Understanding Gynecomastia: Causes, Symptoms, and Treatment Options

Gynecomastia is a condition that causes enlarged breast tissue in people assigned male at birth (AMAB). It is a common condition, affecting up to 65% of boys and men worldwide. While gynecomastia is not usually a sign of a serious health issue, it can cause anxiety and embarrassment for those affected.

What Causes Gynecomastia?

Gynecomastia is typically caused by an imbalance in the hormones testosterone and estrogen. While everyone has some amount of both hormones, people AMAB usually have higher levels of testosterone. If the balance shifts and there is more estrogen than testosterone, breast tissue can swell.

There are many potential triggers for this hormonal imbalance, including:

  • Natural changes in hormones during infancy, puberty, and older age

  • Certain health conditions, such as low testosterone, thyroid issues, and obesity

  • Medications and drugs, including anti-androgens, HIV drugs, and recreational drugs

  • Anabolic steroid use

Symptoms of Gynecomastia

The main symptom of gynecomastia is enlarged breast tissue, which may be accompanied by:

  • A lump under the nipple

  • Tenderness

  • Soreness

  • Swelling

Gynecomastia can range from mild to severe and may affect one or both breasts. While it is not necessarily a sign of cancer, it is important to see a doctor to rule out any underlying health issues.

Diagnosing Gynecomastia

To diagnose gynecomastia, your doctor will likely ask about your medical history and any medications or drugs you are taking. They may also perform a physical exam, including a "pinch test" to feel for firm tissue under the skin.

In some cases, your doctor may order additional tests, such as blood tests, a mammogram, or an ultrasound, to rule out other potential causes of breast enlargement.

Treatment Options for Gynecomastia

In many cases, gynecomastia will go away on its own over time. However, if the condition is causing significant discomfort or distress, there are several treatment options available:

  • Treating any underlying health issues that may be contributing to the condition

  • Making changes to medication or drug use

  • Taking prescription medications such as tamoxifen or raloxifene to block the effects of estrogen

  • Undergoing male breast reduction surgery to remove excess tissue

Your doctor can help you determine the best course of treatment based on your individual circumstances.

Living with Gynecomastia

If you are living with gynecomastia, it is important to remember that you are not alone. There are steps you can take to manage the emotional impact of the condition, such as:

  • Talking to a counselor or joining a support group

  • Confiding in a trusted friend or family member

  • Engaging in physical activity to improve overall health and well-being

While gynecomastia can be distressing, it is important to remember that it is a common and treatable condition. With the right support and care, it is possible to manage the symptoms and feel confident in your own skin.

For more information on gynecomastia, visit Mayo Clinic, Healthline, or the American Academy of Family Physicians.