Gynaecomastia is the scientific name for abnormally enlarged breasts in a man. Also known by less flattering names such as “male breasts”, “man boobs” and “moobs”. Aside from being aesthetically disturbing to some, they can also be signs of underlying medical problem most commonly hormone imbalances.
What is Gynaecomastia? Is it just because I am fat?
Gynaecomastia is abnormally enlarged breasts in men. To be more technically accurate, it is the glandular part of the breast that is enlarged. For most people living with obesity, the fat tissue (not the glands) is enlarged. This can look a lot like Gynaecomastia but is actually Lipomastia (also sometimes called Pseudo-Gynaecomastia). Lipomastia usually resolves with weight loss. However, obesity can also lead to true Gynaecomastia. Click here for our article on healthy weight loss.
In this article we will focus our discussion on Gynaecomastia.
How do I tell if I have Gynaecomastia?
Look at yourself in the mirror. Have your breasts gotten larger or the nipple increased in area? Sometimes this is difficult to tell and is subjective.
Next lie down with one arm behind your head. Use the index and thumb of the other hand to squeeze the breast. Can you feel a rubbery firm mass that extends out from the nipple? If you can then you should have Gynaecomastia. If in doubt, please consult a Doctor.
What causes Gynaecomastia?
Gynaecomastia results from an imbalance between the male and female hormones in your body. Too much female hormone (Estrogen) and/or too little male hormone (Testosterone) can result in Gynaecomastia.
This happens naturally in some periods of life. For example during puberty and also as age advances and the male hormone level drops. Click here for our article on Testosterone.
Obesity can also lead to Gynaecomastia because fatty tissue increases the amount of female hormones in the body.
Gynaecomastia can also be a side effect of hormonal treatment or other medicines. These treatments are given for a variety of reasons. In fact, there is a long list of medicines that include Gynaecomastia as a side effect. These include medicines for blood pressure, antifungals as well as medicines to treat stomach acidity and many more.
Rarely, Gynaecomastia can be due to more serious medical issues like tumours, cancers, thyroid problems or even malnutrition.
Of course, there are cases that Doctors just do not know what the cause is and we term these “idiopathic”.
Is there a test for Gynaecomastia?
Most Doctors would diagnosed gynaecomastia from a physical examination and no testing is necessary. Tests are most often required to exclude other medical illnesses or diseases that can lead to Gynaecomastia.
That said, sometimes Doctors would ask for a CT scan which can image the breast tissue in the chest. If the Gynaecomastia is big enough and there are abnormal lumps felt, Doctors may even ask for a mammogram.
What should I do about Gynaecomastia?
First of all see your Doctor and determine if you truly have Gynaecomastia or not. Perhaps what you have is Lipomastia. Next, your Doctor will try to determine the cause of your Gynaecomastia. It is very important to determine if there is a more serious underlying medical problem or not.
Once any underlying issues have been excluded or resolved, your Doctor can then recommend specific treatments for Gynaecomastia.
How do I treat my Gynaecomastia?
If an underlying cause can be determined, that should be dealt with first.
After examining you, your Doctor will be able to tell you if the Gynaecomastia has a good chance of going away on its own or not. For most patients the Gynaecomastia will resolve on its own. However this can take several weeks to 3 years!
For others, Doctors may choose to prescribe medicines. There are also factors to determine if the medicines will work or not.
One important factor is how long the Gynaecomastia has been there for. The earlier you get it treated, the more likely tablets will work and less likely you will require surgery. So please see your Doctor as soon as you notice a problem
What medicines can I use to treat Gynaecomastia?
I will say this again like a broken record – first treat the underlying cause.
There are several tablets that can be used to treat Gynaecomastia. They work by blocking the effect of female hormones on the breasts. Please note that not all Estrogen lowering or blocking medicines are the same. Some block breast effects more than others. While others block Estrogen effects at other organs like the bones and brain which can lead to unwanted side effects and worse, does not even treat the Gynaecomastia. Please do consult a Doctor familiar with such medicines.
For some patients, Doctors will prescribe medicines to increase the male hormones. Because a higher level of male hormones can block the effect of Estrogen. Click here for our article on Testosterone treatment.
Medications are usually given for 3 to 6 months in order to see effect. Up to 80% of patients will experience partial or complete resolution of their Gynaecomastia with tablets alone.
Do I need surgery for Gynaecomastia?
Surgery is considered when tablets do not solve the problem. Or when the Gynaecomastia is causing significant cosmetic and mental health stress and needs to be dealt with quickly.
In summary
Gynaecomastia is an abnormal enlargement of the breast in men. There are many causes some benign and some more serious.
Treating Gynaecomastia starts with finding out the cause. Specific treatments include medicines and surgery.
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