Gynaecomastia

As the name ‘man boobs’ suggests, enlarged breasts in a male are often dismissed lightly, or even treated as a joke. This article provides information for men who might be embarrassed about seeking help and reassurance for their problem.

What is Gynaecomastia?

The mammary glands in males are normally so small that they are barely noticeable. True gynaecomastia occurs when the gland becomes enlarged, leading to protrusion of the breast. The enlargement is usually seen on both sides, though sometimes only one breast is affected.

The most common form of gynaecomastia is thought to be caused by an imbalance between the male and female sex hormones, testosterone and oestrogen. Both are present in both men and women, with testosterone dominant in men and oestrogen dominant in women. A relative increase in oestrogen levels in a male can lead to breast development.

Certain medications can cause gynaecomastia as a side-effect. These include cimitedine, which is used to treat stomach ulcers, the diuretic spironolactone, and some tricyclic antidepressants and chemotherapy agents. Body-builders who take anabolic steroids may also develop enlarged breast tissue.

Man boobs often occur in men who are overweight or obese. Unlike true gynaecomastia, which is caused by growth of the mammary glands, these breasts are simply fat beneath the skin. This is often called ‘pseudo-gynaecomastia’ or ‘lipomastia’ to distinguish it from true gynaecomastia.

The chest muscles may become greatly enlarged through weight-lifting or other exercise, giving the appearance of breasts, but this is not gynaecomastia.

In some cases, the cause of gynaecomastia is never identified.

Who Gets Gynaecomastia?

• Newborn boys (and girls) may have transiently enlarged breast tissue caused by oestrogens acquired from the mother.
• Gynaecomastia is most common in adolescent boys. Imbalances in the sex hormones are normal during puberty, but breast development can be extremely distressing for a young man who is already concerned about appearance, sexuality and peer relationships.
• Gynaecomastia is also common in older men, as production of testosterone wanes with age.

Can Gynaecomastia Indicate a Serious Health Problem?

In most cases, gynaecomastia is harmless. However, it can occasionally have a more serious cause, including:

• Klinefelter’s syndrome (a genetic disorder in which males have an extra X-chromosome)
• tumours of the adrenal or pituitary gland
• testicular tumours
• chronic liver disease.

Never hesitate to consult your doctor if you are in any way concerned about enlarged breast tissue.

How is Gynaecomastia Treated?

Adolescent gynaecomastia usually disappears by itself as the young man grows up and his hormones ‘settle down’.

Treatment is mainly reserved for men who have gynaecomastia of no known cause, or who continue to have prominent breasts after treatment of an underlying condition.

• Drugs for gynaecomastia combat the action of oestrogen or reduce its production.
• Plastic surgery may be considered for cosmetic or psychological regions. An incision is made in the skin and the breast tissue is removed surgically.
• Liposuction may help in men with lipomastia.

If you are overweight and have man boobs, it might be time to consider shedding a few pounds. Your doctor can advise you on a healthy eating and exercise plan, and organizations such as Weight Watchers now run men-only classes. As well as losing your boobs, you will gain many other health benefits.

Gynaecomastia: No Cause For Embarrassment

Enlarged breasts in males are so common, there is no need to feel embarrassed about them. Gynaecomastia is usually harmless, but never hesitate to see your doctor if you are worried about the problem or have any other concerns.