Gynecomastia is swelling of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly. Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.
Generally, gynecomastia isn't a serious problem, but it can be tough to
cope with. Men and boys with gynecomastia sometimes have pain in their
breasts and may feel embarrassed.
Gynecomastia may go away on its own. If it persists, medication or surgery may help.
Gynecomastia is triggered by a decrease in the amount of the hormone
testosterone compared with estrogen. The cause of this decrease can be
conditions that block the effects of or reduce testosterone or a
condition that increases your estrogen level. Several things can upset
the hormone balance, including the following.
Natural hormone changes
The hormones testosterone and estrogen control the development and
maintenance of sex characteristics in both men and women. Testosterone
controls male traits, such as muscle mass and body hair. Estrogen
controls female traits, including the growth of breasts.
people think of estrogen as an exclusively female hormone, but men also
produce it — though normally in small quantities. But male estrogen
levels that are too high or are out of balance with testosterone levels
can cause gynecomastia.
Gynecomastia in infants. More than half
of male infants are born with enlarged breasts due to the effects of
their mother's estrogen. Generally, the swollen breast tissue goes away
within two to three weeks after birth.
Gynecomastia during puberty.
Gynecomastia caused by hormone changes during puberty is relatively
common. In most cases, the swollen breast tissue will go away without
treatment within six months to two years.
Gynecomastia in men. The
prevalence of gynecomastia peaks again between the ages of 50 and 80. At
least one in four men are affected during this time.
A number of medications can cause gynecomastia. These include:
Anti-androgens used to treat prostate enlargement or cancer and some
other conditions. Examples include flutamide, finasteride (Proscar) and
Anabolic steroids and androgens.
AIDS medications. Gynecomastia can develop in HIV-positive men who are
receiving a treatment regimen called highly active antiretroviral
therapy (HAART). Efavirenz (Sustiva) is more commonly associated with
gynecomastia than are other HIV medications.
Anti-anxiety medications, such as diazepam (Valium).
Ulcer medications, such as cimetidine.
Cancer treatment (chemotherapy).
Heart medications, such as digoxin (Lanoxin) and calcium channel blockers.
Street drugs and alcohol
Substances that can cause gynecomastia include:
Several health conditions can cause gynecomastia by affecting the normal balance of hormones. These include:
Hypogonadism. Any of the conditions that interfere with normal
testosterone production, such as Klinefelter syndrome or pituitary
insufficiency, can be associated with gynecomastia.
Aging. Hormone changes that occur with normal aging can cause gynecomastia, 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
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
Malnutrition and starvation. When your body is
deprived of adequate nutrition, testosterone levels drop, but estrogen
levels remain constant, causing a hormonal imbalance. Gynecomastia can
also occur once normal nutrition resumes.
oils, such as tea tree or lavender, used in shampoos, soaps or lotions
have been associated with gynecomastia. This is probably due to their
weak estrogenic activity.