Gynecomastia is the abnormal development of the breasts, or mammary glands, in males. Gynecomastia often results in enlarged breasts, and can occur in babies while still in the womb, adolescent boys and in the elderly. Although it is not dangerous or painful, it can be embarrassing, especially for adolescents.
The cause of gynecomastia is not certain, but it’s often attributed to an imbalance of sex hormones or the tissue response to them. Fewer than 10 percent of cases are reportedly caused by the medications Digoxin, which is used to treat congestive heart failure, and Furosemide, a diuretic.
There are three different types of gynecomastia:
- Physiologic gynecomastia – seen in newborn infants, boys going through puberty and the elderly.
- Pathologic gynecomastia – this type is caused by a decrease in the production and/or action of testosterone, by an increase in the production and/or action of estrogen, or by drug use. Rarely, gynecomastia can be a secondary condition related to a number of other medical conditions.
- Pseudogynecomastia – this form of gynecomastia occurs in obese men, where there is only fat deposits in the breast area, but not an increase in the mammary glands.
Signs of Gynecomastia
Gynecomastia is first identified through a physical examination. The breasts may look enlarged, or the nipples may be puffy, pointed or unusually large. The breasts also may be different sizes from one another, or asymmetrical.
Diagnosing Gynecomastia
Patients who have gynecomastia rarely need further testing beyond a visual assessment of the condition. However, there are some instances where the doctor may require tests to determine if another condition is present. Further evaluation is necessary when:
- breast size is greater than 5 cm (macromastia)
- the breast has a lump that is tender, of recent onset, progressive or has been there for an unknown amount of time
- there are any signs of malignancy, such as hard or fixed lymph nodes
Treatment for Gynecomastia
Puberty-related gynecomastia will resolve itself within several weeks to three years in 90 percent of cases.
Because gynecomastia is not a dangerous condition there is no treatment that is required. Shriners Hospitals for Children® offers treatment options for those who wish to seek treatment for the condition, or whose gynecomastia is related to another underlying condition that requires treatment.
Some treatments include:
- Identifying and managing an underlying primary disorder that may alleviate breast enlargement.
- Hormone therapy
- Surgery to reduce or reconstruct the breast and/or nipple area