H O R M O N E

Gynecomastia – a condition rarely addressed

Have you been wearing a larger sized shirt/ t-shirt for most of the time?

Even when the sales assistant recommends your correct size, you fear that the shirt will stick to your chest and make your breasts seem larger than normal. Unfortunately, millions of men go through this embarrassment and insecurity every day, not realizing that this can be a medical condition – Gynecomastia.

Gynecomastiais a condition with enlarged or overdeveloped breasts in men. It is a medical condition rather than an aesthetic problem. Gynecomastia can cause emotional discomfort and can really crush a man’s self-confidence. Some may even avoid being intimate or certain physical activities in order to hide their condition.

How can one develop with gynecomastia?

There is no such a single culprit found for this condition. A number of factors can lead to gynecomastia. It may occur at any age and the condition can be a result of hormonal changes, heredity, obesity, use of certain drugs like steroids, or even some health problems like kidney and liver disorders, overactive thyroids, etc. Imbalance between the sex hormones estrogen and testosterone is considered as the most common cause for this condition. Elevated level of female sex hormone (estrogen) in men leads to gynecomastia.

How do I know if I have the gynecomastia?

The primary symptom of gynecomastia is enlargement of the male breasts which can be diagnosed by a physical examination. It feels like a small, rubbery lump in your breasts, or directly under the nipple(s) area. It may develop in one or both breasts. The size of the lump may vary and may not be same in both breasts. Overweight and obese men can get confuse the condition with ordinary fat tissue, for which you can go for expert opinion.

A careful medical history is also important including the medication and drug use. Further laboratory tests may be recommended to examine liver, kidney, and thyroid function. Measurement of hormone levels in the bloodstream may also be recommended depending on the severity.

Does this condition have any serious consequences?

Generally, gynecomastia isn’t a serious medical condition. But it can be an underlying cause of other conditions which may lead to infertility. Individuals with gynecomastia have a five-fold greater risk for developing male breast cancer compared to healthy men; however, gynecomastia is not an independent risk factor of breast cancer.

Gynecomastia mostly takes a toll on a boy’s or a man’s mental health; coping with such issues becomes a difficult task. Anything that makes them you look different can have a dampening effect on their self-esteem and confidence. Worst of all, this condition cannot be resolved with workouts or change in diet patterns.

Who gets gynecomastia?

Newborns, boys going through puberty and older men may develop gynecomastia as a result of abnormal changes in hormone levels, though other causes also exist. Normally, pubertal males may be at higher risk for gynecomastia as their body is in the transition stage of developmental process.

What are my chances of getting gynecomastia?

You have a high risk of developing the condition when you are in your adolescent age. Other risk factors that may increase your chances include:

  • Old age may promote decrease in testosterone production

  • Excessive fat in the body stimulates the body's production of estrogen

  • Use of anabolic steroids or androgens

  • Certain health conditions, including liver and kidney disease, thyroid disease, hormonally active tumors, and Klinefelter syndrome(genetically inherited)

  • High estrogen levels in the womb

  • Excessive alcohol use, which decreases testosterone production and rises estrogen levels

Drug induced gynecomastia is a common complication of patients undergoing hormonal treatment for prostate cancer as those medicines will prevent the production or block the action of testosterone.

Can gynecomastia be treated?

Pubertal gynecomastia normally resolves without any treatment, but it may take some time. Medications are more effective in reducing gynecomastia in the early stages, but when the tissue has become scarred, medications will not be effective and surgical removal is the only possible treatment. Getting to a healthy weight is important before considering surgery.

What should I do if I have gynecomastia?

Instead of feeling awkward and embarrassed, think for the ways by which you can tackle the condition.

  • Maintain a healthy body weight as obesity will worsen your condition as well as your external appearance.

  • Try weight-lifting exercises to develop the muscles in your arms, back, and chest, as it may help balance the shape of your upper body.

  • Wear layers or a thick t-shirt under your normal clothes. Sweatshirts can be a good option.

  • Keep a t-shirt on when you swim, prefer the ones with logo across the chest.

What is lipomastia? How is it different from gynecomastia?

Lipomastia, also called pseudogynecomastia, is a condition in which the male breasts become enlarged due to excess deposition of fat (adipose tissue) in the breasts. The main difference between the two is that lipomastia is due to excess fat deposition and gynecomastia is due to excessive glandular tissue in the breasts.