Articles on Gynecomastia

Gynecomastia does not pose any real danger to male health, but could be sign of hormonal imbalance and cause psychiatric concerns.

Gynecomastia has been called ‘man boobs’ or more discreetly, gyno. It’s also the source of anxiety countless men since it causes psychosocial discomfort.

Some even seek medical attention because of fear that the growth may be cancerous. But what is it really and what are the treatments available for those afflicted by it?

Gynecomastia is the abnormal, although benign, enlargement of a man’s breast tissue. Certain factors may affect the normally small and unnoticeable male breast tissue, causing it to enlarge.

Gynecomastia is usually due to hormonal imbalance, or an increased ratio of estrogen to androgen. This can be caused by increased estrogen production, decreased androgen secretion, or both.

Gynecomastia may develop as a result of the presence of disease, exposure to hormone-like substances, and normal developmental processes.

  • Liver Disease - Patients with liver disease (like cirrhosis) may also show symptoms of gynecomastia due to the increased production of androstenedione from the adrenal glands. A drug called Spironolactone used to treat cirrhosis may worsen the condition.
  • Starvation - Gynecomastia may also be caused by malnourishment because of the decreased T levels and gonadotropin, combined with normal estrogen levels. During refeeding, gonadotropin levels increase which mimics puberty.
  • Hyperthyroidism - Around 10 to 40 percent of males afflicted with Grave’s Disease show signs of gynecomastia. This is often due to the stimulated peripheral aromatase and is usually resolved when hyperthyroidism is cured.
  • Renal Failure - Around half of hemodialysis patients can have gynecomastia mainly due to dysfunctional Leydig cells. Renal failure also causes hormonal abnormalities.
  • Exposure - 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, and that’s why it’s often observed in teenage males. Fortunately, the condition usually regresses as puberty progresses.

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)

Here are some treatments available to those with gynecomastia:

  • Aromatase Inhibitors - These drugs block the synthesis of estrogen, decreasing the ratio of estrogen to androgen. Anastrozole is one such drug and is very selective and potent in decreasing estrogen concentration.
  • Anti-estrogens - The use of anti-estrogens has been increasing over the recent years because of its efficacy on treating gynecomastia compared with other known therapies. Tamoxifen (Tmx) is the most commonly used drug for gynecomastia treatment because of its sheer potency as an estrogen antagonist.
  • Androgen Therapy - Gynecomastia improvement is usually observed during testosterone replacement for patients suffering from hypogonadism. The same treatment, however, is not effective for men with healthy gonads and may even worsen gynecomastia. Androgens commonly used in the treatment are dehydrotestosterone (DHT) and danazole.
  • Surgical Procedure - This should only be the last resort if all other options have failed and is only recommended for cosmetic problems, suspected malignancy, and long-standing gynecomastia.

Articles about Gynecomastia