Why does gynecomastia occur?
Gynecomastia, or breast growth in men, mostly results from a mix of two main sex hormones: testosterone and oestrogen. Men mostly produce testosterone, but they also produce small amounts of estrogen, the female sex hormone. This estrogen has a role in various bodily functions, including the regulation of breast tissue growth.
In healthy males, testosterone levels are much higher than oestrogen, which helps to keep breast tissue growth in check. But if the balance changes and estrogen levels go up, gynecomastia can develop. This can make the breast swell because the tissue there grows.
Puberty, getting older, taking certain medications, or having other health problems can cause it. During puberty hormone levels go up and down, and this can lead to temporary gynecomastia in teenage boys. Luteinizing hormone (LH) plays an important role in controlling the production of testosterone in the body. When LH levels are imbalanced, it can indirectly cause breast enlargement.
As men get older, testosterone levels naturally go down, which can make estrogen more active and lead to gynecomastia. Obesity can also disrupt the hormonal balance by increasing aromatase activity. In short, when estrogen becomes more dominant than testosterone, it can trigger the growth of breast tissue. This causes the typical swelling of the male breast that occurs in gynecomastia.
Impact of Tea Tree Oil on Hormonal Balance
Common causes of gynecomastia
1) Hormonal imbalance and changes
- During puberty (30-60% of boys affected, often temporarily)
- In old age (testosterone levels drop, up to 65% of men affected)
- In newborns (because of maternal estrogen, usually temporarily)
2) Medications and substances
- Anabolic steroids and testosterone replacement therapies
- Some anti-depressants and anti-psychotics for mental health
- Blood pressure lowering drugs, stomach medications (e.g. omeprazole)
- Drugs such as cannabis, heroin, alcohol
3) Diseases
- Liver diseases (e.g. cirrhosis of the liver, impaired hormone breakdown)
- Kidney diseases (medical conditions with hormonal dysregulation)
- Problems with the thyroid (too much or too little thyroid hormones)
- Hormone-producing tumors (e.g. prostate cancer or breast cancer)
4) Obesity
5) Klinefelter syndrome (KS)
Difference between gynecomastia and pseudogynecomastia
Feature | Gynecomastia | Pseudogynecomastia |
|---|---|---|
Cause | Increase in glandular tissue because of hormonal changes | Increase in fatty tissue, because of excess weight |
Hormonal involvement | Yes, caused by an imbalance of testosterone and estrogen | No, caused by fat deposits |
Palpation findings | Firm, gland-like lump palpable behind the nipple | Soft, even fatty tissue without firm lumps |
Frequency of gynecomastia
- Newborns: Around 60-90% have enlarged breasts. This is because of the mother’s female hormones and disappears within a few months.
- Puberty: During puberty, around 30-60% of boys develop cases of gynecomastia. The American society of plastic surgeons says, that hormonal fluctuations are the cause.
- Adult men: Around 20-30% of men between the ages of 20 and 50 are affected. It is often because of certain medication or illness.
- Older men: It becomes more common again after men age of 50. Up to 65% of men have it, often because of an age-related decline in testosterone levels.
Treatment options for gynecomastia
Treatment options for breast enlargement in males vary depending on how bad it is, amd what causes it. In adolescents and newborns the condition gets better on its own without the need to treat gynecomastia. During puberty, changes in hormones often lead to temporary breast tissue enlargement, which typically shrinks as hormone levels stabilise.
If you are a bit overweight, losing a little weight by eating healthily and exercising more can make your breasts smaller. This is because excess fat tissue can make breasts look bigger, and losing weight can reduce fat, which can help with the condition. If gynecomastia is because of medication, hormone therapy, or other medical conditions, it’s important to treat the underlying cause.
In addition, if the cause is medication, like anti-androgens or steroids, changing to a different one can help. If the problem is caused by a hormonal imbalance, testosterone therapy can help. It can bring testosterone and estrogen levels back into balance and reduce breast tissue growth.
Other treatment options
In some cases, drug therapy may be recommended to directly address the hormone imbalance. For example, doctors sometimes give tamoxifen to block estrogen’s effects on breast tissue. Tamoxifen is helpful for gynecomastia caused by high estrogen levels. It works against estrogen’s effects on breast tissue growth.
Another class of drugs, aromatase inhibitors (e.g., anastrozole), works by blocking the enzyme aromatase, which converts testosterone into estrogen. By preventing this conversion, aromatase inhibitors reduce the levels of estrogen, which can slow the growth of breast tissue.
If you have tried medicine or hormone therapy, and it did not help, you might get surgery. Male breast reduction surgery is an effective treatment for people whose breasts do not go down after taking medication.
The procedure involves removing excess glandular tissue or fat, depending on what is causing it. If the problem is mainly fatty tissue, a liposuction in Turkey can remove fat. If this doesn’t work, doctors might need to perform a mastectomy to remove the breast tissue.
When should you see a doctor?
Gynecomastia is a common condition that can affect men of all ages, from newborns to adolescents and older adults. It is usually harmless and temporary, especially in teenagers going through puberty. However, in some cases, it can cause psychological distress or physical discomfort.
If the swelling is ongoing, severe, or causing significant pain, you should see your doctor. A doctor can check if the cause is hormonal, because of medication, or something else. While gynecomastia itself is rarely harmful, symptoms can be a sign of a more serious condition. These can include hormone imbalances, liver or kidney disease, or, rarely, a breast tumour.
If a doctor diagnoses you with gynecomastia, you might need to try a more advanced treatment. If this happens, you should speak to a plastic surgeon. They can assess how bad the problem is and suggest the best type of surgery. These can include liposuction to remove excess fatty tissue or mastectomy to remove glandular tissue.
Cosmedica Aesthetic offers advanced cosmetic procedures, including breast reduction surgery for gynecomastia, performed by experienced surgeons in a modern and professional setting. Gynecomastia surgery in Turkey is popular because it is good value for money compared to other countries. This has made it a popular choice for many men who want to improve the appearance of their chest or regain their confidence.