Gynecomastia: Enlarged Male Breasts

Gynecomastia describes the abnormal growth of excess tissue in male breasts. Most often associated with temporary hormone fluctuations during puberty, gynecomastia can also develop in later life due to a variety of medical conditions, including testicular cancer and steroid abuse.

During an episode of gynecomastia male breasts develop excess tissue beneath the nipple. Gynecomastia may affect either one or both breasts. In severe cases of gynecomastia, male breasts may begin to resemble a pubescent girl's developing breasts. Generally, the area of breast tissue affected by gynecomastia is less than 1½ inches in diameter.

Gynecomastia has few symptoms beyond the enlargement of male breasts. In fact, often gynecomastia is itself a symptom of another underlying condition. Enlarged male breasts may be tender or painful.

The majority of gynecomastia cases occur in early puberty, when a boy's testosterone and estrogen levels fluctuate. Although not often discussed, gynecomastia is not at all uncommon in teenage boys. One study suggests up to sixty percent of fourteen year old boys have some degree of gynecomastia.

Hormonal fluctuations account for most cases of pubescent gynecomastia. Male bodies produce the female sex hormone estrogen, although in much lower amounts than in women. During puberty, excess estrogen levels can cause male breasts to enlarge. Gynecomastia during puberty is almost always temporary: ninety percent of teenage boys with gynecomastia find their breasts return to normal within a year and a half to two years.

Psychologically, gynecomastia can be a source of embarrassment and shame for male teenagers. Boys with enlarged breasts are understandably concerned about peer response, social difficulties, and what enlarged male breasts say about their sexuality.

It is important to assure teenagers with gynecomastia that the condition is temporary, and that they will not have to live with larger than normal male breasts forever (bearing in mind that for many teenagers, two years can seem like forever). Some boys with gynecomastia wear loose shirts to disguise their breast development. Others, however, may be so self-conscious that surgical removal of excess breast tissue is required for mental well-being.

After puberty, gynecomastia is a rare disorder, but some conditions that affect hormone levels can enlarge adult male breasts. Testicular cancer is a possible cause of gynecomastia, as is castration. Liver cirrhosis, which inhibits the liver's ability to break down estrogen, may also result in enlarged male breasts. Kidney failure, genetic abnormalities, or hyperthyroidism can also trigger gynecomastia.

In rare cases, gynecomastia has been linked to tumor activity unrelated to testicular cancer. Lung cancer, for instance, can result in sufficiently high estrogen levels that male breasts enlarge. Male breast cancer is rare, but can occur. Out of every hundred breast cancer patients, one patient is male. Breast cancer tissue differs in texture and feel from excess male breast tissue, but if a diagnosis is in doubt, a biopsy can determine if enlarged male breasts result from gynecomastia or cancer.

Certain medications, most notably antiretroviral medication, may produce gynecomastia symptoms as side effects. Male breasts can also enlarge as a result of anabolic steroid abuse, or abuse of heroin, marijuana, and alcohol.

Pseudogynecomastia, as the name implies, is "false" gynecomastia. Like gynecomastia, pseudogynecomastia results in enlarged male breasts. However, instead of hormonal imbalances, enlarged male breasts associated with pseudogynecomastia result from chest fat. Pseudogynecomastia is a side effect of excess chest fat or obesity.

There is little to be done to treat gynecomastia. Cases of gynecomastia that develop in puberty usually resolve themselves over time. Enlarged male breasts may be tender: regular moist, hot compresses may provide some relief. If breast pain and tenderness create large amounts of discomfort, doctors may suggest analgesic medication for symptom relief (overuse of common analgesics can cause rebound headaches and other side effects, so consult with a doctor before using painkillers to treat gynecomastia symptoms).

In some cases, surgical removal of excess breast tissue may provide physical or mental relief. However, unless the underlying cause of gynecomastia is treated, male breasts may continue to develop after surgery.

Resources

American Academy of Family Physicians. (updated 2002). Gynecomastia: When breasts form in males.

Doctor Joseph F. Smith Medical Library. (nd). Gynecomastia.

National Library of Medicine. (updated 2004). Gynecomastia. MedlinePlus Medical Encyclopedia.

Dowshen, S. (ed). (updated 2004). I'm a guy...so how come I'm developing breasts? Nemours Foundation.