Gynecomastia - Causes, Diagnosis, and Treatment

Introduction

The swelling of male breast tissue is known as gynecomastia. It is a non-cancerous disorder that affects males of all ages. Even though gynecomastia is common, it is rarely discussed since some individuals, particularly boys, feel it degrading. In addition, men with gynecomastia frequently experience anxiety. Gynaecomastia symptoms and size range from modest, firm breast tissue growth to a larger, more feminine-looking breast. One or both breasts may be affected by gynecomastia. Personalized therapy alternatives include lifestyle counseling, reassurance, medicinal treatment, and surgical correction.

Why Do Men Develop Boobs?

While in the womb, breast tissue develops. Boy's breast tissue is identical to girls until they reach puberty and adolescence. When they enter puberty, however, rising hormone levels impact the breast tissue's development. The hormone estrogen stimulates breast growth in females. During puberty, boys have higher quantities of estrogen, but by the end of their adolescence, they usually have significantly higher testosterone levels. As a result, estrogen's impact on breast tissue is inhibited, and the breasts flatten out. The essential feature of gynecomastia is a hormonal imbalance between estrogens and androgens.

What Causes Gynecomastia in Men?

Physiological reasons, endocrine tumors or dysfunctions, non-endocrine disorders, drug use, or idiopathic causes are all possible causes of gynecomastia.

• Aging - People tend to gain more body fat as they age, creating estrogen. Furthermore, as men age, they produce less testosterone. Breasts can enlarge due to a combination of increased estrogen and decreased testosterone.

• Puberty - The growing testes produce more estrogen than testosterone during puberty, which can cause gynecomastia. Gynecomastia of this sort is frequently self-resolving, but it might occasionally last longer.

• Overweight - A person's body produces more estrogen the more fat cells they have. As a result, breast tissue may expand.

• Endocrine Disorders - Various disorders or ailments that impact the estrogen-to-testosterone ratio. These illnesses are uncommon. However, they can involve hereditary issues and chronic diseases (especially kidney and liver disease).

• Drugs and Medicines - Some medications can lead to gynecomastia. This could be because they contain estrogen, which raises the hormone's level or stops testosterone production, lowering testosterone levels in the body. Medications for hypertension (high blood pressure), heart disease, psychological disorders, stomach ulcers, cancer medications, antibiotics, and anabolic steroids (muscle-building drugs) can all induce gynecomastia.

• Alcohol Intake - Alcohol in large doses stimulates the liver and might cause hormonal imbalances. The liver stops breaking down the circulating estrogen, so testosterone levels drop, but estrogen levels rise. This signifies that breast tissue can expand.

How Is Gynecomastia Diagnosed?

• Physical Examination and History - A doctor will diagnose gynecomastia by collecting a medical history (asking questions) and performing a physical exam. Questions are usually asked regarding breast tissue development, medical and drug history, and whether any health concerns run in the family. Breast tissue, abdomen, and genitalia are all evaluated during a physical examination. A rubbery or stiff mound of tissue beneath or around the nipple is familiar in gynecomastia-affected breasts.

• Blood Investigations-Testosterone and estrogen levels in the blood may reveal whether or not there was a hormonal imbalance that resulted in gynecomastia. Few other hormones, such as,

• LH (Luteinizing Hormone).

• FSH (Follicle Stimulating Hormone).

• HCG (human chorionic gonadotropin also provides an insight into the condition.

• Ultrasound Examination- Indicated, especially if any lumps or swelling are present.

• Mammogram - A mammography is recommended to check for any malignancies linked to breast cancer.

• Needle Aspiration and Core Tissue Biopsy - A fine needle aspiration is a procedure that involves taking a sample of cells with a thin needle and syringe and examining them under a microscope. A core tissue biopsy is a procedure that involves taking a small piece of breast tissue using a hollow needle and examining it under a microscope.

Is Gynecomastia Linked to the Development of Breast Cancer in Men?

Men are much less likely to develop breast cancer than women. Breast cancer and gynecomastia are linked because both are associated with excessive estrogen levels. However, breast cancer differs from gynecomastia-caused breast cancer in women. It is usually complex and irregular (rather than soft), occurs in one breast (rather than both), and may include nipple deformity or discharge and lumps in the armpit. Breast cancer is more common in males with Klinefelter syndrome than in other men, but it is still uncommon.

What Is the Treatment for Gynecomastia?

Which treatment is best depends on the underlying reason for gynecomastia, if the changes are expected to go away, and whether there are any cosmetic issues. Mere observation, medicines, or surgery can all treat gynecomastia.

1. Medications - Although the success rates are inconsistent, drugs can be used to treat gynecomastia in men who have no underlying hormonal abnormalities.

• Tamoxifen - Tamoxifen reduces the quantity of estrogen in the body and reduces the breast size in men, making it an effective treatment for painful gynecomastia. It can cause various adverse effects, including nausea and libido loss (sex drive).

• Danazol - Danazol is used to treat gynecomastia that is painful and tender. It works by lowering the estrogen generated in the testicles, which shrinks the breasts and improves symptoms. Weight gain, acne, and voice changes are all possible adverse effect.

2. Surgical Therapy - Surgery may be done to treat gynecomastia that has been present for a long time or when medicine has failed.

• Liposuction - A surgical technique in which fat from the afflicted area is removed.

• Mammoplasty- A surgical breast reduction operation.

Conclusion

Gynaecomastia can be upsetting, humiliating, and alienating for those who suffer from it. In addition, Gynaecomastia is not age-specific. Boys going through puberty and other bodily changes may find it difficult to talk about their developing or painful breasts with others. Older men may be concerned that their breast changes are a symptom of malignancy. Even though gynecomastia does not enhance the risk of breast cancer, it is essential to pay attention to your breasts and be aware of the disease prevalence.