Symptoms, Causes, and Treatments of Gynecomastia

Gynecomastia may affect the breast tissue on one or both sides of the chest, and not always evenly. In addition to swelling, breast tissue may be tender or painful and the areola, the pigmented skin surrounding the nipple, may increase in size. Boys and men with persistent swelling, pain or tenderness through the chest, or nipple discharge, should see a doctor.

Gynecomastia occurs when testosterone decreases and estrogen increases. These two hormones are responsible for the development and maintenance of sex characteristics in men and women. Testosterone is responsible for the "male" traits of body hair and muscle mass while estrogen is responsible for "female" traits, such as breast growth. Though many people think that men do not have estrogen, they do produce small quantities naturally. More than half of male infants who develop gynecomastia do so because of their mothers' estrogen. Swollen breast tissue typically goes away within two to three weeks. Gynecomastia is also common when boys go through puberty. Swollen tissue typically resolves on its own within six months to two years. One in four men develops gynecomastia between the ages of 50 and 69.

Anti-androgens, medications for treating prostate cancer, prostate enlargement, and similar conditions, can result in gynecomastia. HIV-positive men receiving the treatment regimen highly active antiretroviral therapy (HAART) may also develop swollen chest tissue. Other medications that may cause gynecomastia include antibiotics, chemotherapy, androgens, and anabolic steroids, tricyclic antidepressants, anti-anxiety medications, gastric motility medications, ulcer drugs, and heart medications.

Several medical conditions can upset the normal balance of hormones in the male body, which can lead to gynecomastia. Pituitary insufficiency and Klinefelter's syndrome are associated with breast swelling, as these conditions interfere with normal testosterone production. Liver problems and medications that treat cirrhosis can also lead to the hormonal condition. Tumors of the pituitary gland, adrenal glands, or testes can alter normal hormone balance. Approximately half of the men undergoing hemodialysis for kidney disease develop gynecomastia due to hormonal changes. Hyperthyroidism and malnutrition can also cause hormonal imbalances.

Some essential oils, such as lavender and tea tree oil, have weak estrogenic activity, which can result in gynecomastia. These oils are common ingredients in shampoos, lotions, and soaps. Certain street drugs and alcohol can also cause breast breast tissue to swell.

A doctor makes a diagnosis of gynecomastia based upon an individual's medical and family history and a physical examination. Mammograms and blood tests can also help determine the cause. Other tests, such as computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans, tissue biopsies, and testicular ultrasounds may also facilitate diagnoses.

Gynecomastia typically subsides on its own. However, some medications may help with the condition if it persists. Specifically, some medications that treat breast cancer can help men with gynecomastia. Though these medications are approved by the United States Food and Drug Administration for their intended use, they are not specifically approved for the treatment of gynecomastia.

If gynecomastia continues to be bothersome despite treatment, a doctor may recommend surgery. There are two surgical procedures for gynecomastia. In liposuction, breast fat is removed, but the surgeon leaves the breast gland tissue intact. In a mastectomy, the surgeon removes the breast gland tissue. This is often done endoscopically, and people tend to recover from this less invasive surgery more quickly.

Men cannot control all the factors that may lead to gynecomastia, but some actions could prevent swollen breast tissue. Avoiding illegal drugs and keeping alcoholic beverages to a minimum can help. Men who are taking medications known to cause swollen breast tissue can ask their physicians for alternatives.

Gynecomastia can be a stressful experience. It can be challenging to hide, and younger men and boys may get teased for having enlarged "breasts." Talk therapy with a counselor can help individuals cope with their feelings and decrease the anxiety and depression associated with gynecomastia. Talking to supportive family members and friends can also lessen stress. Boys and men with gynecomastia can also seek support from others who are going through the same experience through online gynecomastia forums.