Gynecomastia - Symptoms, Risk factors and Treatment

Gynecomastia, or enlarged boobs in men, is a condition that occurs due to abnormal levels of hormones- estrogen and testosterone. It can affect both breasts or one only, occurring in young boys or male adults. Mostly it goes away on its own. But sometimes, it may need surgery for correction. Although it is not a serious condition, but men and boys having it may feel pain in their breasts tissue and may also feel embarrassed.


Signs and symptoms


The signs and symptoms of gynecomastia are:


  • Tender breasts

  • Swelling of breasts tissues


Causes 


Gynecomastia generally occurs when testosterone levels fall below as compared to estrogen. It can happen if a person has a condition or is taking medication that blocks the effect of testosterone. Various things can upset the hormonal levels in your body. It can occur due to reasons like:


Natural hormonal changes


In men, testosterone is responsible for controlling male traits like hair growth and muscle mass. Whereas, estrogen regulates female characteristics like breast enlargement. Therefore if estrogen levels in men are higher than testosterone levels, it results in breast enlargement.


It is often misconstrued that estrogen is an exclusively female hormone. However, this is not the case. Estrogen is present in males but in very minute quantities as compared to females. Therefore their imbalance can occur, resulting in gynecomastia.


At the time of birth


Almost half of the boys are born with swollen breasts due to high levels of their mother's estrogen. By that time it may decline, and the tissues may return to normal in two to three weeks.


During puberty


During puberty, breasts may enlarge due to increased levels of estrogen. It may get better in 6 months to 2 years on its own.


In adulthood


Gynecomastia may occur in male adults aged between 50 to 69. Around 1 in 4 men get affected by it in their adulthood.


Medications 


Various medications can cause gynecomastia. They can be enlisted as;


Aldosterone Antagonists


  • Eplerenone 

  • Spironolactone


Antipsychotics


Typical or First Generation


  • Chlorpromazine 

  • Fluphenazine 

  • Haloperidol 

  • Perphenazine 

  • Thioridazine 

  • Trifluoperazine 


Atypical or Second Generation


  • Aripiprazole 

  • Asenapine sublingual tablets

  • Clozapine 

  • Finasteride 

  • Iloperidone 

  • Olanzapine 

  • Paliperidone 

  • Quetiapine 

  • Ziprasidone 


Other drugs


  • Cimetidine

  • Digoxin 

  • Efavirenz

  • Estrogen use

  • Alcohol

  • Ketoconazole 

  • Methadone


Other Health Conditions

Some health conditions can also cause gynecomastia like;


  • Hypogonadism

  • Tumors of the testes, adrenal gland, and pituitary gland

  • Kidney failure

  • Hyperthyroidism 

  • Liver failure

  • Liver cirrhosis

  • Starvation 

  • Malnutrition


Herbal Products 


Using herbal products that contain tea tree oil can also cause enlarged breasts in men. To prevent it, avoid using products that contain it. 


Risk Factors


The risk factors for gynecomastia can be;


  • Older age

  • Entering into adolescence

  • Using androgens or anabolic steroids to boost athletic performance


Having health conditions like;


  • liver and kidney disease

  • thyroid disease

  • hormonally active tumors

  • Klinefelter syndrome


Prevention 


To prevent gynecomastia, the following tips may help.


Do not use drugs like amphetamines, anabolic steroids, and androgens for any purpose. 


Keep an eye on your medications, especially the ones you are taking for the long term. If you are taking a drug that causes gynecomastia, talk to your healthcare provider for its substitution. 


Avoid drinking alcohol. If you drink, do that in moderation. 


Conclusion 


Gynecomastia is a condition in which the breasts of men get enlarged. It is not a serious condition but it may cause emotional disturbance as the self-confidence of the person is affected. If it occurs due to hormonal imbalance, your healthcare provider may prescribe hormone therapy to correct it.


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