormones), they also produce the female hormone estrogen. When entering puberty, they may produce more estrogen than androgens. This can result in gynecomastia. The condition is usually temporary and subsides as hormone levels rebalance.
Infants may develop gynecomastia when drinking their mothers’ breast milk. The hormone estrogen is present in breast milk, so nursing babies may experience a slight increase in their levels of estrogen.
Drugs such as steroids and amphetamines can cause estrogen levels to increase slightly. This can result in gynecomastia
Less common causes of gynecomastia include testicular tumors, liver failure (cirrhosis), hyperthyroidism, and chronic renal failure.
To determine the cause of your swollen breasts, your doctor will ask questions about your medical history and your family’s medical history. They will also physically examine your breasts and genitals. In gynecomastia, the breast tissue is greater than 0.5 centimeters in diameter.
If the cause of your condition isn’t clear, your doctor may order blood tests to check your hormone levels and a mammogram or ultrasound to view your breast tissue and check for any abnormal growths. In some cases, further tests such as MRI scans, CT scans, X-rays, or biopsies may be necessary.
Gynecomastia usually requires no treatment and goes away on its own. However, if it results from an underlying medical condition, that condition must be treated to resolve the breast enlargement.
In cases of gynecomastia causing severe pain or social embarrassment, medications or surgery may be used to correct the condition.
Surgery can be used to remove excess breast fat and glandular tissue. In cases where swollen tissue is to blame, your doctor may suggest a mastectomy, a surgery to remove excess tissue.
Gynecomastia may cause you to feel embarrassed or self-conscious. If you feel it’s making you depressed or you’re too self-conscious to take part in your normal activities, speak to your doctor or a counselor. It may also help to talk with other men who have the condition in a support group setting.
Gynecomastia can occur in boys and men of any age. Talking to a doctor can help you discover the underlying cause of the breast enlargement. Depending on the cause, you have several options for treatment and for managing the condition.
Written by: April Khan and Marijane Leonard
Medically reviewed on: Feb 24, 2016: University of Illinois-Chicago, College of Medicine
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