Gynecomastia: What Causes Male Breast Enlargement

Did you know that an enlarged chest is not only a concern for women? Men can also experience abnormal breast enlargement, a condition known as gynecomastia.

What Is Gynecomastia?

Gynecomastia is the enlargement of breast gland tissue in men, sometimes described informally as “pointed breasts.” It is not caused solely by fat accumulation but is generally associated with an imbalance between the male hormone testosterone and the female hormone oestrogen.

Gynecomastia can occur at different stages of life.

Infants

Gynecomastia is relatively common in newborn babies and is usually not abnormal. It is mainly caused by the mother’s oestrogen passing to the baby during pregnancy. The swelling generally disappears naturally within a few weeks.

Adolescents

Gynecomastia commonly occurs between the ages of approximately 10 and 16 due to rapid hormonal changes during puberty.

Testosterone levels may not increase immediately, while a certain level of oestrogen is already present. This can cause a temporary hormonal imbalance.

In most adolescents, the condition improves naturally within six months to two years. However, medical assessment is recommended when the breasts become unusually large, painful, or develop abnormal features, as another hormonal disorder or mass may be present.

Older Men

Gynecomastia becomes more common after the age of 50 because testosterone levels gradually decline while the body continues to produce some oestrogen.

Older men are also more likely to have medical conditions that affect hormonal balance, including:

๐ Liver disease

๐ Kidney disease

๐ Thyroid disorders

๐ Certain tumours

๐ Side effects from some medications

Medicines used for high blood pressure, fluid retention, or heart disease may sometimes contribute to gynecomastia. Men who notice new breast enlargement at this age should consult a doctor to identify the underlying cause.

Although gynecomastia is not usually a serious disease, it may affect confidence and daily life. In some cases, it may also indicate an underlying health condition.

What Causes Gynecomastia?

The main cause of gynecomastia is a reduction in testosterone activity or an increase in the effect of oestrogen, stimulating the growth of breast tissue.

Possible contributing factors include the following.

Age-Related Hormonal Changes

Testosterone production is generally highest during adolescence and early adulthood before gradually declining with age.

After the age of 50, the proportion of oestrogen compared with testosterone may increase, making breast enlargement more likely.

Liver or Kidney Disease

Liver Disease

In conditions such as liver cirrhosis, the liver may not process excess hormones effectively. This can result in increased oestrogen activity in the bloodstream.

Chronic Kidney Failure

Chronic kidney disease, particularly in people undergoing dialysis, may disrupt several hormones, including sex hormones, and contribute to breast enlargement.

Certain Tumours

Some tumours may interfere with normal hormone production.

๐ Adrenal tumours may produce oestrogen or other hormones that disrupt the balance of male hormones.

๐ Pituitary tumours may affect hormone signals that regulate testosterone production.

๐ Certain testicular tumours may produce hormones that stimulate breast tissue growth.

Certain Medications

Medications that may contribute to gynecomastia include:

๐ Spironolactone, which is used for certain heart conditions, high blood pressure, and fluid retention

๐ Certain chemotherapy medicines that affect the endocrine system and testosterone production

๐ Some antidepressants that may influence hormonal balance

๐ Anabolic steroids or long-term steroid use that suppresses the body’s natural testosterone production

Do not stop or change any prescribed medication without consulting the doctor responsible for your treatment.

Alcohol and Recreational Drugs

Substances that may affect hormonal balance or general health include:

๐ Excessive alcohol consumption, which may damage the liver and reduce its ability to regulate hormones

๐ Cannabis, which may affect endocrine function in some individuals

๐ Certain recreational drugs, such as heroin or amphetamines, which may interfere with hormonal and overall health

Malnutrition and Extreme Weight Loss

When the body lacks sufficient energy and essential nutrients, testosterone production may decrease while oestrogen activity remains present.

Extreme dieting may also place the body under significant stress, affecting endocrine function and hormonal balance.

What Are the Symptoms of Gynecomastia?

Common signs that may be noticed include the following.

Thicker or Softer Breast Tissue

During the early stages, the chest may feel unusually soft or appear to contain more tissue.

Glandular breast tissue may feel firm or rubbery beneath the nipple. A medical examination may be required to distinguish gynecomastia from fat accumulation or another type of lump.

Enlargement Around the Nipple

The areola may become wider, more raised, or more prominent due to the growth of breast tissue and hormonal changes. In some people, the areola may also become darker.

Tenderness or Discomfort

The breast may feel mildly painful, sensitive, or uncomfortable, particularly when rubbing against clothing.

Tenderness may occur intermittently or continue for a period of time.

Tightness or Itching

Tightness may occur as the skin around the breast stretches. Itching may be associated with dry skin, skin changes, or irritation from clothing.

Warning Signs That Require Further Examination

Consult a doctor when you notice:

๐ A hard or fixed breast lump

๐ Significant or worsening pain

๐ Fluid or blood coming from the nipple

๐ A cloudy or unusual nipple discharge

๐ Changes in the shape or skin of the breast

๐ Enlargement affecting only one side

๐ A nipple that becomes pulled inward

These symptoms may indicate another condition, such as an infection or breast tumour, rather than uncomplicated gynecomastia.

How Is Gynecomastia Managed and Treated?

Treatment depends on the cause, how long the condition has been present, and the severity of the breast enlargement.

Observation

For adolescents and people who have recently developed symptoms, gynecomastia may result from temporary hormonal changes.

In many cases, the breast tissue gradually decreases naturally within six months to two years without treatment.

During this period, the breast size and symptoms should be monitored. Consult a doctor if the breasts continue to enlarge or become increasingly painful.

Adjusting a Medication That May Be Causing the Condition

When gynecomastia is linked to a medication, the doctor may adjust the dose or change to another medicine with less effect on hormonal balance.

Medication should only be stopped or changed under medical supervision to avoid affecting the condition for which it was originally prescribed.

Treating the Underlying Condition

Gynecomastia may be associated with liver disease, kidney disease, endocrine disorders, or certain tumours.

Treating the underlying health condition may help improve the breast enlargement.

Specialist Medication

For people with significant symptoms or a clear hormonal imbalance, a doctor may consider medication that affects oestrogen activity or addresses the underlying hormone disorder.

These medicines require close medical supervision because they may cause side effects and may not be appropriate for everyone.

Surgery

Surgery may be considered when the breasts are significantly enlarged, symptoms persist, or other treatments have not been effective.

The aim is to remove excess breast tissue and create a chest shape closer to its original appearance.

Surgical options may include:

๐ Liposuction to remove excess fat

๐ Surgical removal of glandular breast tissue

๐ A combination of liposuction and tissue removal

The most suitable technique depends on the amount of fat and glandular tissue, skin elasticity, general health, and the patient’s expectations.

Daily Habits That May Help Reduce the Risk

Gynecomastia cannot always be completely prevented because some causes, such as natural hormonal changes and certain diseases, cannot be controlled.

However, maintaining good health may help reduce some risk factors.

Maintain a Healthy Weight

Being overweight or having obesity may increase fat accumulation in the chest and influence hormonal balance.

Maintaining an appropriate weight can help distinguish true glandular enlargement from excess chest fat and support overall health.

Eat a Balanced Diet and Avoid Extreme Dieting

Eat a varied diet containing all major food groups, with an emphasis on:

๐ Vegetables and fruits

๐ High-quality protein

๐ Whole grains

๐ Healthy fats

Limit foods high in fat, sugar, and highly processed ingredients.

Weight loss should be gradual. Extreme dieting may place the body under stress and negatively affect hormonal balance.

Exercise Regularly

Resistance training can help increase muscle mass and improve the appearance and strength of the chest.

Cardiovascular exercise supports weight management and heart health. Combining both forms of exercise provides more balanced health benefits.

Exercise may improve body composition, but it cannot remove enlarged glandular breast tissue by itself.

Reduce Alcohol and Avoid Recreational Drugs

Excessive alcohol consumption may impair liver function and disrupt hormone regulation.

Avoid recreational substances that may negatively affect hormonal or general health.

Avoid Unnecessary Hormones and Medications

Using testosterone, oestrogen, anabolic steroids, or other hormonal substances without medical supervision may increase the risk of gynecomastia.

When a necessary medication may affect hormone levels, it should be used under close medical supervision.

Summary

Gynecomastia is common among men at different stages of life. It may resolve naturally, particularly in infants and adolescents, but it can sometimes indicate an underlying medical condition.

Men should monitor changes in their bodies and seek medical assessment when breast enlargement persists, becomes painful, occurs on only one side, or is accompanied by a lump or nipple discharge.

Identifying the cause accurately is the most important step in selecting appropriate care and treatment.

 

Reference :

M CLINIC Gynecomastia Men

ArokaGO Providers M CLINIC