Gynecomastia is an enlargement of the male breast gland that is typically caused by a hormonal imbalance.
According to Healthline, “When boys hit puberty and there’s a noticeable change in hormonal activity in the body, gynecomastia may appear. However, it may resolve itself with time and without treatment. The excess of breast tissue may be equal in both breasts, or there may be more in one breast than the other.”
Causes of Gynecomastia
Gynecomastia is a common condition. In fact, between 50 and 60 percent of adolescent males suffer from gynecomastia due to higher-than-normal levels of estrogen in the body related to puberty, and roughly 65 percent of men between the ages of 27 and 92 years experience some degree of gynecomastia.
Some common causes of gynecomastia include:
1. Low Testosterone
The most common cause of gynecomastia is low testosterone levels. Although the male body produces testosterone and estrogen, a man’s estrogen levels should be significantly lower than their testosterone levels.
Testosterone is the male sex hormone that is made in the testicles. During puberty, testosterone is what helps boys develop a deeper voice, muscle strength, and body and facial hair.
Low testosterone (Low-T) or Testosterone Deficiency Syndrome (TD) occurs when the male body does not produce enough testosterone.
If a man’s testosterone levels are low in comparison to their estrogen levels, larger breasts may develop. The American Urology Association (AUA) considers low testosterone as less than 300 nanograms per deciliter.
According to American Family Physician, “Testosterone levels in adult men decline at an average rate of one to two percent per year. This change can be caused by normal physiologic changes of aging, testicular dysfunction, or hypothalamic pituitary dysfunction.”
Some symptoms of low testosterone include:
Low sex drive
Reduced lean muscle mass
2. Certain Health Conditions
Certain health conditions can also cause gynecomastia or enlarged breasts, including:
Tumors of the adrenal gland, testes, or pituitary gland
Overactive thyroid (hyperthyroidism
3. Certain drugs and medications
Some of the medications and drugs that have been known to cause gynecomastia include:
Chemotherapy and radiation
Medications to treat heart disease
Heartburn and ulcer medications, including PPIs
Other lifestyle factors, such as obesity, too much alcohol or the consumption of estrogen found in soy products may also heighten a person’s risk for developing gynecomastia.
Treatment Options for Gynecomastia
In many cases, gynecomastia resolves on its own. However, if the condition worsens or does not get better, there are a couple of treatment options that may be able to help.
1. Testosterone Replacement Therapy
If a doctor determines the cause of gynecomastia is low testosterone, they may recommend testosterone replacement therapy as a treatment.
Testosterone replacement therapy is available in several forms, including:
- Skin patch worn on the arm or upper body
- Gels absorbed through the skin
- Mouth patch that sticks to the upper gums
- Injections and implants
Are there any risks associated with testosterone replacement therapy?
Although there is “no compelling evidence of major adverse side effects resulting from testosterone therapy,” some people may experience rash, itching or irritation at the treatment site.
Additionally, there are a few health conditions that some experts believe testosterone therapy could worsen, including:
Prostate Cancer. Since prostate cancer is thought to be stimulated by testosterone, the possibility of increased risk of prostate cancer during testosterone replacement therapy is of great concern.
Sleep apnea. Although some doctors believe that testosterone replacement therapy can cause sleep apnea to worsen, the U.S. The National Library of Medicine National Institutes of Health states that further studies in this area are needed to fully understand the effects of testosterone replacement therapy on those with sleep apnea.
Blood clots. According to Medical News Today, researchers found a 63 percent increased risk of blood clots during the first six months of testosterone treatment. The report goes on to say, however, that the risks seem to be temporary and very low in absolute terms.
Cardiovascular Disease. Men who underwent testosterone replacement therapy showed a slightly increased risk of heart attack and stroke within the first two years, according to one study.
Are there other benefits to testosterone replacement therapy besides a reduced breast size?
In addition to helping treat gynecomastia, testosterone replacement therapy may also lead to:
- Increased libido
- Increased muscle strength
- Improved mood
- Increased bone density
- Improved cognition
- Increased lean muscle mass
2. Breast Reduction Surgery
Breast reduction surgery is a cosmetic procedure that removes excess fat and glandular tissue to create a flatter chest shape.
According to the American Board of Cosmetic Surgeons, “Currently, male breast reduction is the only consistently effective treatment for gynecomastia that has long lasting, if not permanent, results.”
Is Breast Reduction Surgery Right for You?
Male breast reduction surgery may be right for you if:
- You don’t smoke
- You are physically healthy
- Diet and exercise have not been enough to reduce your breast size
- You have been struggling with gynecomastia for a while and it has not gotten better on its own
Before the Procedure
Before you schedule your breast reduction surgery, you should consider getting a consultation from a reputable surgeon.
During the consultation, your surgeon can help set your expectations and go over your medical history and risk factors.
The consultation is also a good time to ask any questions you have regarding your surgery or your surgeon’s experience.
Some questions you can ask include:
What is your experience with this procedure?
What side effects can I expect from male breast reduction surgery?
How should I prepare for my surgery and what can I expect afterwards?
During the Procedure
Some breast reduction surgeries are outpatient procedures, meaning you do not have to stay overnight in a hospital. Your surgeon will be able to go over specifics with you and decide if an inpatient or outpatient procedure is right for you.
After the Procedure
According to the American Society of Plastic Surgeons, “When your breast reduction procedure is complete, dressings or bandages will be applied to the incisions. An elastic bandage or support bra may be worn to minimize swelling and support the breasts as they heal.”
Beyond that, your doctor will give you specific instructions for recovery after your surgery. Be sure to follow them to ensure timely recovery without complications.
Recovery time can vary from person to person. Some people feel back to normal in as little as a week after their surgery, while others may take longer.