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Last Updated: Dec 20, 2019
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What Is Gynecomastia?

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Dr. Anoop Kumar SonkerSexologist • 14 Years Exp.BHMS
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Gynecomastia or'woman-like breasts.

It is a benign enlargement of the male breast resulting from a proliferation of the glandular component of the breast.

Gynecomastia is defined clinically by the presence of a rubbery or firm mass extending concentrically from the nipples. The condition known as pseudogynecomastia, or lipomastia, is characterized by fat deposition without glandular proliferation. Although it is usually bilateral, it can be unilateral.

It is an abnormal development of mammary glands in males resulting in breast enlargement. It is not normal for men to have breasts and this makes this condition very embarrassing and may causes low self-esteem especially in teenagers.

It is very common in adolescents. It occurs due to hormonal imbalance in the male body between the age of 12- 18 when estrogen is sometim

Causes

  • A number of researchers believe that in many cases an altered androgen / estrogen ratio causes changes in cellular elements in breast tissue. This could be due to:
  • Decrease in production of androgen
  • Increase in estrogen formation
  • Decrease in sensitivity of breast tissue to androgens
  • Physiological during infancy and at puberty: gynecomastia can occur physiologically in neonates (due to female hormones from the mother) and sometimes at puberty.
  • Refeeding: recovery from wasting diseases.

Testicular causes

  • Testicular agenesis: failure of testes to develop.
  • Orchitis: inflammation of testes.
  • Tumor of testes.
  • Klinefelter’s syndrome.
  • Imbalance of sex hormone: imbalance of estrogenic and androgenic hormones causes gynecomastia.

Drugs: digitalis, spironolactone, phenothiazine and so on. Approximately 4-10% cases are due to drugs. Spironolactone is a common cause, inducing gynecomastia in 10% of those receiving it as a treatment for heart failure. Digoxin and furosemide are also reported to cause gynecomastia.

Certain medications can promote breast growth. They interact with the natural levels of testosterone and estrogen, and upset the balance in some manner. Gynecomastia is a common consequence of estrogen treatment in patients with prostate cancer.

Drugs that may cause it include:

  • Hormones (androgens, anabolic steroids, estrogen agonists)
  • Antiandrogens or androgen-synthesis inhibitors
  • Antibiotics (isoniazid, ketoconazole, metronidazole)
  • Anti-ulcer medications such as cimetidine
  • Cancer chemotherapeutics, especially alkylating agents
  • Cardiovascular drugs, such as captopril and digitoxin
  • Psychoactive agents, such as diazepam and tricyclic antidepressants
  • Recreational drugs, such as alcohol and marijuana

Penicillamine

Alcohol and drugs can cause gynecomastia by mimicking estrogen and stimulating androgen production. Steroids and other excess androgens are sometimes converted by the body into estrogens and consequently cause male breast problems.

Men over the age of 50 tend to produce fewer androgens such as testosterone or gain fat tissue that converts androgen into estrogen. In 3 percent of reported cases, gynecomastia can signal lung, liver, or adrenal cancer. Tumors can secrete estrogen, upsetting the hormonal balance.

  • Breast prominence due to excessive adipose is often termed pseudogynecomastia or lipomastia.
  • Cirrhosis of liver, rheumatoid arthritis, leprosy is associated with it.
  • Any of the conditions that interfere with normal testosterone production, such as klinefelter’s syndrome or pituitary insufficiency, can be associated with gynecomastia.
  • Aging: hormone changes that occur with normal aging can cause it, especially in men who are overweight.
  • Tumors: some tumors, such as those involving the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.
  • Hyperthyroidism: in this condition, the thyroid gland produces too much of the hormone thyroxine.
  • Kidney failure: about half the people being treated with regular hemodialysis experience gynecomastia due to hormonal changes.
  • Liver failure and cirrhosis: hormonal fluctuations related to liver problems as well as medications taken for cirrhosis are associated with it.
  • Malnutrition and starvation: when the human body is deprived of adequate nutrition, testosterone levels drop, but estrogen levels remain constant, causing a hormonal imbalance.

Gynecomastia in bodybuilders

Some bodybuilders who abuse steroids develop it. It is often hidden behind the well developed chest muscles, but in later life, when the athlete becomes less active and the muscles become less prominent, the gynecomastia effects show up.

Signs And symptoms

  • Enlargement of breast
  • Pain in breast
  • Tenderness
  • Severe embarrassment or
  • Emotional disturbance

Classification

Puffy nipples is among the most common forms of gynecomastia. This glandular tissue accumulation is concentrated under and typically confined to the areola, or can be slightly extended outside the areola forming a dome shaped appearance to the areola.

Pure glandular gynecomastia is common in bodybuilders and is thought to be a result of the use of anabolic steroids. In this case it is known as anabolic-androgenic steroid (aas) induced gynecomastia. Due to excess testosterone levels from steroids, which is converted to estrogen, bodybuilders and other athletes are sometimes afflicted with gynecomastia in its purest form. Gynecomastia in lean men is usually only a breast tissue gland with little to no adipose tissue.

Congenital or hereditary gynecomastia is typically evident by the ages of 12 to 18 in boys. Thirty percent to sixty percent of young boys suffer from large male breasts. As many as thirty percent may live with enlarged male breasts for the rest of their lives, but in other cases it will recede with age. However, severe forms of adolescent gynecomastia may require an intervention, in consultation with the patient, the parents, and child development professionals.

Pseudogynecomastia is typical of enlarged diameter and or excessive areola projection. However, it is not composed of glandular tissue, but of adipose tissue. It looks much like typical gynecomastia but requires different treatment. Exercise and diet may be effective in combating pseudogynecomastia.

Unilateral / asymmetrical gynecomastia occurs when only one breast is larger due to gynecomastia, the other breast is typically normal in both size and shape. Bilateral asymmetry occurs when it is present in both breasts.

Diet

Green tea can effectively tone down your breast. According to recent studies, people who took green tea on a daily basis tend to burn more chest fat faster than who didn’t drink it.

Flax oil is a very effective appetite suppressant; means it makes you feel satiated. As a result you consume less food and there will be less deposition of fat on your body.

Stop taking all recreational drugs, such as marijuana.

Stop taking all nutritional supplements or any drugs you are taking for bodybuilding.

Exercise

Gynecomastia is a problem affecting more men in society today. There are several causes of man boobs which could include hormonal imbalance and excess body fat. In addition, medical studies have shown that breast enlargement can be due to certain health issues or medical drugs. Diet and exercise along with homeopathy is one way to treat gynecomastia and in most cases are excellent alternatives to surgery.

If you have gynecomastia or man boobs, then it means that you have chest fat. Some people think that surgery is the only cure for the problem, but there are a couple of great chest exercises for gynecomastia. Most likely, the fat will be on your lower chest, so it is best to perform a chest exercise that will target your upper chest.

An exercise recommend for this is the incline bench press exercise. In this exercise, you need an incline weight bench. Most flat benches can be made to incline in case you didn’t know. To perform the exercise, you should lie on the incline bench and raise the weight bar vertically towards the ceiling. To complete one repetition, lower the weight to your upper chest and then raise it again. Try to complete 6 to 8 repetitions with each set, and try to perform 3 sets whenever you do the exercise. You should also adjust the weight such that 6 to 8 repetitions are achievable in each set.

A modification of this exercise is the incline dumbbell press in which dumbbells are used instead of a weight bar. Dumbbells have the advantage of allowing you to work each side of your body independently. When we use weight bars, our body’s stronger side tends to do more work while the other side gets shortchanged.

A treatment doesn’t get any more natural than this. Performing these exercises a couple times per week will have the effect of making your gynecomastia decrease over time along with homeopathy remedies.

Prognosis

Gynecomastia is not physically harmful, but in some cases can be an indicator of other more serious underlying conditions, such as testicular cancer.

Growing glandular tissue, typically from some form of hormonal stimulation, is often tender or painful.

Furthermore, it can frequently present social and psychological difficulties for the sufferer.

Weight loss can alter the condition in cases where it is triggered by obesity, but losing weight will not reduce the glandular component and patients cannot target areas for weight loss. Massive weight loss can result in sagging tissues about the chest, chest ptosis

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