Gynecomastia is the enlargement of breast tissue or boobs in boys or men. All males have breast tissue, and just as in women, it is under the control of hormones in our bodies. Both men and women produce the ‘male’ hormone testosterone and the ‘female’ hormone estrogen.
Breast tissue responds to high levels of estrogen by growing. Normally in males the level of testosterone is much higher than the level of estrogen, so boobs do not grow. If something upsets this balance, breast tissue can get bigger, causing gynecomastia.
It can be caused by either an increase in the level of estrogen or a decrease in the level of testosterone. This change in the balance of hormones in males causes the breast tissue to grow and the man develops boobs or breasts – gynecomastia.
Causes of gynecomastia
Breast enlargement is very common in some groups – many newborn babies, around 1/3 of teenagers and a large number of ageing men will experience some enlargement of their breasts.
In these groups the changes in hormone levels can be normal and often need no treatment. In babies and teenagers the breast swelling usually goes away on its own.
Men who are significantly overweight are very likely to feel some enlargement of their breast tissue – sometimes called ‘man boobs’. This is partly caused by fat tissue under the skin on the chest wall, and partly by true breast glandular tissue. For more details on Gynaecomastia visit Sccaudi
Fat tissue anywhere in the body encourages the formation of estrogen, and thus can lead to gynecomastia.
The most common cause of gynecomastia in other men is medication. Boob swelling can be caused by a wide range of medicines including those used to treat:
A. Prostate cancer – such as flutamide
B. Stomach ulcers – including cimetidine
C. Anxiety – such as Valium
D. Depression (tricyclic antidepressants)
E. Cancer – chemotherapy drugs
F. HIV – HAART medication
G. Some heart problems – including digoxin
Other substances taken for non-medical reasons are also the cause of gynecomastia in some men. These include:
A. Anabolic steroids taken for bodybuilding
If a man is taking a drug – either prescribed medication or recreational drugs – they should visit a doctor to discuss whether this might be the cause of the gynecomastia. Medication should not be stopped before speaking with a doctor as this can be dangerous.
There are often different medications which can be tried and can continue to treat the problem without causing breast swelling.
If none of these are being taken, other causes need to be considered. Other causes of changes in hormone levels in the body include:
A. Tumors which secrete hormones
B. Low levels of hormones caused by problems in the pituitary gland (the part of the brain which controls hormone production)
C. Rare genetic disorders such as Kleinfelter’s syndrome
D. An overactive thyroid gland (hyperthyroidism)
E. Liver disease
F. Kidney disease
Therefore a man who goes to the doctor worried about developing boobs should get a full check-up. The doctor will ask what drugs the man is taking, and any other medical problems they have. They will also examine the man, including the chest area and boobs as well as a more general examination (including the testicles), to rule out any worrying causes of breast enlargement.
Dangerous causes of gynecomastia are rare, but medical help should be sought particularly if the swelling is different on each side, the swelling is painful or lumpy or if there is any fluid discharge from the nipples. Any swelling which persists for a long time or is very distressing for the man should also be discussed with a doctor.
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