Gynecomastia - Types, Causes, Symptoms, and Treatment

Do you have enlarged breasts in spite of being a man? This can be a sign of gynecomastia, a disorder only found in men, where they tend to develop breasts like women. It can develop at any stage, be it puberty, adulthood, or birth. The causes can range from medications to other health disorders.

Individuals experiencing this condition should not ignore it and must opt for proper treatment plans to lead a healthy life.

Gynecomastia is a condition where the breast tissue in men swells and becomes larger than normal. This disorder is primarily common among teenage boys who undergo hormonal changes during puberty. However, it can also develop in newborn babies and older men.

There are generally two types of breast enlargement disorder in men, they are –

1. Glandular Gynecomastia

Caused due to high oestrogen and low testosterone count in the body.

2. Fatty Gynecomastia

Also called pseudo gynecomastia, generally found in men with excess weight.

• Grade I- Small enlargement devoid of excess skin.
• Grade II- Moderate enlargement devoid of excess skin.
• Grade III - Minor skin excess with moderate enlargement
• Grade IV- Mimics enlargement of the female breast

Signs and symptoms of gynecomastia may include:

• Pain in the enlarged breast area.
• Swollen breast tissue on one side or both sides.
• Breast tenderness.
• Sensitivity of nipple when rubbed against clothes.

There are various reasons due to which an individual can suffer from enlargement of the breast, they are -

• Adrenal tumours.
• Alcoholism.
• Kidney disease or kidney failure.
• Klinefelter syndrome (an inherited condition).
• Liver disease.
• Thyroid disease.
• Ageing
• Obesity

Certain medicines also give rise to gynecomastia. For instance, medicines consumed to treat -

• Anxiety and depression.
• Bacterial and fungal infections.
• Enlarged prostate.
• Heartburn and stomach ulcers.
• Heart failure and high blood pressure.
• Male infertility.

Various drugs that lead to breast enlargement in men are:

• Amphetamines, marijuana and opioids.
• Building anabolic muscle steroids.
• Some herbal supplements and skincare products.

The risk of gynecomastia is higher in:

• Adults undergoing hormonal changes
• Men over 50 years
• Individuals consuming athletic performance-enhancing drugs
• Men suffering from diseases of liver, kidney and thyroid.
• Individuals experiencing other hormonal disorders, active tumours and acquired syndromes
• People with excess weight

A doctor, on suspicion of gynecomastia, may examine you thoroughly and prescribe some medications or tests as per the condition demands. Beforehand, the physicians ensure there are no skin problems, oozing fluid, or hard lumps, which can indicate signs of cancer.

Further interrogation regarding your medical history will be conducted. Upon the examinations, doctors might prescribe you tests that includes -

• Urine samples or blood tests 
• Mammogram
• Testicular ultrasounds
• Biopsy
• MRI scans
• CT scans

In some cases, gynecomastia treatment is not required as it fades away with time. But if some medications or other substances are causing breast enlargement, you should avoid using those drugs or supplements. Furthermore, if diagnosed, you should consult an endocrinologist who can prescribe you medicines to address the hormonal imbalance, like –

• Tamoxifen (Soltamox)
• Aromatase inhibitors, such as anastrozole (Arimidex)

Some people also opt for surgical treatments that include –

• Liposuction– Excessive breast fat is removed in this surgical procedure.
• Mastectomy– In this procedure, gland tissues of the breast are removed.

One can implement certain steps to reduce gynaecomastia. They include -

• Restrict the use of recreational drugs, such as androgens, anabolic steroids, marijuana, heroin, or amphetamines.
• Reduce or avoid alcohol consumption.
• Consult your doctor to prescribe alternative medicines if the previous medications show signs of developing gynecomastia.

This breast tissue disorder largely affects the mental health of a man.

• People suffer from anxiety and low self-esteem.
• Individuals get ashamed of exposing their bodies in public.
• They avoid public gatherings.

Side effects of gynecomastia treatment includes –

• Bleeding (hematoma) or blood clots
• Breast asymmetry
• Changes in the sensation of the nipple may be temporary or permanent
• In some cases, it damages nerves, blood vessels, muscles and lungs
• Fluid accumulation (seroma)
• Infection
• Persistent pain
• Poor healing
• Possibility of revision surgery
• Unfavourable scarring

Though gynecomastia is a hormonal disorder among men caused due to low testosterone and high oestrogen counts, it generally fades away with time. But in cases where it remains for long, causes numbness, tenderness and pain in the nipple and breast area, it should be consulted to a physician before it gives rise to other complications. The symptoms can also indicate signs of cancer or tumours, and proper treatment plans can help to curb the dangers.

Moreover, the disfiguration of the body can adversely affect one’s mental health, giving rise to anxiety, depression, and low self-esteem. So, to avoid such scenarios, an individual must exercise daily, eat a balanced diet, avoid intake of drugs, alcohol and supplements to stay fit and lead a healthy lifestyle.