Gynecomastia is swelling of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly. Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.
Generally, gynecomastia isn't a serious problem, but it can be tough to cope with the condition. Men and boys with gynecomastia sometimes have pain in their breasts and may feel embarrassed.
Gynecomastia may go away on its own. If it persists, medication or surgery may help.
Your doctor will ask you questions about your medical and drug history and what health conditions run in your family. The doctor will also do a physical examination that may include careful evaluation of your breast tissue, abdomen and genitals.
Initial tests to determine the cause of your gynecomastia may include:
You may need further testing depending on your initial test results, including:
Computerized tomography (CT) scans
Magnetic resonance imaging (MRI) scans
Conditions that cause similar symptoms
Your doctor will want to be sure your breast swelling is actually gynecomastia and not another condition. Other conditions that can cause similar symptoms include:
Fatty breast tissue. Some men and boys have chest fat that resembles gynecomastia. This is called false gynecomastia (pseudogynecomastia), and it isn't the same as gynecomastia.
Breast cancer. This is uncommon in men, but can occur. Enlargement of one breast or the presence of a firm nodule raises the concern for male breast cancer.
A breast abscess (mastitis). This is an infection of the breast tissue.
Most cases of gynecomastia regress over time without treatment. However, if gynecomastia is caused by an underlying condition, such as hypogonadism, malnutrition or cirrhosis, that condition may need treatment. If you're taking medications that can cause gynecomastia, your doctor may recommend stopping them or substituting another medication.
In adolescents with no apparent cause of gynecomastia, the doctor may recommend periodic re-evaluations every three to six months to see if the condition improves on its own. Gynecomastia often goes away without treatment in less than two years. However, treatment may be necessary if gynecomastia doesn't improve on its own or if it causes significant pain, tenderness or embarrassment.
Medications used to treat breast cancer and other conditions, such as tamoxifen (Soltamox) and raloxifene (Evista), may be helpful for some men with gynecomastia. Although these medications are approved by the Food and Drug Administration, they have not been approved specifically for this use.
Surgery to remove excess breast tissue
If you still have significant bothersome breast enlargement despite initial treatment or observation, your doctor may advise surgery. Two gynecomastia surgery options are:
Liposuction. This surgery removes breast fat, but not the breast gland tissue itself.
Mastectomy. This type of surgery removes the breast gland tissue. The surgery is often done endoscopically, meaning only small incisions are used. This less invasive type of surgery involves less recovery time.
For a man, enlarged breasts can be stressful and embarrassing. Gynecomastia can be difficult to hide and a challenge to romantic relationships. During puberty, gynecomastia can make boys a target for teasing from peers. It can make activities such as swimming or changing in the locker room traumatic.
Whatever your age, you may feel like your body has betrayed you and you may feel unhappy with yourself. These feelings are normal, but to help you cope you can:
Get counseling. Talk therapy can help you avoid anxiety and depression caused by gynecomastia. It can also help you communicate with your partner or family members so that they understand what you're going through.
Reach out to your family and friends. You may feel embarrassed to talk about gynecomastia with the people you care about. But explaining your situation and asking for help will likely strengthen your relationships and reduce stress.
Connect with others who have gynecomastia. Talking with men who have had a similar experience can help you cope. Websites such as Gynecomastia.org provide a forum for connecting with others who have the condition.