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Gynecomastia – Enlarged Breasts in Men

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By Dr. Sunil Soni, Cosmetic/Plastic Surgery

Gynecomastia is characterized by enlarged breast tissues in men. This condition occurs as a result of imbalances in hormones (testosterone and estrogen) which affect either one or both of the breasts, characterized by breast pain, tenderness and nipple discharge.

Gynecomastia can occur during early childhood, puberty, or older age (60 years and older), which can be a normal change. Men can also have gynecomastia due to hormonal changes, or medication side effects. It can happen to one or both breasts. Pseudogynecomastia will not be discussed here, but it is caused by obesity and by more fat in the breast tissue, but not increased gland tissue.

Causes:

  1. The hormones ‘estrogen’ and ‘testosterone’ regulate the maintenance or development of sexual characteristics among men and women. Testosterone is responsible for the male traits, such as body hair and muscle mass while estrogen governs female traits such as development of breasts. However, estrogen is also secreted in male’s bodies in small quantities. Nevertheless, when the level of this hormone in men increases dramatically along with a dip in the testosterone count, it gives rise to gynecomastia.
  2. Certain medications may even cause gynecomastia such as steroids, chemotherapy drugs, antidepressants, anti-anxiety medicines and medicines to treat ulcers, epilepsy or heart diseases.
  3. A number of health conditions can lead to gynecomastia by taking a toll on the normal hormonal balance. Examples are starvation, malnutrition, liver and kidney failure, hyperthyroidism (a condition wherein one’s thyroid gland produces excessive amount of thyroxin), tumors, ageing, obesity and hypogonadism (a condition wherein sex glands produce no or little sex hormones).
  4. Herbal products such as lavender or tea tree used in lotions, soaps or shampoos are associated with gynecomastia.

Treatments-

Gynecomastia does not require any treatment as such. However, should the pain and tenderness be severe, medications might have to be administered.

  1. Medications: Medications used to cure breast cancer and other similar conditions, such as raloxifene and tamoxifen, can be effective in treating this condition. Although these medicines have been approved by the Food and Drug Administration, they are not prescribed particularly for Gynecomastia.
  2. Surgery: Surgery is used to cut out on the excess breast tissues. Liposuction eliminates the breast fat by the process of suction while mastectomy removes the breast gland tissues with the help of small incisions. However, the latter requires minimal recovery time.

Gynecomastia can occur in boys and men of any age. Talking to a doctor can help you discover the underlying cause of the breast enlargement. Depending on the cause, you have several options for treatment and for managing the condition.