Gynecomastia

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Obesity, Sleep & Internal medicine
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Gynecomastia
Synonyms	Gynaecomastia
Pronounce	N/A
Specialty	N/A
Symptoms	Breast enlargement in males
Complications	Psychological distress
Onset	Puberty, middle age
Duration	Variable
Types	N/A
Causes	Hormonal imbalance, medication, liver disease, kidney failure, thyroid disorders
Risks	Obesity, aging, substance use
Diagnosis	Physical examination, medical history, blood tests, imaging studies
Differential diagnosis	Breast cancer, lipoma, pseudogynecomastia
Prevention	N/A
Treatment	Observation, medication, surgery
Medication	Tamoxifen, raloxifene, anastrozole
Prognosis	Generally good
Frequency	Common in adolescent males
Deaths	N/A

Gynecomastia involves the growth of glandular, as opposed to fatty, tissue. It is usually symmetrical in location with respect to the nipple and may have a rubbery or firm feel. While often affecting both breasts, it can also be unilateral.

Causes

The primary cause of gynecomastia is an imbalance in the levels of estrogen and testosterone. Males have both of these hormones in their bodies, but testosterone is usually present in higher amounts. If this balance shifts - such as an increase in estrogen production or a decrease in testosterone production - gynecomastia can occur. Various factors can disrupt this hormone balance, including:

• Natural hormone changes: Hormone levels fluctuate during different life stages. Newborns, adolescents, and older adults are particularly susceptible due to natural hormonal changes during these periods.
• Health conditions: Certain health conditions can affect hormone production. These include tumors, malnutrition, liver disease, kidney disease, and thyroid disorders.
• Medications: Certain medications can cause gynecomastia, including anti-androgens, anabolic steroids, HIV medications, anti-anxiety drugs, antibiotics, and chemotherapy drugs.

Symptoms and Diagnosis

The primary symptom of gynecomastia is enlargement of the male breasts. Other symptoms can include breast tenderness or pain. If the gynecomastia is caused by a disease or condition, such as a tumor or hormonal imbalance, there might be other symptoms as well. To diagnose gynecomastia, a doctor will typically perform a physical examination and take a detailed medical history. Blood tests and imaging studies, such as a mammogram or ultrasound, may also be ordered to confirm the diagnosis and rule out other causes of breast enlargement.

Treatment

Treatment for gynecomastia depends on the cause. If a medication is causing the condition, the doctor may recommend stopping or switching to another drug. If an underlying condition is identified, such as a tumor or liver disease, treating that condition may resolve the gynecomastia. In some cases, medication or surgery may be recommended to reduce the size of the breasts. Medications used to treat breast cancer and other conditions, such as raloxifene and tamoxifen, may be helpful for some men with gynecomastia. Surgical options include liposuction or mastectomy.

See Also

• Breast
• Estrogen
• Testosterone