Gynecomastia is a condition of over developed or enlarged breast tissue in boys or men caused by an imbalance of estrogen and testosterone. Most think of estrogen as an exclusively female hormone, but males also produce it, but just in smaller quantities. Although approximately in 25% of cases, the cause is unknown, some causes may be the result of hormonal changes, hereditary conditions, certain medical conditions,or side effects of certain drugs. It can happen at any age.
Gynecomastia is a common condition which affects 40-60% of males. Although there are few physical complications associated with gynecomastia, having this condition can cause emotional or physiological problems caused by appearance. They may feel awkward in certain social situations and prevent them from engaging in certain activities. . In most cases, gynecomastia can be diagnosed by a physical examination. A careful medical history is important including medication and drug use. More extensive tests may be recommended to determine the cause which may include blood tests to examine liver, kidney or thyroid function. Hormone levels may also be analyzed.
The treatment for gynecomastia in many cases, especially pubertal males, will resolve on its own. If medications are suspected as the cause then the patient is observed for return to normal breast size over several months. If the condition persists, then options can be medical or surgical. Medications used to treat gynecomastia would be indicated if it treats the underlying cause such as testosterone replacement , an anti-estrogen medication- clomiphene, tamoxifen, danazol, which is a synthetic derivative of testosterone and decreases estrogen synthesis . There are over the counter drugs available that claim to treat the condition, but none are approved by the FDA and none have been clinically proven to actually cure it. Surgical treatment is reduction mammoplasty which removes breast gland tissue. It is often performed on an endoscopic basis and done through small incisions. Liposuction also may be indicated, however, this procedure only removes breast fat and not the actual breast gland tissue itself.
Whatever age, gynecomastia can be a stressful time in one's life, but there are resources that are available to help one cope. Counseling is a great option since it can help alleviate anxiety, encourage communication with loved ones, and assist with avoiding depression. Also important is to reach out with others who have gone through a similar experience and research websites and organizations which can connect one with others .