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Gynecomastia – Enlarged breast in men

Overview

Gynecomastia basically is the non-cancerous enlargement of one or both breasts in men due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. it occurs usually in new born males, boys going through puberty and older male, may develop gynecomastia due to natural changes in hormone levels. Gynecomastia can affect one or both breasts, sometimes unevenly. This is commonly associated with obesity and can be ruled out by physical exam. Gynecomastia isn’t harmful to your physical health, but it may make you self-conscious and affect your self-esteem. Your mental health is just as important as your physical health. this is commonly associated with obesity and can be ruled out by physical exam. Gynecomastia may go away on its own. If it doesn’t, medicine or surgery may help.

Symptoms

Gynecomastia symptoms can include:

  • Pain, especially in teenagers.
  • Swollen breast tissue.
  • Tender breasts.
  • Sensitive nipples when they rub against clothes.

Possible Causes

Gynecomastia is more likely to happen during periods of hormonal fluctuations, especially at or during:

  • Birth: More than half of newborns AMAB have enlarged breasts, or breast buds. It typically happens due to exposure to the birthing parent’s estrogen levels. Gynecomastia in newborns usually goes away within a few weeks.
  • Puberty: More than half of adolescents AMAB have some degree of breast enlargement during puberty. It likely happens due to a faster rise in estrogen than in testosterone. But this imbalance usually regulates with time — about six months to two years.
  • Late adulthood: Gynecomastia is common in people AMAB over 50. With age, your body produces less testosterone. People over 50 are also more likely to be taking medications that can cause gynecomastia.

These causes of gynecomastia are natural and to be expected — they’re not physically harmful. But gynecomastia can also be a symptom of certain medical conditions that require treatment.

Conditions that cause gynecomastia

Gynecomastia may be a symptom or result of the following health conditions:

  • Adrenal tumors.
  • Hyperthyroidism (overactive thyroid).
  • Kidney disease or kidney failure.
  • Klinefelter syndrome (an inherited condition).
  • Liver disease and cirrhosis.
  • Male hypogonadism (low testosterone).
  • Pituitary gland tumors (pituitary adenomas), especially prolactinomas.
  • Testicular tumors.

Diagnosis

To diagnose gynecomastia, a thorough history and physical examination are obtained by a physician. Important aspects of the physical examination include evaluation of the male breast tissue with palpation to evaluate for breast cancer and pseudogynecomastia (male breast tissue enlargement solely due to excess fatty tissue), evaluation of penile size and development, evaluation of testicular development and an assessment for masses that raise suspicion for testicular cancer, and proper development of secondary sex characteristics such as the amount and distribution of pubic and underarm hair. Mammography is the method of choice for radiologic examination of male breast tissue in the diagnosis of gynecomastia when breast cancer is suspected on physical examination.

Care and Treatment

What is the treatment for gynecomastia?

Some people don’t want or need treatment for gynecomastia. But if you do, your healthcare provider may recommend a few different strategies depending on your situation:

  • Stopping or switching a medication: If a medication or other substance is causing gynecomastia, your provider may recommend that you switch to a different one or stop using it. Make sure your provider is aware of any nonprescription medications — like dietary and herbal supplements — you’re taking. Never stop taking a prescription medication without your provider’s guidance.
  • Underlying condition treatment: If an underlying condition is the cause, like a tumor or hypogonadism, treatment for the condition may also treat gynecomastia.
  • Gynecomastia surgery: Some people choose to get surgery for gynecomastia (male breast reduction) to remove excess breast tissue. This is an elective cosmetic surgery.

To Conclude:

Gynecomastia itself is a benign finding. It does not confer a poor prognosis, for some patients with underlying pathologies such as testicular cancer the prognosis may be worse. The glandular tissue typically grows under the influence of hormonal stimulation and is often tender or painful. Furthermore, gynecomastia frequently presents social and psychological difficulties such as low self-esteem, depression or shame.

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