Gynecomastia is the development of larger breasts in males. Testosterone is a male hormone that is required for the development of secondary sexual characters in men. It is produced in both male and females, but it is a key male hormone and is produced in females in only trace amounts. Similarly estrogen is a female hormone, but it is produced in minor quantities in males. When the level of testosterone falls in males and there is increase in estrogen hormone it leads to enlargement of breasts in males.
Testosterone is responsible for affecting a man’s sex drive along with sperm production, fat distribution in the body, bone density, increasing muscle mass, strength and red blood cell production in the body. They are normally produced in the leydig cells of the testicles. The testosterone levels increase during puberty and then they decrease after the age of 30. The decrease in testosterone levels is a natural process/result of aging.
Is Gynecomastia A Sign Of Low Testosterone?
When boys hit puberty there are certain changes that take place in the body of the child due to hormonal changes and in some boys enlarged breasts may appear, but this condition resolve on its own without treatment. The excess of breast tissue may be equally distributed in both breasts or it might be more in one breast as compared to the other one. In older men, gynecomastia might develop when the testosterone levels drop and it may persist until and unless it is not treated. It is known to affect 1 in 4 men between the age group of 50-80 years. This condition is not harmful or serious but it might affect a man’s self esteem and confidence.
Levels of testosterone naturally decrease after a certain age but in young adults when they decrease it can be due to damage to cells in the testes that produce testosterone, any accident or childhood disease such as mumps or orchitis, testicular cancer, chemotherapy or radiation therapy for cancer treatment, pituitary disorders, genetic disorders, klinefelter’s syndrome, opioid use, obesity and use of anabolic steroids.
Gynecomastia presents with inflamed breast gland tissue and breast tenderness. It can also be accompanied with swelling, pain and nipple discharge from one or both the breasts. It is important to visit a doctor when these symptoms are accompanied as it may be indicative of male breast cancer. It is a very rare condition, but it can affect anyone.
A number of medicines can sometimes cause gynecomastia. They are anti-androgens (flutamide, finastride, spironolactone) used to treat prostate cancer, prostate enlargement and few other illnesses. Androgens and anabolic steroids, AIDS medicines, HIV+ve people undergoing HAART regimen, use of efavirenz (sustiva) has been more generally identified with gynecomastia. Anti-anxiety medicines (diazepam/valium), antibiotics, tricyclic antidepressants, ulcer medicines like cimetidine, chemotherapy for cancer treatment, digoxin used for heart conditions, calcium channel blockers; gastric motility medications (metoclopramide) can cause gynecomastia. Use of alcohol & drugs abuse have also been related to enlargement if breasts in males. Amphetamines, marijuana, alcohol, heroin and methadone cause gynecomastia.
Treatment For Gynecomastia
Gynecomastia that occurs as a result of obesity is resolved on its own once the person loses weight and makes lifestyle changes. But in other people even losing weight does not help the condition. In these people use of medications such as raloxifene (evista) and tamoxifen (soltamox) are beneficial. These drugs are also used to treat breast cancer. Other options include use of surgery and liposuction that removes excess fat from your breast. It is done via a small incision and has a short recovery period. Mastectomy can also be performed where your breast gland is removed. The corrective and cosmetic surgeries help in providing the look and shape a person desires to get.
For low testosterone levels skin gels, patches and injections are used. It is called as testosterone replacement therapy and is being widely used nowadays with excellent results.
- Mayo Clinic – Gynecomastia: Symptoms and Causes URL: https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793
- Cleveland Clinic – Gynecomastia URL: https://my.clevelandclinic.org/health/diseases/17644-gynecomastia
- Healthline – Gynecomastia: Enlarged Male Breasts URL: https://www.healthline.com/health/gynecomastia
- American Society of Plastic Surgeons – Gynecomastia Surgery (Male Breast Reduction) URL: https://www.plasticsurgery.org/cosmetic-procedures/gynecomastia-surgery