Gynecomastia is a condition that affects males and is characterized by abnormal swelling of breast tissue. Usually, there are no physical complications of the condition; however, the emotional and psychological factors can make it difficult or embarrassing for men to deal with. Gynecomastia can occur in adult males, pubescent males and even in newborns. If you have been diagnosed with gynecomastia, a better understanding of the condition will help.
The Facts
The underlying reason for the abnormal swelling is due to an imbalance in hormonal levels (decreased testosterone, increased estrogen). Testosterone is responsible for male characteristics like body hair and muscle mass. While many people assume that estrogen is a female-specific hormone, it is present in smaller quantities in men as well. Estrogen plays a role in mood regulation, sperm production and maintains bone density. A variety of causes which can trigger the condition, like medications, other health conditions and natural hormonal changes. In about a quarter of all cases, the exact cause is not known.
Risk Factors
Medications that can cause gynecomastia include anti-androgens (which are used to treat prostate and other conditions), HIV/AIDS medications, anti-anxiety medications (like diazepam), antibiotics, cimetidine (an ulcer medication), tricyclic antidepressants, chemotherapy and certain heart medications (like calcium channel blockers).
Illicit drugs like steroids, heroin, marijuana, amphetamines and even alcohol can also cause the condition.
Health conditions which affect your hormonal balances may cause swelling of the breasts. This includes hypogonadism, tumors, thyroid conditions, kidney failure, liver failure, cirrhosis, malnutrition and even the normal aging process.
Certain herbs are associated with gynecomastia. Oils like lavender and tea tree have mild estrogenic properties.
Who Is Affected
According to the Mayo Clinic, approximately 50 percent of male babies are born with a form of gynecomastia as a result of their mother's estrogen affecting them. The swelling usually dissipates in two or three weeks after being born.
The hormonal changes that puberty triggers can result in an imbalance and swelling of the breast tissue. This usually does not require treatment and resolves itself in 6 months to 3 years.
Men between the age 50 and age 80 are at the highest risk of developing gynecomastia. According to the Mayo Clinic, approximately 25 percent of men will be affected in this age group.
Treatment
In the majority of cases, gynecomastia goes away on its own. If the condition is caused by another health problem (like cirrhosis, malnutrition or hypogonadism), the underlying problem will require treatment. If your gynecomastia is caused by medication, your doctor may be able to switch you to a different drug. Adolescent gynecomastia usually resolves on its own. If it does not it may require treatment.
According to the Mayo Clinic, tamoxifen and raloxifene (medications used to treat breast cancer) have been helpful for some gynecomastia patients.
Surgery
If the problem does not resolve or proves to have a significant emotional impact, surgery may be an option. Two types of surgical procedures are available. The first, mastectomy, removes the glandular breast tissue and is performed endoscopically. The other surgical alternative, liposuction, eliminates fat in the breast but leaves tissue intact.
Psychological Impact
The psychological ramifications of gynecomastia can range from feelings of embarrassment, humiliation and shame to feeling emasculated, powerless and filled with self-hate. Many men choose surgery to remove the physical manifestation of the condition; however, counseling may be necessary to resolve any negative feelings or distress.
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