GYNECOMASTIA: CAUSES, SYMPTOMS AND TREATMENTS

WHAT IS GYNECOMASTIA?

Gynecomastia in men is the enlargement of the glandular breast tissue in the male breasts. During childhood, puberty, and in middle-aged to older men, it can be common and lead to psychological and emotional problems.

True gynecomastia results from the growth of glandular or breast tissue, which is present in very small amounts in men.

Although gynecomastia in men is not a serious problem, it is the most common reason for medical evaluation of the male chest.

It must be distinguished from pseudogynecomastia, a term by which we refer to an excess accumulation of adipocytes or fat cells, in the breast area of ​​men with considerable excess weight or those who manifest obesity.

CAUSES OF GYNECOMASTIA WHY DOES IT APPEAR IN MEN?

Pubertal males, that is, those who are in adolescence and therefore in the process of normal development, may be at risk of developing it.

Many of the male babies when they are born have overly large breasts with inflamed breast tissue, as a consequence of the high levels of estrogens present in the blood, received from the mother.

After several weeks this situation normalizes.

Other risk factors include:

• Aging or advanced age and diseases such as Klinefelter syndrome can promote decreases in testosterone production that can lead to gynecomastia.
• The risks of developing enlarged man boobs related to specific diseases and conditions are the same risk factors that predispose to those conditions.
• Taking certain medications can increase the risk of developing it, as can the use of steroids and other drugs.

WHAT ARE THE SIGNS OR SYMPTOMS OF GYNECOMASTIA?

The main symptom that characterizes this medical condition is excess mammary gland tissue, not fatty tissue in male breasts.

Signs of gynecomastia include or are characterized by:

• Swelling and pain in the breasts, especially in the case of adolescent boys.
• The tissue growth usually appears symmetrical to the nipple and can produce a feeling of both rubberiness and firmness.
• It is usually bilateral, that is, it occurs on both sides. It can also develop unilaterally in only one breast in some cases.
• The enlargement may be larger in one breast.
• There may be tenderness to clothing, touch, or pressure, although there is usually no severe pain.

It is recommended that you go to the best plastic surgeon in Malad in the case of swelling, acute pain, sensitivity and/or discharge from the nipple.

The most important distinction between gynecomastia symptoms from male breast cancer is that the cancer is generally confined to one side, is not necessarily centered around the nipple, feels hard or firm, and may be accompanied by other symptoms such as dimpling of the skin, nipple retraction, nipple discharge, and enlarged axillary lymph nodes.

WHAT ARE THE CAUSES OF MALE GYNECOMASTIA IN ADOLESCENCE, AND ITS DURATION?

In adolescence it occurs as a result of a hormonal imbalance or gap between the hormonal levels of estrogens (female hormones), which suffer a relative increase with respect to androgen levels (male hormones). 

When it occurs in newborn babies and children going through puberty in a normal growth phase, and which in most cases usually disappears over time, it is called physiological gynecomastia.

All individuals, whether male or female, possess both female hormones called estrogens, and also male hormones, or androgens.

During puberty, estrogen and androgen levels can change, with relative estrogen levels sometimes being abnormally high.

The different studies carried out to try to see the presence in pubertal adolescents, show a great variation in the results. In some of these studies it occurred in only 4% of cases, while in others the presence or prevalence rates reached 69%.

These differences probably result from variations in what is perceived as normal and the different ages of the children examined in the studies.

In the event that it is produced by the changes that can occur in the levels of hormones in the growth stages, it usually disappears without taking action, after a period that ranges between six months and two years.

Occasionally, that which develops in the pubertal growth phase and does not subside within two years, gives rise to what is known as persistent pubertal gynecomastia.

OTHER CAUSES: DISEASES AND CONDITIONS

MEDICAL CONDITIONS

• Malnutrition and subsequent recovery have been shown to cause hormonal changes that can cause gynecomastia.
• Cirrhosis in the liver alters the metabolism of hormonal secretions and is therefore capable of causing gynecomastia.
• Some tumors in the adrenal glands or in the testicles affect the hormonal balance and can trigger gynecomastia.
• Disorders of the testicles can cause a decrease in the production or secretion of male hormones.

By reducing male hormones, a relatively high level of female hormones can remain, thus triggering it.

These disorders can be genetic or acquired due to trauma, infection, reduced blood flow, or aging.

Testicular cancer can also secrete hormones that can cause gynecomastia.

• Other medical conditions that are associated with a disturbance in the normal levels of hormones in the body, and that may be associated with this medical condition, are kidney failure or hyperthyroidism. 

MEDICINES

This pathology can be a side effect of many drugs, for example diuretics that have antiandrogenic activity, calcium channel blockers that are used to treat hypertension, some antibiotics, anti-ulcer drugs, therapies against certain cancers of the prostate…

Other substances also related to gynecomastia are:

• Drugs of abuse such as alcohol, marijuana... can cause gynecomastia.
• Use of steroids and anabolics to improve muscle performance.
• Lavender oil and tea tree oil, when used in skin care products, have been associated with gynecomastia.

It is appropriate to see a plastic surgeon in Mumbai if you think you may be developing or have the condition.

HOW DO I KNOW IF I HAVE GYNECOMASTIA (DIAGNOSIS)?

Men suffering from gynecomastia have excess breast tissue in the mammary glands, not fatty tissue, with dimensions greater than 0.5 cm in diameter, which is usually found in the area around the nipple in a man, commonly under the breast. the areola

The presence of fatty tissue in the male breasts is not considered as such.

• In most cases, it can be diagnosed with a simple exploratory examination. 
• For its diagnosis it is equally necessary to carry out a careful medical history, mentioning aspects such as the habitual or occasional use and consumption of medicines and drugs.
• The plastic surgeon in Malad may order a mammogram to be performed, in the event that he considers it plausible that there could be a suspicion of cancer.
• In addition, additional tests may be recommended to help detect the cause that has led to the appearance of glandular mammary tissue in the man's breasts, such as a blood test to examine liver, kidney and thyroid function.
• Measurement of blood estrogen and androgen levels may also be recommended in some cases.

HOW LONG DOES IT TAKE TO DISAPPEAR?

Although pubertal gynecomastia usually regresses on its own, in rare cases it can persist and require treatment.

When it has been present for 12 months or more (long-term) it can lead to fibrosis and scar formation, making drug treatment much more difficult, if not impossible, to achieve a response.

Psychological consequences can occur if breast enlargement is pronounced or a source of embarrassment.

TREATMENTS FOR GYNECOMASTIA IN MEN

DRUG TREATMENT

Gynecomastia in men, especially in males in the pubertal phase, often disappears on its own within approximately six months, so in many cases it is preferable to maintain observation during that time period, to see if subsides naturally, before starting to apply a specific treatment.

Suspending medications and treatment of existing medical problems or health conditions that cause enlarged breasts, eliminating the use of substances such as steroids and anabolics that may cause their appearance, are also pillars of treatment.

Medical treatments are available to treat it, but the data on their effectiveness are limited.

PLASTIC SURGERY TREATMENT

Medications are most effective in reducing gynecomastia in the early stages, as scarring often occurs after about 12 months.

Once the tissue has healed, medications may not be effective, and surgical removal is the only possible treatment.

Gynecomastia surgery in Mumbai has been used in severe cases of the condition, when it persists long-term, or in cases where pharmacological therapies have not been effective, to help restore an appearance normal mammary

In fact, gynecomastia surgery in Mumbai is the treatment that eliminates gynecomastia forever, through an excision surgical procedure that removes excess tissue through a small incision.

ARE GYNECOMASTIA AND MALE BREAST CANCER RELATED?

Men with gynecomastia have a five times higher risk of developing male breast cancer compared to the general population.

It is believed that it itself is not a condition that appears prior to the appearance of cancer, but that the hormonal changes (relative increase in estrogen, lower levels of androgens) that produce it in adult men also increase the risk of developing male breast cancer.

CAN IT BE PREVENTED?

That which occurs due to hormonal fluctuations with growth or aging cannot be prevented.

That related to medical conditions can only be prevented to the extent that the underlying or responsible condition can be prevented.