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Gynecomastia: Symptoms, Causes, Treatment and Cost

Last Updated: Sep 30, 2023

What is Gynecomastia?

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A common disorder known as Gynecomastia causes enlarged male breast tissue. Men of all ages can exhibit it, but it is most common during puberty, the infant stage, and later life. Gynecomastia can have a variety of causes, but the most prevalent one is a testosterone and oestrogen imbalance.

What are the stages of Gynecomastia?

There are currently four stages of gynecomastia, according to research:

  • Grade I: Gynecomastia begins as a slight expansion of the breast without any indication of extra skin. The patient develops a slight breast growth, particularly near the nipple or areola, which is undetectable by clothing. The nipples may seem bloated and distinct in colour, resembling a cone in shape. If the treatment begins at this point, the patient experiences positive outcomes.
  • Grade II: Compared to grade I, grade II gynecomastia has wider tissue growth, but it still doesn't show any evidence of extra skin growing across the chest. Under the nipple, the chest could feel constricted. The outside region, however, could feel softer and greasy. For the best outcomes, it is simply treated with the use of liposuction followed by gland removal.
  • Grade III: Minor skin addition and a moderate increase in breast size are also possible at this stage. They appear drooping because of the extra skin that is visible around the areola area. Additionally, the width of the chest widens to a moderate to severe extent, which can be concerning for a person because even in loose-fitting clothing, one can detect a definite sagging of the breasts.
  • Grade IV: Gynecomastia grade IV, the final and most severe stage, causes it to seem saggy and droopy, which can resemble female breasts. At this point, the male breasts have gotten so big that the only treatment option is liposuction along with gland ectomy.

Gynecomastia Symptoms

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Gynecomastia in adult men is typically asymptomatic. This illness's warning signs and symptoms could include:

  • Especially in adolescents, pain
  • Enlarged breast tissue
  • Breast sensitivity
  • Sensitivity in the tips of the breast when touching against clothing

Gynecomastia Causes

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Hormone dysregulation

Gynecomastia may be caused by an imbalance of the sex hormones testosterone and oestrogen. Oestrogen causes breast tissue to enlarge and although oestrogen is produced by all men. Men typically have far higher levels of testosterone, which prevents the oestrogen from encouraging the growth of breast tissue.

A man's breasts may enlarge if the hormone balance in his body alters. This imbalance might occasionally have no known reason.

Obesity

Obesity, or being extremely overweight, is a common contributor to gynecomastia because it raises oestrogen levels, which can lead to the growth of breast tissue. Being overweight increases your risk of having excess fat, which can cause the breast tissue to grow. Losing weight or exercising more may be helpful for some people, but these actions may not always improve their health.

Newborn boy infants

Because oestrogen travels from the mother to the baby through the placenta, gynecomastia can affect newborn boys. A few weeks after the baby is born, this will pass away because it is only temporary.

Puberty

The hormone levels of boys change during puberty. If the level of testosterone drops, oestrogen can stimulate the growth of breast tissue. Many teenage boys have varied degrees of breast enlargement. When boys reach puberty and their hormone levels stabilise, gynecomastia typically goes away.

Older age men

Male testosterone production declines with age. Additionally, older men have a tendency to have greater body fat, which may increase the production of oestrogen. Breast tissue growth that is excessive can result from these variations in hormone levels.

Other factors

Other uncommon causes of gynecomastia include:

  • Medication adverse effects, such as those from anti-ulcer or heart-disease medications.
  • Illicit substances, such as marijuana or anabolic steroid
  • Misuse of alcohol
  • A health condition like liver disease or kidney failure
  • Klinefelter disease (a rare genetic disorder)
  • Infections or tumours in the testicles
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What causes gynecomastia in older males?

Men over 50 are more likely to have enlarged breasts. As men ages, their bodies produce less testosterone. Additionally, they might have greater body fat, which promotes the growth of breast tissue and oestrogen production.

Does gynecomastia result from low testosterone?

Gynecomastia may be caused by an imbalance of the sex hormones testosterone and oestrogen. Oestrogen causes breast tissue to enlarge. And although oestrogen is produced by all men. Men typically have far higher levels of testosterone, which prevents the oestrogen from encouraging the growth of breast tissue.

A man's breasts may enlarge if the hormone balance in his body alters. This imbalance might occasionally have no known reason.

How can you prevent Gynecomastia?

There are a few things you can change that could lower your risk of developing gynecomastia:

  • Stop using drugs. Anabolic steroids, amphetamines, heroin, and marijuana are a few examples.
  • Skip the alcohol. Avoid consuming alcohol. If you choose to drink, do so sparingly.

For the majority of teenagers, the shift is just transient, but some men who have gynecomastia may experience embarrassment or self-consciousness due to their looks. Many men discover that covering it up with loose-fitting clothing until the breasts decrease helps to lessen their visibility.

Consult your doctor about treatment options if you have gynecomastia and it affects you a lot or has persisted for more than two years.

At Pristyn Care, you can find the best doctors in the country for your suitable treatment. So book your appointment and talk to the doctors here, for your better successful treatment.

Dos

  1. Act upon it. The decision to rebuild your self-esteem and confidence ultimately rests with you. Make a consultation appointment to discuss all of your treatment options with a cosmetic surgeon.
  2. Do not anticipate seeing the complete effects of a Breast Reduction within a year of surgery. About 30% of the benefits will be noticeable right away, 80% after three months, and typically 100% after six to eight months, once all swelling has subsided.
  3. Definitely take a few days off of work to rest up from the procedure. Plan on taking three to five days to relax and recover afterward because you might feel mild to moderate chest pain and a little edema.
  4. Research the topic. A smooth and enjoyable Male Breast Reduction can be achieved by being aware of what to anticipate from your surgical procedure and recuperation.
  5. Do keep your chest in place. Pay close attention to the post-surgery instructions provided by your doctor. Wear your compression garment, take it easy, and hold off on any strenuous exercise for at least four weeks.

Don’ts

  1. Don't just wait for your gynecomastia to go away by itself. Yes, this is possible, but if you've had this excess tissue for more than a year, it will probably call for medical attention.
  2. Go to your primary care provider on time. Finding the source of your gynecomastia is crucial since it could indicate a more serious medical condition or be treated simply by stopping a prescription.
  3. Avoid hiding in layers or loose-fitting garments. Enjoy your life because you only get one. You may feel more at ease and confident after a male breast reduction, which will enable you to return to the gym or the beach shirtless.
  4. Scars shouldn't be a problem. The breast reduction process for men differs significantly from that for women. Around the areola, a small incision will be created, allowing for the removal of extra glandular tissue. To remove additional fat, the doctor will frequently make a small incision under the armpit and insert a liposuction cannula. The scars will be nearly undetectable.
  5. Don't be ashamed to ask for assistance. In their lifetime, almost half of all men will experience gynecomastia in some way.

Gynecomastia - Diagnosis and Tests

The patient's symptoms, medical and related history, and even family history will all be discussed with the doctor. The breast tissue will be physically examined, and it might also include the abdomen and genitalia.

The doctor can advise against treating the issue if the hormone imbalance appears to be the root of the problem.

A biopsy or blood test may be requested by the doctor if the lump is very large, painful, or one-sided in order to exclude breast cancer.

Additional testing will aim to rule out other factors, such as a cyst abscess or a furuncle.

  • Benign tumours such as lipomas or hamartomas
  • Mastitis is a breast tissue infection.
  • Hematoma, a mass of solid, clot-filled blood
  • Cancer metastasis, which has spread from another part of the body
  • Harm to fatty breast tissue leading to fat necrosis or a lump

The doctor might also order imaging tests such

  • Mammograms or breast ultrasounds
  • A chest X-ray
  • MRI images
  • Ultrasounds of the testicles

What potential side effects could gynecomastia have?

According to studies, men who have gynecomastia may be somewhat more likely to get breast cancer. Consult your doctor if you notice any strange breast changes or if you have any.

Home Remedies for Gynecomastia

Most DIY treatments make use of ingredients that are often found in our kitchens. Here are several natural treatments for gynecomastia that also relieve discomfort and swelling in the breasts.

Compressing cold

Gynecomastia symptoms include tenderness and soreness in the breasts. A cold compress can be applied to the area to reduce pain. The cold compress aids in the nerve's contraction, which lessens swelling and discomfort brought on by men's breats.

Turmeric

A decline in male body testosterone levels is the primary cause of male breast development. Turmeric's primary ingredient, curcumin, lowers inflammation while simultaneously encouraging the body to produce more testosterone. You can mix half or one spoonful of turmeric powder with hot milk or lukewarm water and consume the concoction at least twice daily.

Lactis Thistle

One of the symptoms of any liver disease is an enlarged breast. In such cases, the liver issue may be treated with milk thistle. The liver functions better as a result, and the breast size lowers. To produce a milk thistle mixture, crush 3 cups of milk thistle seeds. You might also include honey.

E- vitamin

Vitamin E diets are rich in poly-unsaturated fatty acids and antioxidants. Thus, consuming these meals can lessen the production of free radicals. Additionally, meals rich in vitamin E prevent the activity of an enzyme that blocks the oestrogen receptor. This helps to balance out the body's fluctuating hormonal levels by lowering the high oestrogen levels.

Flaxseeds

Flaxseed also has that potent combination in its arsenal against gynecomastia. It has a lot of omega-3 fatty acids, which are believed to raise testosterone while lowering oestrogen levels. Additionally, lignans, which have antiestrogenic qualities and support the regulation of oestrogen activity, are abundant in flaxseed.

Fish oils

In the future, gynecomastia may be treated using fish oil. Fish oil-containing supplements are additionally offered. Omega-3 fatty acids, which support the breakdown of oestrogen and increase testosterone levels, are also abundant in fish oil. Omega-3 fatty acids can be found in abundance in fish from cold waters, such as mackerel, salmon, and tuna.

Treatment of Other Health Problems

The growth of additional breast tissue in males may result from medical conditions that cause a hormonal imbalance in their bodies. Some of the illnesses include hyperthyroidism, liver failure, kidney failure, and other problems. Doctors advise resolving these problems as soon as possible to reduce the chance of gynecomastia.

Foods Rich in Zinc

Zinc-rich foods encourage the body to manufacture more testosterone. Anyone who exercises frequently should eat meals high in zinc. Some of the foods include cashews, raisins, oysters, lobsters, and chickpeas. In addition, zinc supplements are offered.

Epsom Bath and Salt

Some natural gynecomastia treatments might not require consumption. Magnesium sulphate, which is present in an Epsom salt bath, helps with detoxification and, as a result, hormone balance.

Exercise

You can reduce extra chest fat by choosing exercises and routines that target the pectoral muscles on a regular basis. Try these workouts for gynecomastia to get rid of man breasts:

  1. Swimming
  2. Running and Walking
  3. Bench Press
  4. Pushups
  5. Rowing apparatus
  6. Cable Crossover With a Bent-Forward

Red Clover

Red clover flavonoids speed up the metabolism of oestrogen levels. Consuming red clover can therefore aid in re-establishing healthy amounts of testosterone and oestrogen in the body.

What to eat in Gynecomastia?

Soy-based products

Products derived from soy are particularly abundant in substances known as phytoestrogens. These substances could have estrogen-like effects on the body since they share the same chemical structure as oestrogen.

Products made from soy include several meat alternatives and edamame. Some studies claim that soy products might raise the body's oestrogen levels, while others claim the opposite. Ironically, both are accurate.

Isoflavones, a kind of phytoestrogen found in soy, are thought to be selective oestrogen receptor modulators. This means that when they connect to oestrogen receptors, they might have a range of consequences. They could have a neutral, pro-, or anti-estrogenic effect.

As a result, various isoflavone varieties may cause the body to produce more or less oestrogen. Because of these variances, it can be challenging to establish generalisations regarding how foods containing phytoestrogens affect human health.

Even though soy offers several health advantages, further study is still needed to determine how phytoestrogens from soy affect people.

Cruciferous vegetables

Indole-3-carbinol, a substance found in cruciferous vegetables, may have anti-estrogenic properties. This implies that they might lower male oestrogen levels.

However, there is no conclusive evidence to support the claim that consuming cruciferous vegetables lowers oestrogen levels in humans.

These veggies fall into this category:

Consuming cruciferous veggies may reduce your risk of developing prostate cancer, according to studies.

Mushrooms

Compounds found in oyster mushrooms have the potential to inhibit aromatase, an enzyme that transforms testosterone into oestrogen. They might lessen the body's oestrogen levels as a result.

A micronutrient called hispolon that is present in some medicinal mushrooms may similarly inhibit aromatase. It might also increase the estrogen-like chemical estradiol at the same time. Mushrooms and oestrogen levels require more study.

Turmeric and curcumin

Curcumin is a substance found in turmeric. According to a 2013 study, curcumin may lower oestrogen levels. It is uncertain whether curcumin has the same impact in individuals because the researchers discovered this result in cells outside the body.

Large doses of curcumin were found to raise testosterone levels in rats in a 2014 study. There needs to be more research on how curcumin affects people.

What not to eat in Gynecomastia?

Meat and dairy

Because even male animals generate the hormone, there are traces of oestrogen in all animal products. Phytoestrogens may also be present in cow's milk.

According to one study, eating red and processed meat may increase a woman's risk of getting breast cancer. The accumulation of oestrogen caused by meat's high oestrogen content is one potential cause. There is no study demonstrating comparable effects in men.

However, research on the impact of meat and dairy on oestrogen levels and cancer risk is conflicting. According to an analysis published in 2018, milk's oestrogen content is not high enough to have an impact on human health. The levels of oestrogen, dairy products, and meat require more study.

Alcohol

According to research, persistent alcohol abuse can cause reduced testosterone and higher oestrogen levels. These two hormonal conditions may be a factor in erectile dysfunction.

There are several effects of low testosterone that alcohol may amplify. Alcohol, for instance, has a lot of calories and might make you gain weight.

Grains

Due to its resemblance to estrogens that naturally present in the body, a fungus called zearalenone found in some grains has the potential to upset the balance of oestrogen.

Studies have mostly concentrated on the molecular mechanisms and effects of zearalenone in animals. Although there is no proof that the fungus is harmful to human health, some experts speculate that it might have similar effects in people.

Healthy diets include grains including barley, wheat, rice, and maize.

Legumes

Lentils, peanuts, and chickpeas are just a few of the numerous healthy options of legumes. For instance, they are a well-liked meat substitute since they have a high protein content.

Phytoestrogens are also present in legumes, especially in the form of isoflavones. According to research, the isoflavones genistein and daidzein found in yam beans may cause mice to produce more oestrogen.

Notably, certain isoflavones, especially those found in soy, may reduce oestrogen levels. It is likely that the kind and quantity of isoflavones affect oestrogen levels differently, indicating the need for more study in this area.

Legumes may also help to maintain heart health and lower the chance of developing metabolic syndrome. Instead of eliminating them from your diet, think about having them sometimes in tiny portions.

Can eggs cause gynecomastia?

No, eggs don’t cause Gynecomastia. Rather it helps in reducing man breasts via aid in increasing testosterone levels.

Does fenugreek cause gynecomastia?

There is some worry that taking fenugreek could lead to gynecomastia (development of breast tissue) in men because it can enhance milk production in women and possibly expand breasts. Although there is no proof for this notion, discussion of the potential problem continues nevertheless.

Many consider it to be a reasonable extrapolation, but others point out the complete lack of evidence.

We'll say it again: we won't promote the myth that fenugreek causes gynecomastia unless there is solid data to support it.

Treatment for Gynecomastia

The majority of situations gradually get better on their own without any medical help.

If you have gynecomastia, your doctor could suggest seeing an endocrinologist, a specialist who deals with issues linked to hormones and how they affect your body. The treatment of your condition may vary depending on your age, general health, the likelihood that your sickness will last a long time, and how well you react to particular treatments.

If gynecomastia arises throughout adolescence, it normally goes away on its own. It can take from six months to three years to complete this.

Treat the underlying ailment if it turns out that your hormones are out of balance as a result of another medical issue. To correct the hormonal imbalance that is promoting breast growth, you might be prescribed medication.

Occasionally, you might require surgery. Your doctor might suggest methods like:

  • Mastectomy (removal of breast gland tissue)
  • Liposuction (removal of extra breast fat)

Gynecomastia Treatment without surgery

Gynecomastia is typically treated by addressing the underlying issue. Among the nonsurgical procedures a doctor might suggest are:

  • Unapproved pharmaceuticals. Your doctor might recommend raloxifene or tamoxifen for gynecomastia as an off-label medication.
  • Changing prescriptions. A doctor may change your prescription or reduce your dose if they believe one of the medications you are taking is contributing to your gynecomastia.
  • The use of testosterone. Your testosterone levels can be raised using testosterone replacement treatment (TRT), which comes in the form of patches, skin gels, or injections.
  • Treating underlying medical problems. Gynecomastia symptoms may be lessened by treating underlying medical conditions like hyperthyroidism or malnutrition.

Which are the best medicines for Gynecomastia?

It may be beneficial for some men with gynecomastia to take drugs for conditions including breast cancer and other ailments. They consist of: Aromatase inhibitors like anastrozole and tamoxifen (Soltamox) (Arimidex).

Despite having received permission from the Food and Drug Administration, these medications are not specifically approved for use in gynecomastia patients.

Do medications for gynecomastia work?

Gynecomastia treatment options are not currently approved by the USFDA. Furthermore, since these medications function as nutritional supplements rather than therapeutic agents, their efficacy is still unknown. Additionally, it takes time for the consequences to fully manifest.

Gynecomastia Surgery

The breast is made up of softer fatty tissue and solid, dense glandular tissue.

The ratio of glandular to fatty tissue in the breasts varies from person to person. It's possible for a male with gynecomastia to have too much of both tissues.

With liposuction, extra fatty tissue can be eliminated. A tiny tube must be inserted by making an incision. Excision is the surgical removal of extra glandular tissue by excising tissue with a scalpel. The edge of the nipple will typically be scarred as a result of this.

If a large reduction in tissue and skin is necessary, the incision and scar will be wider.

After surgery, the chest will be bruised and swollen; the patient may need to wear an elastic pressure garment to reduce the swelling.

People typically need six weeks to get back to their regular routines. Surgery complications are uncommon. They include inconsistent chest contour, insufficient removal of breast tissue, and diminished sensation in one or both nipples. A blood clot could form after excision and might need to be drained.

How long does it take to recover from Gynecomastia?

Initial male breast reduction healing takes, on average, 1-2 weeks. Patients should take it easy during this time and refrain from engaging in strenuous activity to promote healing and avoid problems.

What is the price of Gynecomastia treatments in India?

The stage and degree of the gynecomastia surgery determine the cost. Depending on the severity, gynecomastia surgery costs might range from Rs 40,000 to Rs 80,000. The procedure, dressings, and aftercare are covered in this.

Are the treatment's effects long-lasting?

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Your gynecomastia surgery may require 3-6 months to provide its full effects. Although permanent, incision lines will gradually disappear with time.

Who is eligible for the treatment?

Candidates for gynecomastia surgery include:

  • Men whose conditions are not treatable with alternative medicine
  • Those in good health, free from conditions that could risk their lives or prevent them from recovering
  • Those who don't take drugs or smoke
  • Men with a positive mindset and clear objectives for reducing the gynecomastia's physical symptoms
  • Men who are physically fit and weigh a generally average amount
  • Men with reasonable aspirations
  • Those who have stabilised their breast development
  • Men who feel that their breasts are excessively enormous

Who is not eligible for the treatment?

Candidates not eligible for gynecomastia surgery include:

  • Individuals in bad health who suffer from a fatal illness or another condition that may interfere with their ability to heal
  • Addicts of any kind, including smokers and drug users
  • Men with obesity
  • Men who do not set reasonable goals

What are the post-treatment guidelines?

To ensure a healthy, quick recovery and to prevent problems, you must adhere to the surgeon's instructions.

  • Diet: Following surgery, patients are advised to start with clear drinks before gradually transitioning to solid foods. The patient needs to eat regularly and consume a lot of water with each meal. To avoid dehydration, add fruit juice and soft drinks. Alcohol must be completely avoided for 72 hours prior to and following surgery. Avoid drinking and smoking.
  • Activities: Your surgery recovery will be better if you get more sleep. It is advised against engaging in any vigorous activities during the first twenty-four hours following surgery, including operating heavy machinery or driving a car. After the second day, you should go for brisk walks to aid in a speedy recovery. It's not necessary for you to stay in bed the entire time.
  • You can drive and engage in moderate activities on the second or third day, but never any strenuous activities like working out in the gym, doing aerobics, running, or swimming. You must gradually and day by day increase your everyday activity level while staying inside your comfort zone. Nevertheless, after two or three days, people typically return to their workplace.
  • Wearing a compression garment is the thing that is most strongly advised throughout the recuperation phase. Wearing it will improve the appearance and help to lessen bruising and swelling. The first week after surgery, the compression garment must be worn continuously.
  • Make the change to 18 hours each day during the second week. To prevent infection, the compression garment's cleanliness and sanitation must be regularly maintained. The garment should be dried after being washed in cold water. You can switch out your compression garment with any comfy clothing after three weeks.
  • Medication: Avoid taking aspirin or ibuprofen throughout the full recuperation period. These run the risk of interfering with the blood clotting system and raising the risk of problems. You might nevertheless take a daily dose of vitamin E or multivitamin tablets.
  • Be careful – You must be extremely cautious when taking medications that have already been prescribed. Within 48 hours or two days after the treatment, you should start them. Three days before to your surgery, you should also stop smoking and drinking alcohol. Such actions will decrease blood flow and begin to cause difficulties.

What are the side effects of Gynecomastia treatments?

Gynecomastia surgery is often highly safe, and most patients experience a smooth recovery. Even though the patient and surgeon take every precaution to ensure their safety, complications can still occur. Common outcomes include asymmetry, bruising, bleeding, fluid collections, irregular shapes, nipple skin loss, noticeable scars, numbness of the nipples, and inverted nipples. Good outcomes depend on careful surgical technique and pre-, peri-, and postoperative therapy.

Gynecomastia - Outlook/Prognosis

Many men are afflicted by the medical condition gynecomastia. Bodybuilders are often impacted as a result of using anabolic steroids. Even though this particular form of gynecomastia is not life threatening, it can nevertheless be extremely upsetting psychologically and emotionally, especially in a sport where appearance is so important.

Surgery is needed to treat fully established clinical gynecomastia in order to remove the glandular and fatty tissues. The majority of patients express satisfaction with the outcomes, and these surgeries have a high success rate.

Despite being uncomfortable and potentially upsetting, the ailment doesn't prevent success in the sport of bodybuilding; many well-known, famous bodybuilders have dealt with it while competing at the top levels in the activity.

Consult a medical expert if gynecomastia is causing you any concern. You can relax knowing that the condition is completely treatable and relatively common.

Frequently Asked Questions (FAQs)

Can gynecomastia go away with exercise?

It is impossible to target a specific location for fat loss. Therefore, cardiovascular workouts to help burn overall body fat and chest exercises to help increase the size of the pectoral muscles are the two main workout types to help minimise the look of gynecomastia.

Can you get gynecomastia again after surgery?

The firm breast tissue will typically not grow back once it has been removed. But there are other things that can cause it to happen again. A recurrence of the illness may occur if the original cause of it was the use of drugs, anabolic steroids, or hormones.

Can I turn over in bed after having gynecomastia surgery?

Sleep on your back and support yourself with pillows. Getting in and out of bed will be simpler as a result. For two weeks after your procedure, refrain from sleeping on your stomach or your side.

What does gynecomastia feel like?

The area of the chest could feel hard or rubbery. Just behind the nipple, the growth could become visible. When touched, the breast or nipple may hurt or be sore.

References

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Written ByDr. Sumit Agrawal MS - General Surgery,MCh - Plastic and Reconstructive Surgery,MBBSCosmetic/Plastic Surgery
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