Everything you need to know about gynecomastia or ‘man boobs'

Gynecomastia — unkindly referred to as ‘man boobs’ — is a common condition where men develop breast tissue that’s bigger than what’s considered normal. More than half of boys experience gynecomastia during puberty, which generally disappears as they age, and one in three adult men will develop it. While it’s not a life-threatening condition, it can have a serious and significant impact on men and their self-esteem. Here’s how to figure out if you might be experiencing gynecomastia and what you can do to manage it.  

Firstly, what is gynecomastia?

Gynecomastia is when male breast tissue grows larger than usual and it begins feeling like a rubbery, firm mass under and around the nipple before it spreads across your chest. Sometimes it only affects one side of your body but it usually affects both. This growing tissue can feel tender or painful to touch.

Changes to this area of the body might make you raise a mental red flag for breast cancer, but gynecomastia is benign, which means that it’s not cancer. However, the condition can still be a real source of stress and anxiety for most blokes and the term ‘man boobs’ certainly doesn’t help. Many men with gynecomastia feel embarrassed about their chest, which might lead them to avoid certain activities where it might be on display or clothes that highlight it. If your mental health is being impacted by gynecomastia it can help to chat to friends, family, a psychologist, or counsellor if you’re feeling down about the condition.

What causes gynecomastia?

Understanding the causes of gynecomastia can help you work with a doctor to determine any underlying reasons for the condition and whether they can be treated. There are three main causes of gynecomastia, including hormone imbalance, certain drugs and treatments, and health issues.

1. Hormone imbalance

Gynecomastia is commonly caused by a hormonal imbalance involving oestrogens and androgens. Both men and women produce these hormones in different amounts.

Estradiol is the main oestrogen and it plays an essential role in reproduction, bone health, body composition and metabolism. Testosterone is the main androgen and in men, it controls sexual characteristics such as the breaking of your voice, the development of your Adam’s apple, the broadening of your shoulders, body hair, your muscle mass and the development of your genitals.

If your estradiol levels are higher than your testosterone levels, it can cause gynecomastia. Hormone imbalance can occur at any age. It can be diagnosed using a blood test, and medications can be prescribed to balance your hormone levels.

2. Certain drugs and treatments

There are drugs and treatments that can contribute to gynecomastia because they affect the ratio of estradiol and testosterone in men, either directly or indirectly.

Medications and treatments that can affect your hormone balance include:

• Anti-androgens
• Anabolic steroids and androgens
• AIDS medication
• Anti-anxiety medications
• Tricyclic antidepressants
• Antibiotics
• Ulcer medications
• Cancer treatment
• Heart medications
• Stomach-emptying medications
• Alcohol
• Amphetamines
• Marijuana
• Heroin
• Methadone.

3. Health issues

There are several health issues that can cause gynecomastia by affecting the balance between testosterone and estradiol.

These health conditions include Klinefelter syndrome, hypogonadism, tumours, hyperthyroidism, kidney failure, liver disease and malnutrition.

If you’ve noticed swelling around your chest or more breast tissue than usual, book in to have a chat with your doctor to get diagnosed properly and come up with a treatment plan.

How do you treat gynecomastia?

The treatment for gynecomastia will depend on the underlying cause of your condition, as well as the severity of the condition. It will also depend on your concerns around the appearance of your chest.

Treatments for gynecomastia include ‘careful watching’ or monitoring the condition to see if it will go away on its own, prescribing medications that will be used to balance out your hormones, and in some cases, surgery to remove excess breast tissue if the medications have not been effective.

What is pseudo gynecomastia?

Pseudo gynecomastia may look the same as gynecomastia, but it’s a build-up of fat that may happen if you’re overweight. Bench presses won’t make a dint for those with gynecomastia, however pseudo gynecomastia can be improved with regular exercise, diet changes and weight loss. Your doctor can determine which gynecomastia you’re dealing with.

Gynecomastia and male breast cancer

Gynecomastia and breast cancer are not the same, but both are associated with increased levels of oestrogens in the blood. However, if you have gynecomastia, you have twice the chance of being diagnosed with breast cancer.

While this stat seems alarming, it’s important to remember that breast cancer is quite rare in men. In Australia, it’s predicted that 137 Australian men will have been diagnosed in 2020, the equivalent of 1 man in every 100,000. There’s also an 85% survival rate at five years after diagnosis.

The connection between gynecomastia and male breast cancer does, however, highlight the importance of visiting your doctor if you are experiencing symptoms, as they will be best placed to diagnose the condition and set you up with a treatment plan.

Keep reading: Male breasts (gynecomastia)