Gynecomastia in men: what is it, causes, treatment and operation

The male gynecomastia refers to the benign enlargement experienced by the breast tissue in males , a condition that is caused by an imbalance between the hormones estrogen and testosterone. All men have a little estrogen, however, an excess of it can cause this increase in the size of the breasts. The growth may occur on one or both breasts and may be uneven.

Gynecomastia is more common in newborns, puberty, and adult men as they age due to normal changes in their hormone levels. However, when gynecomastia is pathological, it is associated with diseases and medical conditions that should be diagnosed and treated early. In the next section we will see what are the causes of pathological gynecomastia.

During the early stages of embryonic development, fetuses do not have a distinct sex but nevertheless begin to develop body structures such as the mammary glands, but in males the development of these organs stops. In three stages of life, growth can be briefly resumed with the characteristic of being self-limiting known as physiological gynecomastias :

• Neonatal gynecomastia: occurs in the newborn due to exposure to placental hormones. They resolve after a few months.
• Pubertal gynecomastia: up to 70% of boys in adolescence can present this condition. It usually occurs around the age of 14 and does not usually last more than 14 months.
• Senile gynecomastia: seen in approximately 60% of men over 45 years of age due to decreased testosterone and increased estrogen.

Outside of these three stages, any situation that alters the balance between androgens and estrogens (male and female hormones) can lead to gynecomastia, which is known as pathological gynecomastia . Among the main causes of pathological gynecomastia in men are:

• Development of tumors in the testicles, adrenal glands, or pituitary gland.
• Hypothyroidism or hyperthyroidism .
• Liver or kidney failure
• Síndrome de Klinefelter.
• Poor testicular function ( hypogonadism ).
• Malnutrition: a hormonal imbalance occurs because testosterone levels fall but estrogens remain stable.
• Drugs such as: anabolic steroids, chemotherapy, tricyclic antidepressants, anxiolytics, antibiotics, heart medications, ulcer medications, etc.
• Drugs such as alcohol, marijuana, methadone, heroin, or amphetamines.

It is important to distinguish gynecomastia from pseudogynecomastia , which is an increase in fatty tissue in the pectoral region as a result, generally, of weight gain.

Basically, the only thing that is referred to is the growth of a firm or elastic mass in the pectoral region behind and around the areola, and in most cases it is bilateral but it can appear on one side only. Other symptoms of male gynecomastia can be:

• Local pain when touching the affected area.
• Increased sensitivity in the chest.

Gynecomastia can be classified according to its size:

• Grade I: growth is slight and is concentrated in the area of ​​the areola.
• Grade II: there is moderate growth, which is diffuse and is usually accompanied by fat. It may or may not stretch the skin.
• Grade III: the growth is large and produces a surplus of skin.

The main problem of gynecomastia is the psychological impact that the feminization of their breasts causes in men, generating shame and concealment behavior.

It is important to see a doctor urgently if symptoms such as:

• Inflammation
• Severe or persistent pain
• Pain when touching the breast
• Discharge from the nipple
• Nipple retraction

The clinical evaluation of the affected person together with the medical history where the age, time of evolution, symptoms and antecedents is reflected is usually enough to specify the diagnosis of gynecomastia.

It is important to evaluate the function of the kidneys, thyroid and liver , since these can be related to the development of gynecomastia. Similarly, inquire about drug and medication use.

The palpation to determine the content of the mass growth and thus differentiating a pseudoginecomastia of real gynecomastia. When this mass is firm in consistency, it is usually glandular tissue, and if it is soft, it is fatty tissue. A mammogram can be very helpful, but it is not entirely necessary. The size of the mass and the growth of the skin in the area should also be assessed.

Similarly, testicular palpation should be done to evaluate the size and symmetry, as well as the presence of nodules or tumors. The evaluation of other secondary sexual characteristics, such as the amount of chest hair or muscle mass, often helps to identify alterations in the production of sex hormones.

First of all, it should be mentioned that there is no indicated treatment for physiological gynecomastias unless they present problems such as, for example, excessive growth, psychological affectation or prolonged duration of the condition. In these cases, the patient is medicated with hormonal drugs (androgens or anti-estrogens).

Treatment of pathological gynecomastia is really aimed at controlling the condition that precipitated the hormonal changes. However, sometimes surgery is necessary to remove tissue from the chest.

The gynecomastia operation can be more or less complex depending on the size and characteristics of the breast growth:

• Simple adenectomy: consists of removing the glandular tissue when the growth does not involve fat tissue or increase in skin.
• Liposuction: when the growth is fatty tissue, that is, it is a pseudogynecomastia.
• Adenectomy with liposuction: in cases where there is growth of both types of tissue.
• Skin resection: it is necessary to complete the surgery with a removal of excess skin when the growth produces a stretch of this.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Gynecomastia in men: what it is, causes, treatment and operation , we recommend that you enter our Endocrine System category .