Gynecomastia is the growth of glandular breast tissue in men either through hypertrophy (enlargement of cells) or hyperplasia (increase in the number of cells). True gynecomastia includes breast prominence due to glandular cell growth, and typically includes these cells in combination with fat tissue. Male breast growth due to obesity is called pseudogynecomastia or lipomastia.
Gynecomastia is thought to be caused by an imbalance between estrogen (female) and androgen (male) hormones. Gynecomastia can be caused by hormone imbalancing genetic conditions such as Klinefelter syndrome, which interferes with testosterone production. Male breast growth has also been linked to certain medications, such as those used in androgen deprivation therapy for prostate cancer patients, as well as anabolic steroids. Gynecomastia can occur unilaterally (one breast) or bilaterally (both breasts) and can be characterized by tenderness, which is common with glandular tissue growth.
Gynecomastia has three peak times when it typically develops: in infancy, adolescence, and in men over 50 due to normal changes in hormone levels. Male newborn patients develop breast growth due to exposure to maternal hormones through the placenta, and half or more male adolescents develop breast growth from natural hormone imbalances that can occur during puberty. The condition typically resolves itself in infants and adolescents within 6 months to two years, but it can be distressing psychologically, resulting in low self-esteem and shame for the sufferer.
Hormone imbalances can be caused by other factors as well. Conditions such as Klinefelter syndrome and pituitary insufficiency, both of which interfere with testosterone production can cause gynecomastia. Declining testosterone levels due to normal aging can also be a factor and can cause gynecomastia usually found in men 60 to 80 years old. Malnutrition can lead to low testosterone levels as well. More serious causes of the type of hormone imbalances that cause gynecomastia are endocrine tumors, which include testicular cancer, pituitary gland tumors, and adrenocortical tumors (cancerous growths on the perimeter of the adrenal glands), hyperthyroidism, kidney failure, and liver failure.
Gynecomastia can be treated by hormone therapy, but in patients that have had the condition for more than a year, surgery is usually necessary due to scar tissue forming. As long as breast development and weight has stabilized, male breast reduction surgery performed by a plastic surgeon is permanent in most cases.
Gynecomastia can be a side effect of serious medical conditions like testicular cancer. Please see a doctor if you think you may be suffering from this condition.