What is Gynecomastia?
Gynecomastia is swelling of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly. Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.
Generally, gynecomastia isn't a serious problem, but it can be tough to cope with the condition. Men and boys with gynecomastia sometimes have pain in their breasts and may feel embarrassed. Gynecomastia may go away on its own. If it persists, medication or surgery may help.
What are the Symptoms of Gynecomastia?
Signs and symptoms of gynecomastia include:
- Swollen breast gland tissue
- Breast tenderness
When to see a doctor
See your doctor if you have:
- Swelling
- Pain
- Tenderness
- Nipple discharge in one or both breasts
What Causes Gynecomastia?
Gynecomastia is triggered by a decrease in the amount of the hormone testosterone compared with estrogen. The cause of this decrease can be conditions that block the effects of or reduce testosterone or a condition that increases your estrogen level. Several things can upset the hormone balance, including the following.
Natural hormone changes
The hormones testosterone and estrogen control the development and maintenance of sex characteristics in both men and women. Testosterone controls male traits, such as muscle mass and body hair. Estrogen controls female traits, including the growth of breasts. Most people think of estrogen as an exclusively female hormone, but men also produce it — though normally in small quantities. However, male estrogen levels that are too high or are out of balance with testosterone levels can cause gynecomastia.
Gynecomastia in infants. More than half of male infants are born with enlarged breasts due to the effects of their mother's estrogen. Generally, the swollen breast tissue goes away within two to three weeks after birth.
Gynecomastia during puberty. Gynecomastia caused by hormone changes during puberty is relatively common. In most cases, the swollen breast tissue will go away without treatment within six months to two years.
Gynecomastia in men. The prevalence of gynecomastia peaks again between the ages of 50 and 69. At least 1 in 4 men in this age group are affected.
Health conditions
Several health conditions can cause gynecomastia by affecting the normal balance of hormones. These include:
- Hypogonadism. Any of the conditions that interfere with normal testosterone production, such as Klinefelter's syndrome or pituitary insufficiency, can be associated with gynecomastia.
- Aging. Hormone changes that occur with normal aging can cause gynecomastia, especially in men who are overweight.
- Tumors. Some tumors, such as those involving the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.
- Liver failure and cirrhosis. Hormonal fluctuations related to liver problems as well as medications taken for cirrhosis are associated with gynecomastia.
Most cases of gynecomastia regress over time without treatment. However, if gynecomastia is caused by an underlying condition, such as hypogonadism, malnutrition or cirrhosis, that condition may need treatment. If you're taking medications that can cause gynecomastia, your doctor may recommend stopping them or substituting another medication. Gynecomastia often goes away without treatment in less than two years. However, treatment may be necessary if gynecomastia doesn't improve on its own or if it causes significant pain, tenderness or embarrassment.
