Enlarged Breasts in Men (Gynecomastia)

Gynecomastia, which is brought on by an estrogen and testosterone hormone imbalance, is an increase in the quantity of breast gland tissue in boys or men. One or both breasts may be affected by gynecomastia, occasionally unevenly. Pseudogynecomastia describes an increase in fat in male breasts without an increase in glandular tissue.

Gynecomastia can emerge from typical variations in hormone levels in newborns, boys going through puberty, and older men, however, there are other reasons as well. Gynecomastia is often not a significant issue, although managing the illness can be challenging. Gynecomastia can cause men and boys to experience discomfort in their breasts as well as feelings of embarrassment.

Gynecomastia could disappear by itself. Surgery or medicines could be helpful if it continues.

Gynecomastia: Causes

The following are the important causes of developing enlarged breasts in men (gynecomastia) −

• Hypogonadism. Gynecomastia can be related to conditions that reduce testosterone production, such as Klinefelter syndrome or pituitary insufficiency.

• Aging. Gynecomastia can be brought on by aging hormone changes, especially in overweight men.

• Tumors. Certain tumors, such as those affecting the testicles, adrenal glands, or pituitary gland, can release hormones that change the balance of male and female hormones.

• Hyperthyroidism. The thyroid gland overproduces the hormone thyroxine in this disease.

• Kidney disease. Gynecomastia is a side effect of dialysis that affects around 50% of patients because of hormonal abnormalities.

Gynecomastia: Symptoms

The patient with enlarged breasts in men (gynecomastia) mainly present with the following symptoms that include −

Gynecomastia in adult males is typically asymptomatic. An illness's warning signs and symptoms might include −

• Especially in teens, pain

• Enlarged breast tissue

• Breast sensitivity

• Sensitivity in the lips while touching against clothing

Gynecomastia: Risk Factors

Several factors play an important role in the development of enlarged breasts in men (gynecomastia) which includes −

• Adolescence

• Greater age

• Use of anabolic steroids to improve performance in sports

• Many medical disorders, such as hormonally active tumors, thyroid disease, liver and renal illness, and Klinefelter syndrome

Gynecomastia: Diagnosis

The diagnosis of enlarged breasts in men (gynecomastia) is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes −

Gynecomastia is diagnosed after reviewing your symptoms and performing a thorough examination of your breast tissue, belly, and genitalia.

Tests Your doctor will probably request tests to rule out other illnesses find a potential cause of gynecomastia, and screen for breast cancer. They may consist of −

• A blood test

• Mammograms

• Scans using computerized tomography (CT)

• Scans using magnetic resonance imaging (MRI)

• Ultrasounds of the testicles

• Biopsies of tissue

To rule out any other conditions, your doctor will want to confirm that your breast swelling is due to gynecomastia. Other ailments that might produce comparable symptoms include −

• Fat in the breast (pseudo gynecomastia). Some certain men and boys have breast fat that mimics gynecomastia, especially those who are obese. There is no need for further testing because this is not the same as gynecomastia.

• Ovarian cancer. While it is rare, males can develop breast cancer. Concern for male breast cancer is increased by the enlargement of one breast or the development of a hard nodule.

• Abscess on the breast. This is a breast tissue infection.

Gynecomastia: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Gynecomastia instances often go away on their own over time. Gynecomastia may require therapy, though, if an underlying illness like hypogonadism, starvation, or cirrhosis is what's to blame.

Your doctor could advise quitting any drugs you're taking or switching to another one if they may be contributing to your gynecomastia.

The doctor may advise frequent reevaluations every three to six months to examine if the disease improves on its own in teenagers with gynecomastia that does not appear to be caused by typical hormone changes associated with puberty. Teenage gynecomastia frequently disappears on its own in less than two years. If gynecomastia doesn't go away on its own or if it causes a lot of pain, soreness, or humiliation, treatment can be required.

Medications

Some men with gynecomastia may benefit from taking medications for disorders like breast cancer and other illnesses. They consist of Aromatase inhibitors for tamoxifen, such as anastrozole. Although the Food and Drug Administration has given these drugs its approval, they have not been explicitly authorized for use in patients with gynecomastia.

Surgical Treatment

Your doctor could suggest surgery if the size of your breasts persists despite initial therapy or monitoring.

Two procedures for gynecomastia are −

• Liposuction. The breast gland tissue is not removed with this procedure; just the breast fat is.

• Mastectomy. The breast gland tissue is removed during this kind of surgery. The procedure is frequently performed with very few incisions. Less recuperation time is required following this less intrusive kind of surgery.

Gynecomastia: Prevention

Some of the measures that can help to prevent enlarged breasts in men (gynecomastia) include −

• Use no drugs. Anabolic steroids, amphetamines, heroin, and marijuana are a few examples.

• Skip the booze. Avoid consuming alcohol. If you choose to drink, do so sparingly.

Conclusion

Gynecomastia is not a life-threatening condition, although it can be quite upsetting due to cosmetic reasons. Breast cancer is also a very little possibility. An interprofessional team that includes a nurse practitioner and pharmacist is the most effective in treating gynecomastia. The initial step is to rule out any drugs that are contributing to the disorder; as a result, the pharmacist should review the patient's prescriptions and advise stopping the offending medication. Moreover, patients must be made aware of the negative effects of alcohol and marijuana, two rather typical causes of gynecomastia.

Second, gynecomastia is not a surgical emergency, and it is advised to keep a close eye on the condition because some instances may resolve on their own. The patient should be informed by the nurse that the majority of acute cases go away on their own and don't need any treatment. The pharmacist should inform the patient about the potential side effects and the fact that results may take time to manifest if anti-hormonal medications are prescribed for treatment.

Referrals to a plastic surgeon should be made for situations that don't go away. Liposuction could not always be effective in chronic situations because of fibrosis, necessitating open surgery. Lastly, a mental health nurse should offer therapy since gynecomastia can result in serious emotional anguish. The morbidity of gynecomastia can only be reduced by an interprofessional strategy with open communication. Gynecomastia has acceptable results for guys, yet it can cause shame and solitude.