Updated: December 16, 2019
For some women, round and perky breasts are considered an asset. However, the same could not be said if these grow on men. Gynecomastia, or man boobs, is a condition that is usually suffered in silence. Despite being a benign condition, those afflicted usually have a hard time coping as some would choose not to discuss it out of embarrassment.
The Two Sides to Gynecomastia
Gynecomastia is not just a physical concern, it also breeds a psychological issue. The embarrassing physical alteration to the male physique sometimes pales in comparison to the emotional discomfort it stirs up. It can impair one’s self-confidence, with some men skipping certain physical activities, clothing options, and even intimacy.
While there are no Australian statistics available, in 2017, 26,839 American men underwent breast-reduction surgery, according to the American Society of Plastic Surgeons (ASPS). These numbers show guys who are suffering in silence that they are not alone.
Here’s Why You Should Keep Your Guard Up with Gynecomastia
Gynecomastia is common in men and boys at various stages of development and is sometimes linked to certain medical conditions. True Gynecomastia refers to enlarged breast tissue rather than fat (adipose) tissue. The condition is mainly the result of hormonal changes, but it is also linked to genetics, obesity or the use of certain drugs.
However, in rare instances, man boobs could also be a symptom of potential health problems. So, you should also keep your guard up for what seems to be a harmless condition. This is not meant to cause any panic, rather it is a way to educate you.
Moreover, the knowledge about specific diseases and its link to Gynecomastia will also serve as a guide to help you understand and find the appropriate treatment.
Conditions Linked to Gynecomastia
During World War II, American prisoners were starved for long durations. When they finally received food assistance, several cases of Gynecomastia emerged.
Prolonged periods of starvation can result in the development of man boobs. The liver, impaired by protracted starvation, becomes unable to inactivate estrogen, but can still squelch androgen. Consequently, malnutrition can cause testosterone and gonadotropin levels to drop while female hormone levels stay normal. This explains why some secondary female characteristics, such as breast enlargement, surface.
As the person resumes normal food intake, temporary breast enlargement is still likely to occur. As your system rewires, it results in an elevation in female hormone levels which outpaces the production of male hormones. This proves that your diet plays a vital role in ensuring the healthy balance of your hormone levels.
Hepatic Cirrhosis or Liver Diseases
The liver is responsible for clearing excess hormones out of your system. However, a cirrhotic or damaged liver would mean that the body’s filtration system is affected. The liver’s ability to properly metabolize hormones such as estrogen also becomes impaired, resulting in an increased concentration in your system.
Hence, specific secondary female sex characteristics may start to take shape – such as breast enlargement.
What makes matters worse is that Spironolactone, the medication used to treat cirrhosis, exacerbates gynecomastia. This drug alters the metabolism of testosterone resulting in changes in the ratio of male and female hormones, which eventually results in man boobs.
Hyperthyroidism is a condition where there are excessive amounts of thyroid hormones in your system resulting in thyrotoxicosis. The initial presentation of which is an enlargement of both male breasts.
This condition is a known culprit behind 1.5% of adult gynecomastia. However, one study showed a decreasing trend of gynecomastia in thyrotoxicosis over the past two decades due to early diagnosis of the condition.
Early treatment not only address gynecomastia, but it also spares you from serious complications mostly related to the heart.
Kidney Failure and Dialysis
In male patients with renal failure, testosterone production decreases while estrogen levels experience a spike. The problem can be corrected by kidney transplantation. However, medications like cyclosporin which is prescribed after the surgery can also cause gynecomastia.
Regular dialysis in patients with end-stage renal failure can also result in male breast enlargement. This starts around the first two months of dialysis and it usually affects both breasts, with the extent of growth ranging between minor to “impressive.” Fortunately, spontaneous regression is observed in most cases within a year.
Type 1 Diabetes
Diabetic mastopathy is a benign condition where men who are suffering from type 1 diabetes grow multiple palpable painless breast masses, which mainly consists of fibrotic and inflammatory elements. While they are benign, these can be mistaken for malignant tumors.
Researchers found that diabetic mastopathy could potentially create a misleading pattern of benign tumor-like lesion simulating Gynecomastia. If the person has type 1 diabetes, there is a possibility that the growth could be a malignant lesion.
Appropriate testing can delineate the unique pattern of growth developing inside your chest, and with that, proper treatment can be given.
Tumors that involve the testes, adrenal glands or pituitary gland can also produce hormones that alter the balance of male and female hormones. Man boobs is a common incidental finding in males caused by various benign or malignant tumors.
Other Known Causes Behind Man Boobs
There are several drugs that can lead to drug-induced gynecomastia. It is an adverse effect that associated with the following medications:
- Antiandrogens (ex. Finasteride and Dutasteride)
- Calcium channel blockers
- ACE inhibitors
- Gastrointestinal drugs (ex. Cimetidine)
- Antiretroviral therapy (for HIV)
- Chemotherapy drugs (ex. Methotrexate and Cyclophosphamide)
Although gynecomastia is not a health-threatening condition it can cause psychological distress due to alterations in your physical appearance. Most of the drugs mentioned above are meant to be taken for the long term. Therefore, it is important that you discuss your concern with your prescribing physician.
You may be advised to discontinue the drug. The doctor may also reduce the dosage or substitute the suspected drug with another that belongs to the same class but has a weaker association to gynecomastia.
Always remember that you should never stop any medication without medical advice. If gynecomastia is a troubling side effect, always seek professional consultation to address this problem. Abruptly stopping a long-term treatment can also lead to serious consequences.
Your habits can also tip the balance of normal testosterone and estrogen levels. For example, excessive alcohol consumption and recreational drugs can lead to male breast enlargement.
Other seemingly innocent products such as tea tree or lavender oils used in shampoos, soaps and lotions can also heighten your risk.
Don’t Be Mum, Seek Help
Gynecomastia may seem pretty harmless, but its potential impact on your life exceeds the mere embarrassment of having enlarged breasts. Therefore, don’t put your guard down against its potential effect on your health. Apply health-seeking behaviors that not only spares you from the psychological impact of having man boobs but the serious complications from a disease or condition that it may be attached to.
Do you have more questions about gynecomastia? Are you curious if gynecomastia surgery is necessary for your case? Book a consultation with Dr. Daood today and get the help you need.