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OVERVIEW

What is gynecomastia?

Gynecomastia is a condition in which males have enlarged breasts. It is caused by an increase in breast tissue, not fat tissue. Gynecomastia may be present on one side or on both sides.

It can occur at any age, including newborn.  When there is excess fat that looks like breasts, this is called pseudogynecomastia. It is a similar, but different condition than gynecomastia.

SYMPTOMS

The main symptom of gynecomastia is enlarged breasts. Your breasts may be tender, as well. You may feel a slight bump or lump behind the nipple.

CAUSES & RISK FACTORS

What causes gynecomastia?

The main cause of gynecomastia is a change in hormones. Most often, this happens at birth, puberty, or as part of aging.  These are natural times when the hormones in your body change levels. An imbalance of hormones—estrogen and testosterone—can enlarge your breasts.

Newborns who are born with enlarged breasts often have too much estrogen. Mothers transfer this hormone to their babies in the womb.

Gynecomastia is common in the teenage years. More than half of biologic males have some degree of the condition during puberty.

• In adulthood, the balance of hormones is affected by aging. Gynecomastia is more common in those who are 50 years of age or older. Other causes include health conditions, such as:Tumors of the adrenal glands, testes, or pituitary gland
• Hyperthyroidism (overactive thyroid)
• Hypogonadism (low testosterone)
• Kidney disease
• Liver failure

It can also be caused by medicines, such as:

• HIV/AIDS medicines
• Chemotherapy and radiation
• Antibiotics
• Medicines for heart disease
• Anti-anxiety medicines
• Tricyclic antidepressants
• Ulcer and heartburn medicines, such as proton pump inhibitors (PPIs)

Another potential cause is drugs, such as:

• Opioids
• Anabolic steroids
• Amphetamines
• Heroin
• Marijuana

Gynecomastia can also be caused by other lifestyle factors including obesity, alcohol use, and the consumption of estrogen in medicines or in foods that contain soy.

It is very rare for breast cancer to be the cause of gynecomastia. Lumps caused by cancer are usually not underneath the nipple—where breast tissue from gynecomastia grows. Breast cancer feels different than the breast tissue of gynecomastia. Breast cancer may also cause dimpling of the skin or a bloody discharge from the nipple.

DIAGNOSIS & TESTS

How is gynecomastia diagnosed?

Make an appointment with your healthcare provider if you have concerns. They may notice symptoms during a routine check-up.  Your healthcare provider may ask you about your symptoms, such as how long you’ve had the growth, and if the area is tender. Your healthcare provider may also ask you about your health history and what medicines you take.

The healthcare provider will decide if tests are needed to diagnose gynecomastia. The most common test is a blood test to check your hormone levels. More tests may be done if your healthcare provider suspects a disease. These can include:

• An ultrasound
• Mammogram
• Breast biopsy

PREVENTION

Can gynecomastia be prevented or avoided?

Most cases of gynecomastia cannot be prevented. They are caused by natural changes in hormone levels. Adults can help prevent gynecomastia by avoiding certain medicines, drugs, and lifestyle factors.

TREATMENT

How is gynecomastia treated?

In most cases, treatment is not needed. Your doctor may want to check the size of your breast tissue every few months.

If treatment is needed, options vary based on the cause of the condition. Talk to your healthcare provider before stopping any prescription medicine to treat other medical conditions. You may need to make lifestyle changes as well. If it caused by a disease or tumor, you will need to treat the problem. This may include medicine or surgery. Medicine can help to balance your hormones. In rare cases, the healthcare provider may suggest plastic surgery to remove the extra breast tissue.

Living with gynecomastia

For most newborns and teenage boys, gynecomastia does not last long. The breasts go back to normal in 6 months to 2 years.

Ask the healthcare provider about taking an over-the-counter pain medicine to relieve breast tenderness. Using a cold compress on the area can help as well.