Articles on Gynecomastia

Gynecomastia itself isn't dangerous, but it's often a sign of severe hormonal imbalance.

Gynecomastia is often called ‘man boobs’ or more discreetly, gyno. It’s the source of anxiety and other psychiatric issues in countless men around the world due to the psychosocial discomfort it causes.

Some men seek medical help for their gynecomastia because they fear the growth may be cancerous. But what exactly is gyno and what treatments are available for it?

Gynecomastia is an abnormal, although benign, enlargement of a man’s breast tissue. Certain factors may affect the usually small and unnoticeable male breasts, causing them to grow.

Gynecomastia is usually caused by hormonal imbalance. More specifically, it's often the result of an increased ratio of estrogens to androgens. This may be due to an increase in estrogen production, decreased androgen synthesis, or both.

In a nutshell, gynecomastia may develop as a result of health issues, excessive exposure to hormone-like substances (estrogens, usually), and just as a normal part of growing up. 70 to 90% of teenage males develop gyno that regresses over 1 to 3 years in most cases.

The most common causes of gynecomastia include:

  • Liver Disease. Patients with liver disease (like cirrhosis) may also show symptoms of gynecomastia due to an increased production of androstenedione in the adrenal glands, along with an increased transformation of this compound into estrogens. A drug called Spironolactone used to treat cirrhosis may worsen the condition.
  • Starvation. Gynecomastia may also be caused by malnourishment because of the decreased production of gonadotropins and testosterone, combined with normal estrogen levels. During refeeding, gonadotropin levels increase which mimics puberty.
  • Hyperthyroidism. Around 10 to 40 percent of males suffering from Grave’s Disease show signs of gynecomastia. This is often due to the stimulation of peripheral aromatase in the fatty tissue (the enzyme that transforms androgens into estrogens) and is usually resolved when hyperthyroidism is cured.
  • Renal Failure. Around half of all male hemodialysis patients have gynecomastia due to an impairment in the function of their Leydig cells. Renal failure also causes hormonal abnormalities.
  • Exposure to harmful substances. Around 25% of gynecomastia cases have been found to be caused by substances with actions that imitate hormones. These include phytoestrogens.
  • Puberty/ This is perhaps the most common cause of gynecomastia, observed in 70 to 90% of teenage males. Fortunately, the condition usually regresses on its own over 1 to 3 years.

Of course, there are other possible causes of gynecomastia, such as:

  • Hypogonadism
  • Hermaphroditism
  • Kennedy’s syndrome
  • Ectopic hCG production
  • Type 1 Diabetes
  • Aromatases excess syndrome
  • Klinefelter's syndrome
  • Stress and aging (low testosterone)

Available gynecomastia treatments include:

  • Aromatase Inhibitors. These drugs block the production of estrogen, decreasing the ratio of estrogens to androgens. Anastrozole is a good example. This drug is very selective and effective in decreasing estrogen levels.
  • Anti-estrogens. The use of anti-estrogens has been gaining popularity in the last years because of their effectiveness in treating gynecomastia compared with other known therapies. Tamoxifen (Tmx) is the most often used drug for gynecomastia treatment because of its sheer potency as an estrogen antagonist.
  • Androgen Therapy. Gynecomastia improvement is usually observed during testosterone replacement therapy (TRT) in patients suffering from hypogonadism. The same treatment, however, is not effective for men without hypogonadism and may even make their gynecomastia worse. Androgens commonly used in this treatment are dehydrotestosterone (DHT) and danazol.
  • Surgical Treatment. This form of treatment should be considered only as a last resort if all other options fail. Surgical treatment of gynecomastio is only recommended for cosmetic problems, suspected malignancy, and long-standing gynecomastia.

Articles about Gynecomastia