Gynecomastia
What is gynecomastia?
Gynecomastia is a medical condition in which boys' and mens’ breasts expand and become abnormally large. It can affect one or both breasts and is commonly noted in teenage boys and older men. It occurs because of an imbalance in the hormones; such as testosterone and oestrogen, causing an increase in the volume of breast glandular tissue or by an underlying medical condition.
Gynecomastia can be the cause of anxiety, reduced self-esteem, body dissatisfaction and depression and needs to be treated appropriately
Causes of gynecomastia
All men and women produce both testosterone (male hormone) and oestrogen (female hormone) which control sex characteristics in the body. Normally, testosterone is produced in higher volume in men and similarly, oestrogen in women. In gynecomastia, a higher proportion of oestrogen is produced in males causing the male breast tissue to swell. Some of the factors that may cause gynecomastia to include:
- Puberty
- Age
- Side effects of medications
- Hormones, such as anabolic steroids
- Recreational drugs, such as marijuana
- Excessive alcohol
- Thyroid problems
- Liver disorder
- Kidney failure
- Obesity
- Tumours or cancers
- Herbal products
Signs and symptoms
Some of the common signs and symptoms of gynecomastia include:
- Enlargement of the breasts
- Tenderness and sensitivity in the breasts
- Additional tissue around the nipples
Diagnosis
To diagnose gynecomastia, your doctor will conduct a review of your medical history to look for any history of medications and health conditions that run in your family. A thorough physical examination is also performed for careful evaluation of your breast tissue to look for signs of unusual growths, lumps, or other skin issues. To further confirm the diagnosis, your doctor may order tests and imaging procedures, such as:
- Blood tests- to look for signs of abnormal hormone levels.
- Ultrasound scan– use of high-frequency sound waves to create pictures of breast tissue to differentiate between a fluid-filled cyst and a solid mass.
- Mammogram and tissue biopsy are only indicated when there is concern about breast cancer.
These diagnostic steps help in confirming the root cause of gynecomastia and determine the best course of therapy.
Treatment
In most cases, gynecomastia resolves on its own over time without treatment. However, if the condition does not resolve, the following treatment methods may be employed:
Nonsurgical methods
- In cases of drug-induced gynecomastia, replacement of the offending drug with an alternative and safer medication is recommended.
- When gynecomastia is secondary to an underlying medical condition, the treatment should be focused on treating that disease.
- If the gynecomastia is due to hormonal imbalance or hormone therapy, your doctor may recommend a drug such as tamoxifen to treat large or painful breasts.
Surgical methods
In patients not responding to nonsurgical methods, surgery is considered as the best option. The surgical methods for management of gynecomastia include:
- Liposuction – a procedure for removal of breast fat.
- Mastectomy – a procedure for excision (removal) of breast gland tissue from a small incision hidden in areolar line.
- A combination of the above surgical techniques usually is most reliable way to archive best outcome.
