Gynecomastia: What Are Man Boobs?

Dr. Bibilash Babu

Plastic And Cosmetic Surgeon

A man without Gynecomastia looking his chest

Most of us have heard of Gynecomastia or come across the term ‘man boobs’, haven’t we? Here’s everything you need to know about this condition, its causes and treatment plan.

Gynecomastia, commonly known as man boobs, is a condition in which male breasts overdevelop or enlarge like female breasts. It can happen at any age. However, it is commonly seen among newborns, adolescent boys and older men. It can happen due to multiple causes. Oftentimes, it occurs due to reasons that are idiopathic, or that are unknown to us. 


What Are The Causes Of Gynecomastia?


  • Hormonal Imbalance In The Male Body

This condition can occur due to multiple physiological and pathological reasons. Its primary cause is said to be hormonal fluctuation happening in the male body. 

Here’s a brief understanding of the male and female sex hormones found in our bodies.

Testosterone is the male sex hormone responsible for normal sexual maturation, the functioning of the male reproductive system, and the development of secondary sexual characteristics in a male.  

Estrogen or Oestrogen is a female sex hormone. It is responsible for the growth and regulation of the female reproductive system, and for the development of secondary sexual characteristics.

Due to the prominence of testosterone, in a male body, breasts will not enlarge as they do so in a female body. But when there is a hormonal imbalance, it causes either less testosterone or more Oestrogen in the body. Thus, a male body will begin to show enlarged breasts. This hormonal imbalance is believed to be the primary cause of ‘man boobs’.

At any given age, you will see that, in a male body, both these hormones are present. There is a certain balance maintained between Testosterone and Estrogen levels. The amount of Testosterone is much higher than that of Estrogen in a male body. 


  • Congenital Conditions

Apart from these, there are multiple other causes of Gynecomastia. Klinefelter’s Syndrome is a congenital condition in which a male body has an extra X chromosome. These Congenital condition is also a prominent reason behind Gynecomastia


  • Side Effects Of Prescribed Medication

Side effects of certain seizure medications or drugs to treat epilepsy can also result in this condition. Furthermore, anti-androgens that are used for the treatment of enlarged prostate or prostate cancer can cause enlarged breast tissue in males. 

Anti-anxiety pills, drugs used to manage ADHD, tricyclic antidepressants, medication for AIDS, ulcers and heart conditions can contribute to the same. Chemotherapy used as a treatment for cancer is also known to be a common cause of Gynecomastia. 


  • Pre-Diagnosed Medical Conditions

Additionally, medical conditions like hypogonadism, hormonally active tumours such as adrenal tumours or pituitary tumours and thyroid-related diseases are common causes of this condition. In fact, even liver failure or cirrhosis and kidney failure can alter hormone levels in your body. It, in turn, results in overdeveloped or swollen breasts in men. 

Hypopituitarism, commonly known as pituitary insufficiency, is a rare condition that affects the production of hormones in the body. It, then, causes hormonal imbalance and Gynecomastia. HCG (Human Chorionic Gonadotropin) treatments or supplements used to treat male infertility are also predominant causes.  


  • Malnutrition, Eating Disorders And Starvation 

Malnutrition is another common trigger behind this condition. When your body is deprived of adequate nutrients, the testosterone levels in your body drop while the Estrogen level remains constant. This skewed mismatch of the male and female sex hormones in the male body can then result in man boobs. 


  • Abuse Of Recreational Or Illicit Drugs And Alcohol

Prolonged alcohol or cannabis abuse can give you gynecomastia. The use of opioid-based drugs such as heroin and methadone can result in this condition. Regular use and further abuse of anabolic steroids that help build muscle and enhance athletic performance can cause man boobs.


  • Obesity

If you are obese or have more body fat, you are more likely prone to this condition. It is because increased body fat stimulates Estrogen production resulting in swollen breasts. 


  • Acute Injury Or Trauma

Blunt force trauma to the breasts can result in the progression of pre-existing gynecomastia. It can even be the cause for the development of this condition in males. 


  • Use Of Products Made Using Herbs or Natural Ingredients

Plant oils such as lavender and tea tree oils, used in skincare or haircare products and locally produced herbal supplements, are also believed to result in enlarged breasts. They are associated with Gynecomastia due to their weak Estrogenic properties.


Gynecomastia in Newborns

Most male infants you will see are born with enlarged breasts. It is an effect of their mother’s Estrogen that stays in their blood resulting in swollen breast tissue. But it is not a cause for concern! You will observe that this condition goes away within 2-3 weeks post-birth as their hormone levels balance out.


Gynecomastia in Adolescent Boys

Among adolescent boys, the prominent cause of gynecomastia is hypogonadism. What is this, you may ask? Well, hypogonadism is a condition in which the maturation of the testes and other male sex organs is inhibited. Due to this lack of development, testosterone levels are much lower in a male body. 

Furthermore, you will see that this leads to conditions like gynecomastia or other symptoms of hypogonadism. These include changes in pitch of voice, altered body hair growth pattern and an overall decreased development of the male genitalia. 

In adolescence, if the reason behind the enlarged breasts is hormonal imbalance or hypogonadism, you must be treated at the earliest. Your treatment would involve hormonal supplementation to correct the imbalance. 

Such a treatment plan is followed to reverse both the conditions and not just treat the overdeveloped breast tissue alone. This hormonal treatment has to be administered at the right time. If not, it can lead to decreased sperm count, infertility and lack of development of the male genitalia.


Gynecomastia in Older Men / Adults

There is a rather large prevalence of gynecomastia among men aged 50 to 80. However, it is crucial to note that swollen breast tissue occurring later or resulting in the enlargement of only one breast can indicate breast malignancy. 

One tell-tale sign that you need to visit the doctor is if you’re experiencing breast tenderness or lumps in the breasts. Sensitivity or discharge from the nipples, increased breast pain and swelling are also vital symptoms to look out for. Since male breast cancer has a bad prognosis, you must spot the signs soon and treat the condition in its early stages.


How Do You Diagnose Gynecomastia?

Although it is mostly self diagnosable, your doctor may insist that they run a couple of tests to rule out the possibility of other diseases or conditions. These include a thorough hormone study of your body and working of the liver through urine and blood tests. A mammogram (an X-ray of your breast), a breast ultrasound or a biopsy may be conducted to check for breast cancer. 


How Do You Treat Gynecomastia?

Since most occurrences are during adolescence, the condition is subsequently treated on its own without medication. Hormone treatments and supplements may be given to you if required. 

If you have other medical conditions that give rise to this condition, you will need to treat the underlying diseases to undo gynecomastia. 

In other cases, you will have to probe into the medication that might be the reason behind the enlarged breasts and talk to your doctor about it. The doctor may take you off the previously prescribed medication and substitute them with an alternative.

However, in some rare situations, you may have to undergo surgery to remove the enlarged breast tissue. 

At the end of the day, this condition is treatable and if spotted at the right time has a very good prognosis. So, you’ve got little to worry about. There’s no shame and anxiety associated with it. However, if you do feel embarrassed, enlisting the help of mental health professionals can help you. Awareness about this condition and spotting the symptoms can help you and those around you come a long way!


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