What Is Gynecomastia And How To Treat It?

male issues

Gynecomastia can be one of the most uncomfortable issues to talk about. It happens when breasts are enlarged in males, and it can take a toll on the confidence of many men. As gynecomastia usually appears in puberty when boys grow and their bodies go through changes, it can have an even bigger effect on their confidence, perception of self-worth, and overall mental health. Even though many boys and men are affected by gynecomastia and that it’s not really dangerous, it’s not something boys, and men around the world want to live with.

A guy is as likely to have issues with his appearance and confidence as a woman, even if society doesn’t focus on that so much. Luckily, there are ways to treat gynecomastia and become more confident.

Signs & symptoms

Gynecomastia is recognized primarily by the enlargement of the male breasts. In truth, this is the enlargement of glandular tissue and not fatty tissue. It’s typically symmetrical in location and may have a rubbery or firm feel. Gynecomastia usually occurs on both sides of the chest and can even be unilateral. The enlargement can be larger on one side than the other. Tenderness and sensitivity may also be present, but there’s usually no severe pain involved.

Note that gynecomastia is not male breast cancer, as cancer is usually present only on one side. It’s also not centered around the nipple and feels hard and firm.

What causes gynecomastia during puberty and how long does it last?

As gynecomastia is the result of an imbalance in hormone levels, it’s normal to expect it during growth years. Estrogen levels are relatively increased to levels of androgens. I.e., the level of the female hormone is higher. As the body goes through a lot of changes during puberty, it’s perfectly normal to expect gynecomastia to appear. It’s also very important to talk to your child about what’s going on, especially if they seem very uncomfortable with their body.

Not dealing with something perceived embarrassing can often be the cause of a distorted body image in later years. As well as that, your child may get bullied by the other boys because of his condition. He needs to understand that this is not his fault, that it is perfectly normal, and that it will go away on its own. This is a way to build your child’s confidence and a positive body image throughout the most sensitive years of growing up. Even though gynecomastia by itself isn’t dangerous, the psychological consequences can be tough, especially for a young boy.

The condition will usually disappear between six months and two years. Even if the condition persists past the estimated two-year mark, it’s not a big deal. This is considered persistent pubertal gynecomastia and will also disappear on its own, or you can solve it with treatments.

What diseases can cause gynecomastia?

Some medical conditions can also cause gynecomastia. For example, malnutrition and re-feeding both create hormonal changes that can lead to gynecomastia. Cirrhosis of the liver can also alter normal hormone metabolism and cause gynecomastia.

If you have a disorder of the testes, you might have a decreased testosterone production and relatively high estrogen levels, which also causes gynecomastia. This can be generic or a result of trauma, aging, reduced blood flow, or even infection. In some cases, even testicular cancer may secrete hormones that cause gynecomastia.

In rarer cases, gynecomastia can be caused by other conditions that cause hormonal changes. For example, chronic renal failure and hyperthyroidism are both common conditions that cause gynecomastia. Of course, in extreme cases, some other cancers can also cause your body to produce hormones that cause gynecomastia.

What medications can cause gynecomastia?

Gynecomastia can sometimes occur as a side effect of some medications. Most often, it is the side effect of these medications:

  • Calcium channel blockers used to treat hypertension (such as nifedipine [Procardia and others])
  • ACE inhibitor drugs for hypertension (captopril [Capoten], enalapril [Vasotec])
  • spironolactone (Aldactone), a diuretic that has anti-androgenic activity
  • Anti-ulcer drugs (such as ranitidine [Zantac], cimetidine [Tagamet], and omeprazole [Prilosec])
  • Some antibiotics (for example, isoniazid, ketoconazole [Nizoral, Extina, Xolegel, Kuric], and metronidazole [Flagyl])
  • Highly active antiretroviral therapy (HAART) for HIV disease, which may cause fat redistribution leading Anti-androgen or estrogen therapies for prostate cancer
  • methyldopa (Aldomet)
  • to pseudo gynecomastia or, in some cases, true gynecomastia
  • digitoxin
  • Drugs of abuse (for example, alcohol, marijuana, heroin)
  • diazepam (Valium)
  • Lavender oil and tea tree oil, when used in skin-care products, have been associated with gynecomastia

Diagnosis

By definition, gynecomastia is the presence of breast tissue greater than 0.5 centimeters in diameter in a male. Gynecomastia is actually the presence of true breast tissue which is generally located around the nipple. Fat deposition isn’t considered to be true gynecomastia.

Diagnosis is achieved through physical examination. Medical history will also be important, including the history of use of any medication and drugs. There can also be suspicion of cancer, in which case a mammogram is conducted. Some medical professionals will also recommend more tests to establish the cause of gynecomastia in certain cases.

These usually include blood tests to examine the kidneys, liver, and thyroid function. Since hormones are usually one of the main causes of gynecomastia, measurement of hormone levels in the bloodstream can also be recommended by the medical professional.

 How long does it take to go away?

If gynecomastia occurs in puberty, it typically goes away on its own. In rare cases, it may persist and require treatment. Long-term gynecomastia has been present for twelve months or more and can undergo scarring. In this case, treatment with medications is more difficult.

Psychological consequences can develop during this period, as gynecomastia is often the source of embarrassment and lack of self-confidence.

Treatment

Treating gynecomastia is possible in several ways. Most of them involve using different drugs that help your body go back to the state it was before. You should be aware that gynecomastia usually goes away by itself within six months, and that treatment isn’t necessary before than period is up. Also, know that medical treatments are available but that they’re not often very useful.

One treatment is using testosterone replacement that has shown some effectiveness when treating older men with low testosterone levels. Alas, the treatment is not effective for those who have normal levels of testosterone. Clomiphene, tamoxifen, and danazol can all be used as well.

Since medication is usually not as effective as you’d hope it would be, professional gynecomastia surgery is recommended. Medications are more likely to treat the early stages of gynecomastia when the tissue is not yet scarred. As time goes on, it becomes more clear that reduction mammoplasty may be the answer to the problem. Of course, the surgery can be performed even in cases when the drugs aren’t working, regardless of how much time has passed.

Prevention

Gynecomastia that occurs because of hormonal changes caused by aging and growth cannot be prevented. On the other hand, if it is caused by medical conditions, it can be prevented only if the responsible condition can be prevented.

Conclusion

This is all you need to know about gynecomastia. If you or someone you know suffers from it, you’ll now have the information necessary to treat it. As well as that, you’ll be more familiar with the illness, and that will make you fear it less. This is key in improving your mental health and taking a step towards solving the problem you have.

Additional References:

https://www.medicinenet.com/gynecomastia/article.htm

https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793

https://www.panthea.com.au/procedures-for-men/body-surgery/treatment-for-gynaecomastia/

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