What is Gynecomastia ? Causes, cure and how to prevent it

Gynecomastia is a medical term used to describe an enlargement or swelling of the breast in men.

It is caused by a variety of reasons mainly hormonal imbalance, imbalances in the level of testosterone, and estrogen. It can occur in one or both breasts. Clinical manifestations include swelling and tenderness of the breast tissues.  

What causes Gynecomastia?

There are many causative factors for gynecomastia but the main reasons include the following:

  • Hormonal changes/hormonal imbalances – Two primary sex hormones control the sexual characteristics of men and women, and these are estrogen and testosterone. The former controls female characteristics while the latter controls male sexual traits. Estrogen, in particular, is the one responsible for the growth of breast in women. Although common in women, a small number of estrogen can also be found in men. If the level of estrogen in men is abnormally high, it could lead to gynecomastia.
  • Infant – gynecomastia is common in male infants because of the effects of the mother’s rise in estrogen levels during pregnancy. As the infant grows, the enlargement of the breast gradually disappears.
  • Puberty – it is also common for boys undergoing puberty to experience enlargement of the breast as a result of hormone imbalances. It usually goes away in just a few months as the hormone stabilizes. 
  • Side effects of medications – Some drugs cause abnormal enlargement of the breast. These include:
  • Anti-androgen drugs – They are used to treat prostate-related problems such as enlargement of the prostate and prostate cancer. Examples of anti-androgen drugs are spironolactone and flutamide.
  • Anti-retroviral drugs – Men receiving anti-retroviral therapy for AIDS usually experience gynecomastia, especially those receiving Efavirenz.
  • Anabolic steroids – These drugs are used by athletes to grow muscles and enhance their overall athletic performance.
  • Anti-anxiety and tricyclic anti-depressants such as diazepam.
  • Other drugs that cause abnormal enlargement of the breast in men are antibiotics, over-the-counter ulcer medications, heart medicines, and drugs used to manage cancer. 
  • Illegal substances – These include excessive intake of alcoholic beverages, marijuana, amphetamines, methadone, and heroin.

Existing medical conditions

Some medical conditions can cause abnormalities in hormone level leading to gynecomastia. These include:

o   Hypogonadism

o   Klinefelter syndrome

o   Tumor in the adrenal glands and testes

o   Hyperthyroidism

o   Cirrhosis

o   Liver failure

o   Kidney failure 

 Other causes

  • Aging – Men who are overweight usually develop gynecomastia as they age.
  • Malnutrition – When the body lacks nutrition, the level of hormone testosterone drops while the estrogen level remains the same, thus, causing hormonal imbalances. 

How to cure gynecomastia?

Gynecomastia does not always require treatment as it usually goes away or lessens with time. for hormonal imbalance reasons, the underlying condition has to be addressed to significantly lessen the enlargement of the breast.

If a certain drug is causing gynecomastia, then you have to inform your doctor about your concerns and your doctor might replace the drug with something that doesn’t cause gynecomastia. Do not stop the medication without consulting your doctor as it may have a dramatic effect on your health. 

If gynecomastia doesn’t improve even after attempting to normalize the levels of hormones in the body, then your doctor might ask you to see an endocrinologist, a doctor specializing in hormone-related problems.

Surgery is not usually performed as most cases improved after achieving a balance of hormones in the body. In some instances, counseling is given, especially to teen boys and young adults as gynecomastia can significantly affect their self-esteem and confidence. 

Some drugs can be used to treat gynecomastia, although sufficient data on their effectiveness are limited. To date, there is no single drug approved by the Food and Drug Administration for the treatment of gynecomastia. Some of the drugs that have been of help for improving gynecomastia are:

  • Clomiphene – it should be taken for at least six months before you will see an improvement in the size of the breast.
  • Testosterone replacement therapy – it is helpful in restoring the level of testosterone, especially in older men. 
  • SERM (Selective Estrogen Receptor Modulator) – Some drugs categorized as SERM can significantly reduce the size of breasts in men with gynecomastia. However, it cannot completely get rid of the breast tissues. 
  • Danazol – It is a synthetic derivative of testosterone. It helps decrease the level of estrogen by inhibiting the secretion of luteinizing hormone and follicle-stimulating hormone – the hormones that instruct the sex organs to produce hormones. 

Can Gynecomastia be prevented? 

There are easy ways to prevent gynecomastia and these include:

  • Avoiding drugs and substances that can cause hormonal imbalance such as androgens, steroids, excessive intake of alcoholic beverages, heroin, amphetamines, and marijuana. 
  • If you are on a medication prescribed by your doctor and you notice a significant change in the size of your breast, you have to consult your doctor right away. Do not stop the medication unless your doctor told you to do so.

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