Causes of Gynecomastia: Why Do Men Develop Enlarged Breasts?

Gynecomastia is a condition that causes the enlargement of breast tissue in males. It is characterized by an imbalance between the hormones testosterone and estrogen, leading to the development of excess breast tissue. While this condition can occur at any age, it is most commonly seen in infants, adolescents, and older men. Understanding the underlying causes, risk factors, and available treatments for gynecomastia is crucial for those affected by this condition.
In this blog post, we will share comprehensive insights into the causes of gynecomastia, its diagnosis, treatment options, gynecomastia surgery side effects, recover time, and more. Read on for more.

Causes of Gynecomastia

Gynecomastia occurs when the balance between testosterone and estrogen is disrupted. Testosterone, the primary male sex hormone, is responsible for traits such as muscle mass and body hair. Estrogen, although present in small amounts in males, plays a role in the growth of breast tissue. An increase in estrogen levels or a decrease in testosterone levels can lead to the development of gynecomastia. Several factors can contribute to this hormonal imbalance.

Natural Hormone Changes

1. Infants: More than half of male babies are born with enlarged breasts due to the effects of maternal estrogen during pregnancy. This swollen breast tissue typically resolves within a few weeks after birth.
2. Puberty: Hormonal changes during puberty can cause gynecomastia. This is relatively common and usually resolves without treatment within six months to two years.
3. Adults: Gynecomastia is prevalent among older men, affecting approximately 24% to 65% of men aged 50 to 80. In many cases, these adults do not exhibit symptoms.

Medications

Several medications can cause gynecomastia by affecting hormone levels or hormone activity in the body. These include:

1. Anti-androgens: Used to treat conditions such as an enlarged prostate and prostate cancer. Examples include flutamide, finasteride (Proscar, Propecia), and spironolactone (Aldactone, Carospir).
2. Anabolic Steroids and Androgens: Often used to treat delayed puberty or muscle loss from other diseases.
3. Antiretroviral Medicines: Some HIV medications, such as efavirenz, have estrogen-like properties that can cause gynecomastia.
4. ADHD Medications: Drugs containing amphetamines, such as Adderall, can contribute to the condition.
5. Other Medications: Anti-anxiety drugs (e.g., diazepam/Valium), tricyclic antidepressants, certain antibiotics, opioids, ulcer medications (e.g., cimetidine/Tagamet HB, omeprazole/Prilosec), chemotherapy drugs, heart medications (e.g., digoxin/Lanoxin, calcium channel blockers), and stomach-emptying medications (e.g., metoclopramide).

Recreational Drugs and Alcohol

Substances that can lead to gynecomastia include:

1. Alcohol
2. Anabolic Steroids
3. Amphetamines
4. Marijuana
5. Heroin
6. Methadone (Methadose)

Health Conditions

Certain health conditions can alter the balance of hormones and contribute to gynecomastia:

1. Hypogonadism: Conditions such as Klinefelter syndrome and pituitary insufficiency lower testosterone production.
2. Aging: Hormonal changes associated with aging, particularly in overweight individuals, can lead to gynecomastia.
3. Tumors: Tumors of the testes, adrenal glands, or pituitary glands can produce hormones that disrupt the body’s hormonal balance.
4. Hyperthyroidism: Excessive production of thyroxine by the thyroid gland.
5. Kidney Failure: Approximately half of individuals receiving dialysis develop gynecomastia due to hormonal changes.
6. Liver Failure and Cirrhosis: Hormonal changes associated with liver problems and medications for cirrhosis can cause gynecomastia.
7. Malnutrition and Starvation: Testosterone levels drop during periods of malnutrition, but estrogen levels remain the same, causing an imbalance.
8. Herbal Products

Some plant oils, such as tea tree oil and lavender oil, used in shampoos, soaps, or lotions, have been associated with gynecomastia. These oils may contain compounds that mimic estrogen or affect testosterone levels.

Read More: Gynecomastia 101: Recognizing and Treating Male Breast Enlargement

Risk Factors for Gynecomastia

Several factors increase the risk of developing gynecomastia, including:

1. Puberty: Hormonal changes during adolescence.
2. Older Age: Hormonal changes in older men.
3. Obesity: Increased body fat can alter hormone levels.
4. Anabolic Steroid Use: Use of steroids to enhance athletic performance.
5. Certain Health Conditions: Liver and kidney disease, thyroid disease, Klinefelter syndrome, and specific tumors.

Diagnosing Gynecomastia

The diagnosis process of gynecomastia involves a thorough evaluation by a healthcare provider. The process typically includes:

1. Medical History: Discussing symptoms, medical history, drug use, and family history.
2. Physical Examination: Examining breast tissue, genitals, and abdomen.
3. Hormone Imbalance: If a hormone imbalance is suspected, the condition may resolve without treatment.
4. Biopsy or Blood Test: Ordered if the lump is abnormally large, tender, or one-sided to rule out breast cancer.
5. Further Tests: To eliminate other causes such as cysts, abscesses, benign tumors (e.g., lipoma, hamartoma), mastitis, hematoma, metastasis, fat necrosis, etc.

Imaging tests may include:

1. Mammograms or Breast Ultrasounds
2. Chest X-rays
3. MRI Scans
4. Testicular Ultrasounds

Treatment for Gynecomastia

Conservative Methods

In many cases, gynecomastia resolves on its own without treatment. This is often the recommended approach in adolescents. But if the condition does not go away in a few days, you need to opt for other methods.

In addition, if an underlying health condition or medication is causing gynecomastia, treating the condition or discontinuing the medication usually improves the situation. This should always be done under medical supervision.

Moreover, sometimes doctors also prescribe estrogen-blocking drugs like tamoxifen or raloxifene for a short course of treatment, typically three to six months. This is often considered during puberty or in adult males with tender breast tissue.

Breast-Reduction Surgery

Surgery is a common treatment option for gynecomastia, especially in cases where the condition has not resolved with other treatments. Various surgical techniques can reduce breast tissue, including glandular tissue and excess skin removal, areola reduction, and liposuction. Gynecomastia surgery is generally not recommended for adolescents until puberty is complete to ensure breast tissue has stopped growing.

Gynecomastia Surgery Recovery Time

Post-surgery, patients are provided with support garments to aid healing by reducing swelling and bruising. Medications are prescribed for pain relief, and it is normal to experience numbness or tingling sensations in the operated areas for a few months. Physical activity should be limited for a few days, with a typical recovery duration of one to two weeks.

Coping with Gynecomastia

Coping with gynecomastia can be challenging, particularly for younger males going through puberty. Feelings of embarrassment, insecurity, and depression are common. It is important to remember that gynecomastia is a relatively common condition, and support is available. Talking to supportive family members or friends, or seeking counseling or therapy, can help you manage your feelings about body image.

Where to Get the Best Gynecomastia Surgery in Surat?

Celebre Aesthetics is a leading cosmetic center in Surat and Ahmedabad, offering a wide range of surgical and non-surgical cosmetic procedures, including gynecomastia surgery in Surat, Gujarat. The clinic is committed to providing compassionate and attentive care for those wanting to undergo breast reduction surgery, under expert supervision.

Under the guidance of Dr. Siddharth Sakhiya, a highly qualified plastic surgeon with decades of experience, Celebre Aesthetics offers state-of-the-art facilities, advanced technology, and stringent hygiene measures to ensure patient safety and satisfaction. Confidentiality is a top priority, and patients can expect personalized care and exceptional results.

For more information or to book a consultation with Dr. Siddharth Sakhiya, call Celebre Aesthetics today and take the first step towards a more confident you.