Gynecomastia is swelling of the breast tissue in men or boys caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts.

Gynecomastia is not a serious problem but it can be a bothersome condition. In some cases, gynecomastia in boys and men can be painful and embarrassing.

Gynecomastia may resolve on its own; however, persistent gynecomastia may require medication or surgery.

 

Symptoms

Symptoms of gynecomastia include:

 

  • Swelling of the breast gland tissue
  • Breast tenderness

 

Symptoms that may require medical attention:

 

  • Swelling
  • Pain
  • Tenderness
  • Nipple discharge in one or both breasts

 

Causes

Generally, gynecomastia is triggered by a decrease in the production of the hormone testosterone in comparison to estrogen. The cause of this decrease may be conditions that block or reduce the effects of testosterone or a condition that increases the levels of estrogen.

 

Natural hormone changes

 

  • Gynecomastia in infants: Many infants are born with gynecomastia due to the effects of the mother’s estrogen. The swollen breast tissue typically goes away within a couple of weeks after birth.
  • Gynecomastia during puberty: Hormone changes during puberty commonly cause gynecomastia. In most cases, the swollen breast tissue goes away within 2 years.
  • Gynecomastia in men: Older age increases the susceptibility to gynecomastia. It commonly occurs between the ages of 50 and 80.

 

Medications that cause gynecomastia

 

  • Anti-androgens used to treat prostate enlargement, prostate cancer and other conditions
  • Anabolic steroids and androgens
  • AIDS medications
  • Tricyclic antidepressants
  • Antibiotics
  • Anti-anxiety medications
  • Cancer treatment (chemotherapy)
  • Certain heart medications
  • Ulcer medications

 

Street drugs and alcohol associated with gynecomastia

 

  • Alcohol
  • Marijuana
  • Amphetamines
  • Heroin
  • Methadone

 

Health conditions that cause gynecomastia

 

  • Hypogonadism (interference with normal testosterone production)
  • Aging (hormonal changes)
  • Tumors (hormone imbalance)
  • Hyperthyroidism (hormone imbalance)
  • Kidney failure (hormonal changes due to treatment)
  • Liver failure and cirrhosis (hormonal fluctuations due to liver problems and medications)
  • Malnutrition and starvation (hormonal imbalance)

 

Risk factors

Factors that increase the risk of gynecomastia include:

 

  • Adolescence
  • Older age
  • Anabolic steroids or androgens
  • Health conditions such as liver and kidney disease, thyroid disease, hormonally active tumors and Klinefelter syndrome

 

Complications

Gynecomastia has only few physical complications; however, it may cause psychological or emotional issues due to appearance.

 

Prevention

The following factors may help reduce the risk of or prevent gynecomastia:

 

  • Avoiding illegal drugs such as steroids, androgens, heroin and amphetamines
  • Avoiding alcohol
  • A review of medications that may cause gynecomastia