Male breast enlargement, or gynecomastia, is excess growth or swelling of breast tissue in boys or men, leading to enlarged breasts. Male breast enlargement is caused by an imbalance between the male sex hormone testosterone and the female estrogen * hormones. Although male breast enlargement is usually harmless, it can cause embarrassment and sometimes tenderness or pain.
Male breast enlargement is caused by the formation of firm breast gland tissue, not excess fat tissue. Male breast enlargement can occur in one or both breasts or can occur unevenly in the two breasts so that one breast is larger than the other. The most common cause of male breast enlargement is normal changes in hormone levels that can occur in newborns, during puberty * , and in older men as a part of aging. Some boys and men have fat on their chests that makes the breasts appear enlarged. This excess fat is called pseudogynecomastia, or false gynecomastia, and is not male breast enlargement.
Testosterone and estrogen control the development and maintenance of male and female sex characteristics, respectively. Males and females have both androgens * , including testosterone and estrogens, but males have mostly androgens with only small amounts of estrogen, and females have high levels of estrogen that promote breast growth at puberty.
Changes in the relative levels of these hormones—decreased testosterone compared with estrogen or increased estrogen—or in the body's response to or utilization of these hormones can cause breast enlargement in males.
In newborns, male breast growth in caused by exposure to the mother's estrogen. In preteen and teenage males, breast growth is caused by normal hormonal changes. During male puberty, androgen production by the testicles * increases significantly, causing physical changes including muscle development, facial and body hair, voice deepening, and lengthening of the penis. During female puberty, estrogen controls breast growth and other female characteristics. Although estrogen production in males remains low during puberty, some males produce enough estrogen for the development of breast tissue. This is normal and almost always temporary. Nevertheless, male breast enlargement can cause self-consciousness or embarrassment in teenage boys and can even lead to psychological or emotional problems.
Although puberty is the most common cause of male breast enlargement, it can be caused by normal aging, especially in men aged 50 and over or men who are overweight. Hormone imbalances caused by certain diseases and conditions or side effects of medications and illegal drugs, as well as radiation treatment of the testicles, can also cause male breast enlargement. Diseases and conditions that can cause breast enlargement in adult men include:
Drugs that can cause male breast enlargement include:
More than half of male newborns have enlarged breasts—called breast buds—from the effects of their mothers’ estrogen. The swollen breast tissue usually disappears with two weeks to six months after birth but sometimes lasts longer.
Male breast enlargement during puberty is also common, affecting one or both breasts in an estimated half of all males and in as many as 65 percent of 14-year-olds. The swollen tissue usually disappears, and the breasts flatten out completely on their own within six months to three years.
At least one in four older men experiences normal breast enlargement, most often between the ages of 50 and 80. In addition, about one-half of men undergoing regular hemodialysis for kidney failure experience breast enlargement.
Some male newborns have breast development that is accompanied by a milky discharge from the nipple called galactorrhea. This usually continues for only about two weeks, although rarely it can last up to two years.
Breast enlargement in teenage boys and older men begins as a sometimes tender lump directly under one or both nipples. The lump is generally less than 1.5 in. (3.8 cm) across. Some men with breast enlargement fear that they have breast cancer. However, male breast cancer is very rare, and cancerous lumps are not usually beneath the nipple.
If the patient is a prepubescent boy or a younger adult male or the doctor suspects that breast enlargement could be due to an underlying medical condition such as an infected abscess (mastitis) or cancer, diagnostic procedures may include:
Male breast enlargement does not usually require treatment. Breast enlargement usually disappears on its own within a few weeks in newborns and in less than three years in 90 percent of teenage boys. The doctor may continue to check the size of breast tissue in adolescent males every few months. Meanwhile, loose-fitting shirts can hide the condition. Tenderness from swollen breasts can be treated by applying cold compresses and using pain relievers.
In other cases of breast enlargement, it may be necessary to stop taking a medication, change to a different medication, or stop using nutritional or bodybuilding supplements or other drugs. In rare cases of persistent, uneven, extreme, or painful male breast enlargement, hormone treatments can block the effects of estrogen or breast-reduction surgery may be performed. Medications such as tamoxifen (Soltamox) and raloxifene (Evista) that are used to treat breast cancer and other conditions are effective for some men with gynecomastia, although these drugs have not been specifically approved for this use by the U.S. Food and Drug Administration (FDA). Surgical options for gynecomastia include liposuction * , which removes breast fat but not breast gland tissue, or mastectomy * , which removes the glandular tissue. Mastectomy often can be performed with minimally invasive endoscopic surgery that requires only small incisions and a shorter recovery time. Breast enlargement that is caused by a tumor or underlying condition—such as hypogonadism, cirrhosis, or malnutrition—requires treating the underlying cause.
Because male breast enlargement can be embarrassing, stressful, or even traumatic for teenage boys, counseling or talk therapy may help with anxiety and depression. Explaining and discussing the condition with romantic partners, family members, and close friends can be helpful, as can talking to other males with similar experiences, either personally or online.
A healthcare provider should be consulted if breast enlargement occurs in a male who has not yet reached puberty or is accompanied by:
Although male breast enlargement is not necessarily preventable, certain factors can reduce the risk:
See also Alcoholism • Breast Cancer • Obesity • Puberty and Sexual Development
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American Academy of Family Physicians. PO Box 11210, Shawnee Mission, KS 66207-1210. Telephone: 913-906-6000. Toll-free: 800-274-2237. Fax: 913-906-6075. Website: http://www.aafp.org (accessed March 25, 2016).
* estrogen (ES-tro-jen) is a steroid hormone that stimulates the development of female sexual characteristics and maintenance of the female reproductive system.
* puberty (PU-ber-tee) is the period during which sexual maturity is attained.
* androgens are male sex hormones, especially testosterone.
* testicles (TES-tih-kulz) are the paired male reproductive glands that produce sperm.
* hypogonadism (HI-poh-go-NAD-ih-zum) is dysfunction of the male gonads with impaired production of hormones and germ cells.
* adrenal glands (a-DREEN-al glans) are the pair of endocrine organs located near the kidneys.
* pituitary gland (pih-TOO-ih-tare-e gland) is the small ovalshaped gland at the base of the skull that produces several hormones that affect various body functions.
* testes (TES-teez) are the paired, hormone- and sperm-producing male reproductive glands that descend into the scrotum.
* cirrhosis (sir-O-sis) is long-term inflammation and scarring of the liver.
* dialysis (dye-AL-uh-sis) or hemodialysis is a process for removing waste, toxins, and extra fluid from the blood when the kidneys are unable to perform these functions adequately.
* prostate (PRAH-state) is a male reproductive gland that produces the fluid part of semen and is located near where the bladder joins the urethra.
* anabolic steroids (a-nah-BAH-lik STIR-oyds) are drugs and hormones that cause muscle and bone growth and a shift from fat to muscle in the body.
* mammograms are breast x-rays for detecting cancer.
* liposuction is the removal of localized fat deposits by suction through a small tube, usually for cosmetic purposes.
* mastectomy (ma-STEK-tah-mee) is the surgical removal of part or all of a breast and sometimes associated lymph nodes and muscles.