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Causes, Symptoms and Treatments for Gynecomastia

Gynecomastia is an issue that can make it hard for a man to let his guards down and enjoy outdoor activities to the fullest. It is that kind of issue that will make you think twice before taking off your clothes in a public place. It can also make you the butt of most jokes by your friends.

What is gynecomastia? What causes and how do you get rid of it? These are some of the questions we will be addressing in this article. After reading this, you should know better how to do away with those embarrassing moobs or to avoid them, in case they are not present yet.

What is Gynecomastia?

Gynecomastia, sometimes called “gyno,” is a medical term used for hypertrophy or abnormal enlargement of breast tissue in males. It is what you will often hear people, somewhat derogatorily, call “man boobs” or “moobs.”

This enlargement of glandular tissue can occur in one or both breasts. When it affects both breasts the increase in size may not be even.

Gynecomastia typically results from hormonal changes taking place in the body. It is among the changes that young men may experience during puberty. It also occurs in older men and newborns.

Most cases of gyno resolve within a short time or maximum of two years.

Although this condition is considered synonymous with enlarged breasts in men, it does not always describe all cases of larger than normal breast sizes. There is a similar one called lipomastia or pseudogynecomastia, which describes deposition of fat in the breast area of obese men.

Gyno is not just about having excess fat deposits in the chest area. The enlargement of glandular tissue must be the result of a hormonal imbalance.

Gynecomastia is usually noncancerous and so isn’t a grave issue. The only thing that worries most men is the embarrassment that comes with having moobs. This can have considerable adverse effect on confidence and make men more self-conscious.

How Common is Gynecomastia?

Man boobs is relatively common these days. Research suggests that it is the most common reason for breast evaluation in men. It is the most widespread benign disorder affecting the male breast. Cases are more prevalent among newborns, pubertal boys, and men who are older than 50 years.

Estimate has it that up to 90 percent of newborn males has gynecomastia. Among adolescents the upper threshold of estimates is about 70 percent, while the estimation is between 24 and 65 percent among older men.

It is thought that there may have been an increase in cases in recent years. The specific reason for this is, however, not entirely clear.

Signs and Symptoms of Gynecomastia

Apparently, the most visible sign of gyno are male breasts that are bigger than normal. This enlargement may be observed in one or both breasts. It affects glandular tissue, not just fat tissue.

You may experience tenderness and your breasts may become more sensitive to touch. Chest tissue asymmetry and increase in the diameter of the areola (the dark, circular ring around your nipple) are among the symptoms you may observe.

Pain is not always present with gyno, but some sufferers may experience it. Retraction of the nipples and skin dimpling are not symptoms of gynecomastia. It is also not usual to have milky discharge, but people with a tumor that secretes prolactin may experience this.

Hormonal Changes and Gynecomastia

Disruption in your hormone levels is the main reason you may have gyno. It is the result of imbalance between the effects of male and female hormones in the body. This is why it can be present in newborns and also in older men.

You might find it surprising to learn that every human has male and female hormones in their body. Males usually have more of testosterone and less of estrogen; the reverse is true for females.

So, when a man experiences an increase in female hormone levels, there is increase likelihood of feminine features, including pronounced breasts.

An increase in estrogens leads to a rise in the amount of sex hormone binding globulin (SHBG) in the blood. It also suppresses secretion of luteinizing hormones that promote testosterone production.

SHBG binds to the active form of testosterone in the body thereby reducing the effect of the male hormone in breast tissue. This also allows estrogen to work more freely to create man boobs.

Gynecomastia develops from the enlargement of breast glandular tissue, the skin, and chest fat tissue that results from this imbalance.

You may be wondering how come newborns also can have this condition.

The placenta converts androgenic (male) hormones into estrogenic variants during pregnancy. The latter makes its way into the circulation of the unborn baby. This leads to temporary gynecomastia. Strangely, infants may even produce milk – a type known as “witch’s milk” – in rare cases.

Reduction in testosterone levels and accumulation of fat tissue that is often part of the natural aging process can cause a man to have moobs. This type is sometimes called senile gynecomastia.

Medications Causing Gynecomastia

The use of certain drugs can predispose you to man boobs. The resulting type of gyno is referred to as non-physiologic gynecomastia.

Drugs that men take for treatment of prostate enlargement, cancer or some other conditions can increase their risk of having moobs. Examples include finasteride (Propecia) and flutamide.

Gyno can also be a side effect of the following:

Anti-ulcer medications, such as cimetidine (Tagamet) or ranitidine (Zantac)
Heart medications, such as calcium channel blockers (e.g. Procardia)
Drugs for cancer treatment
Anti-anxiety medications
Antidepressants
HIV/AIDS drugs
Gastric motility medications, including metoclopramide (Reglan)
Certain antibiotics, including metronidazole (Flagyl)

Also among the most notable agents that can cause you to have man boobs are anabolic steroids. Many of these drugs have a reputation of aromatizing into estrogen in the body of users. This increases the amount of the female hormone and promotes feminine features.

Additionally, drugs of abuse or street drugs, including heroin and marijuana, can cause you to develop man boobs. Alcohol consumption is another factor capable of fueling them.

Components of some personal care products can also promote gynecomastia. For example, tea tree oil and lavender oil present in some skincare products have been linked to this condition.

Furthermore, certain supplements, including Tribulus terrestris and dong quai, are thought capable of causing gyno. This is probably likely when you take them in excess.

Disorders or Conditions Causing Gynecomastia

Man boobs can be a result of several health conditions, among which are:

Malnutrition – You may develop man boobs if you are malnourished. When your body doesn't have adequate nutrition, there is risk of hormonal imbalance. You will be less able to produce testosterone, but your ability to produce estrogen will not be affected.

Strangely, there is also risk of gyno when you resume normal nutrition afterward.

Kidney failure – People who are having issues with their kidney often develop gynecomastia. This is because they tend to easily become malnourished. A significant proportion of people with kidney failure also experience hormonal changes from regular hemodialysis.

Liver problems – Hormonal fluctuations can occur when you have liver issues, thus leading to gynecomastia. Liver failure or cirrhosis inhibits efficient metabolism of hormones, including estrogen.

Also, alcoholic liver disease involves disruption of testosterone production due to the activity of estradiol, a form of estrogen. This leads to increase in estrogen to testosterone ratio and, of course, gyno.

The medications taken to address these problems, especially cirrhosis, may also cause you to develop man boobs as well.

Tumors – People with certain kinds of tumors can produce hormones capable of disrupting the male-female hormone balance and causing gynecomastia. Examples of such include testicular tumors, adrenal tumors, and pituitary gland tumors. Lung cancer can also be a reason for moobs.

Any disorder that interferes with the natural production of testosterone can cause you to have this condition. Men also experience enlarged breasts when their thyroid gland produces excessive amount of thyroxine.

How is Gynecomastia Diagnosed?

We already mentioned that not cases of enlarged breasts can be described as gyno. Medical professionals will usually only start to suspect this problem when the breast tissue diameter of a man exceeds 0.5 centimeters.

Diagnosis typically begins with a careful examination of a patient’s medical history. A thorough physical examination will also be crucial. Your doctor will evaluate your breast tissue, testicular development, penile size, and distribution of pubic hair. He will also look for masses that may be suggestive of testicular cancer.

You may also expect questions on the drugs or substances that you take.

Usually, a number of laboratory tests will be useful in making an accurate diagnosis. Serum creatinine test is one of such. This helps to find out whether kidney damage is the cause of your man boobs.

Tests for alanine transaminase and aspartate transaminase are useful for detecting liver problem that may be responsible for gynecomastia. Serum testosterone, estradiol, and luteinizing hormone tests can help to unmask hormone imbalance.

There are several other tests your doctor may recommending depending on what he suspects to be responsible for your man boobs. These include those assessing markers of tumors and serum DHEA.

If your health care provider suspects cancer, he may order a mammogram. But recourse to mammography is rare for diagnosis of gynecomastia.

How Do You Treat Gynecomastia?

It is possible to correct gyno with lifestyle changes, especially in adolescent boys. In these cases, a doctor may advise the individual affected to exercise more regularly and maintain a healthy diet.

Men, whose cause of gyno is medication or illegal substance use, may improve when they put an end to such.

There are two main options available for treatment if all else fails. These are: medications and surgery.

Medications

There are drugs that may help in getting rid of man boobs. However, the U.S. Food and Drug Administration (FDA) has not approved any of these for treatment of gynecomastia. This is mainly because there is insufficient evidence on their efficacy.

The medication options available include:

Testosterone – It has been found that testosterone replacement can be helpful to older men with enlarged breasts due to low T levels.

However, there is risk of this being aromatized into estradiol to worsen the condition. Some researchers suggest using topical androgens for this reason.

Selective estrogen receptor modulators (SERMs) – Scientists have found that these agents can reduce breast volume in men with gyno. SERMs are commonly used for treating painful or severe cases. However, they do not eliminate the swollen breast tissue in its entirety.

Examples include tamoxifen (Nolvadex) and raloxifene (Evista).

Research shows that combination of tamoxifen and radiation therapy can be more helpful for prevention than for treatment. This can also be useful for reducing breast pain in men with prostate cancer.

Aromatase inhibitors (AIs) – Some men with gynecomastia have responded to treatment with this type of drugs, an example of which is anastrozole (Arimidex). But aromatase inhibitors are less potent than SERMs.

Treatment of man boobs with medications is more likely to produce desired results if you start within two years of the beginning of the enlargement – the earlier, the better.

You are less likely to notice impressive improvement once there is scarring of the breast tissue.

Surgery

Some cases of chronic gyno may require surgical removal of the glandular breast tissue for effective correction. Surgery is usually the only way out when there is scarring of tissue.

Breast reduction surgery, also known as reduction mammoplasty, has been found effective for treating chronic cases of gynecomastia or those that have not improved from drug therapies.

There are several surgical approaches for treating man boobs. These include laser-assisted liposuction, subcutaneous mastectomy, and liposuction-assisted mastectomy.

Surgery may be rather expensive for some men to pay for, though. The American Society of Plastic Surgeons put the average cost at $3,641 for 2017. This cost is often not covered by insurance companies on the ground that this is a cosmetic procedure.

Possible complications from gynecomastia surgery include infection, painful scars, changes in breast sensation, and death of cells in the nipple.

Are There Natural Remedies for Gynecomastia?

Medications and surgery may produce side effects. And if you are someone that doesn’t like those options, you may be wondering whether there are herbs that can help in the treatment of gynecomastia. Yes, there are!

Natural remedies that may help correct man boobs include:

Red glover – This flowering plant of the Fabaceae family contains the isoflavone genistein. Owing to the presence of this constituent, red clover can help reduce the amount of estrogen in your body to deal with gyno.

Phytoestrogens – Also known as plant-based estrogens, these can both mimic the effects of estrogen and act as antagonist. Phytoestrogens are beneficial in the latter sense. They bind to estrogen receptors and reduce the levels of the female hormone in the body. You can get them from flaxseed, soy, and linseed, among others.

Turmeric – This popular spice is known to boost the amount of testosterone in the body. It does this by dealing with chronic inflammation that adversely affects the hormone’s production. Turmeric also blocks estrogen at the cellular level.

There are several other natural remedies that may help with gyno besides these ones. They are often packaged and presented in supplement form.

Gynectrol is an example of products that blend natural ingredients that may help to deal with man boobs. This particular gyno supplement appears to be especially popular. You may first try a natural remedy such as this one, especially if you have had this problem for less than two years.

Conclusion

It is not always correct thinking you have gynecomastia if you observe your breasts becoming larger. The condition goes beyond an increase in fatty tissue; it is characterized by enlargement of glandular breast tissue.

Gyno are more common in newborns, adolescents, and older men. The primary cause is hormonal imbalance that occurs when the amount of estrogen in men rises relative to testosterone. Medications, tumors, and chronic conditions can cause this.

Man boobs resolve without any intervention in many cases. In some others, the solution is to stop using medications or substances that may be responsible. Treatment of any underlying medical condition can promote recovery.

Your doctor may prescribe medications or recommend surgery, depending on the degree. Some herbal or natural remedies may also help.

It is very important to commence treatment early enough to ensure rapid and full recovery.

Gynecomastia can occur as part of the natural aging process. But you can reduce your risk of having it by maintaining a healthy lifestyle. Avoid substance abuse, cut alcohol intake, eat healthily, and do regular exercise.