Four Causes of Gynecomastia

Most people associate the condition of overly large, painful breasts as unique to females. Although that is true in most cases, men and boys can also suffer from breast enlargement. The pectoral breast tissue becomes enlarged and swollen. It can appear in one or both breasts. This condition is not serious and may resolve on its own.

Hormone imbalances between estrogen and testosterone in the male body are the most common reason for gynecomastia. Many people may think that men only have testosterone and women have estrogen, but that is not true. Males and females have both hormones in their bodies, but different amounts. Men will have more testosterone, and women will have more estrogen. In cases where males have too much estrogen compared to testosterone, the body may begin to take on female characteristics, such as enlarged breast tissue. Some conditions can cause this hormone imbalance.

1. Hormonal Changes during Puberty
   Some research estimates that as many as 70 percent of boys in early to mid-puberty may experience gynecomastia at some point. Hormone changes within the body cause this. In some cases, the condition will go away independently; in others, surgical treatment is required.
2. Disease and Injury
   Certain diseases, injuries, and medical conditions may also cause imbalances between testosterone and estrogen. These include:
   • Malnutrition and refeeding (recovery from malnutrition)
   • Genetic disorders such as Klinefelter’s Syndrome
   • Liver cirrhosis or failure
   • Kidney failure
   • Hyperthyroidism
   • Certain testicular, adrenal, or pituitary cancers
   • Trauma or injury to the testes
3. Medication Side Effects
   In some cases, the hormonal imbalance may come about as a result of medication side effects. Some of these medications include:
   • Calcium channel blockers or ACE inhibitors for hypertension
   • Tricyclic antidepressants
   • Anabolic steroids to enhance sports performance
   • Some antibiotics
   • Certain antiretroviral drugs to treat AIDS
   • Chemotherapy
   • Some anti-ulcer medicines
   • Hormonal therapies for prostate cancer
   • Certain illicit drugs, such as heroin or marijuana
   • Valium

   Additionally, lavender oil or tea tree oil in skin-care products may lead to gynecomastia.

4. Aging
   As the body ages, the hormone balance will change. In some cases, this will lead to gynecomastia. The prevalence of this condition will peak again in men between the ages of 50 and 80. This may be particularly true for men who are overweight.

Treatment

Gynecomastia can be treated with medications such as tamoxifen or raloxifene. However, neither of these is approved by the U.S. Food and Drug Administration for treating this condition.

Liposuction and gynecomastia surgery are the most common surgical treatments for this condition. With liposuction, a thin metal tube is inserted into the breast tissue at targeted areas to remove fat, but not the breast tissue; other cases require removing the actual breast tissue itself.

Although gynecomastia is not a severe condition, it can still cause embarrassment and pain. It is best to discuss any concerns and potential treatment options with a physician.

*The content in this blog is developed to spread the awareness towards plastic surgery. Our blog is not intended to serve as a replacement for an actual in-office consultation with Dr. Marin. As such, the information within this blog reflects the unique cases of our individual patients.