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Gynecomastia (breasts development in males)

Men's Health | August 19, 2020 | Author: Naturopath


Gynecomastia (breasts development in males)

When a male appears to have breast, this is called gynecomastia and is usually a result of an imbalance of hormones – too much oestrogen (commonly known as the female hormone) and too little testosterone (commonly known as the male hormone). This condition can occur at times of hormonal changes, such as puberty or in aging. But some medication and some medical conditions can also affect hormones.

What is gynecomastia (GM)

GM is a benign proliferation of glandular tissue (a mass of non-invasive tissue) in the breast occurring in males. The reason for this may be unknown (until investigated), but is most probably due to an imbalance of oestradiol/testosterone which causes abnormal stimulation of breast tissue. Gynecomastia usually results from an underlying cause. Testosterone deficiency, thyrotoxicosis, Cushing’s disease, hyperprolactinaemia and testicular cancer are some disorders associated with breast growth in males. There may be more than one reason, and a thorough medical evaluation is important.

Symptoms of gynecomastiaSymptoms of gynecomastia

Symptoms of gynecomastia include breast tenderness and swelling.

Both breasts may be affected or only one.

Puberty breast development

In both female and male the histology and growth potential of mammary gland is similar during early growth and development. For females, after puberty a synergistic effect of growth hormone, insulin-like growth factor 1 and oestrogen are responsible for complete breast development. Whereas in males, androgens are responsible for supressing this development.

Puberty associated gynecomastia

GM can occur at any time when hormone imbalances occur and in infancy and puberty it is common and usually benign. The condition will often resolve itself in most cases within a short amount of time as sexual maturation of oestrogen to androgen ratio normalizes. Although a thorough examination is still required to rule out any underlying causes.

Adult gynecomastia

When a mature male suddenly develops gynecomastia, it is usually associated with some pathological condition. These might include:

  • Tumors – some tumors especially affecting the testes, adrenal glands or pituitary gland can produce hormones which change the male/female hormonal ratio
  • Hypogonadism – conditions which interfere with normal testosterone production
  • Hyperthyroidism – this occurs when the thyroid gland produces too much of the hormone thyroxine
  • Chronic liver impairment – such as cirrhosis may cause hormone levels to change
  • Androgen-resistance syndromes
  • Aging – hormonal changes may occur - especially with weight gain
  • Dialysis treatment for kidney failure
  • Diet – malnutrition and starvation can cause testosterone levels to drop whilst oestrogen levels remain the same, resulting in hormonal imbalance
  • In many cases the reason is not apparent and may be due to hormonal changes or alterations in the actual tissue. Medication used for treating other conditions may also cause gynecomastia

Assessing gynecomastia

A detailed endocrine investigation is warranted to determine the underlying cause of the condition and will usually comprise a thorough medical history and physical exam (both of the breast and genitalia).

Laboratory investigations may evaluate:

  • Testosterone (T)
  • Estradiol (E2)
  • Sex hormone binding globulin (SHBG)
  • Luteinizing hormone (LH)
  • Follicle stimulating hormone (FSH)
  • Thyroid stimulating hormone (TSH)
  • Prolactin
  • Human chorionic gonadotropin (hCG)
  • Alpha-foetal protein (AFP)
  • Liver and renal function 

Metabolic syndrome and Cardiovascular disease

Concerns also emerge in cases of steroid imbalances which have been on-going for some time, and an association with metabolic dysfunctions.

These might include metabolic syndrome and cardiovascular disease.  

Metabolic syndrome is associated with obesity, hypertension, raised triglycerides, cholesterol imbalances, diabetes or pre diabetes.

Cardiovascular disease is associated with atherosclerosis, high blood pressure and stroke. 

Treat the underlying cause

In order to resolve gynaecomastia, the underlying cause needs to be addressed. When the cause is unidentified treating the hormonal imbalances may help resolve the disorder. This may include:

  • Androgen Therapy - testosterone replacement usually improves gynecomastia in males with hypogonadism
  • Anti-oestrogens - used to decrease the stimulatory effects of estrogen on the male breast
  • Aromatase Inhibitors - these block oestrogen synthesis and as such decrease the oestrogen to androgen ratio
  • Surgery – this may be considered as a last resort, to resolve discomfort both physical and psychological and in long-standing gynecomastia or if malignancy is suspected.

Gynecomastia needs to be assessed and treated under the care of a medical doctor, but there are some natural ways which may help.

Maintain a healthy weight and follow a nutritious diet. Although weight isn’t the cause of gynecomastia, weight gain and related health issues such as metabolic syndrome, diabetes and cholesterol are associated with this condition. Obesity is strongly associated with gynecomastia and testosterone levels will lower when the diet is poor.

Physical exercise has been shown to improve testosterone levels. Choose weight-bearing, sprinting and jogging, but don’t over-train or the opposite result may occur.

Adequate sleep. The majority of the daily testosterone release in men occurs during sleep. Insufficient or interupted sleep and obstructive sleep apnea are associated with reduced testosterone levels. 

Stress reduction. Chronic long-term stress leads to elevated cortisol and negatively influences testosterone.

Zinc deficiency can lead to a substantial decline in testosterone secretion.

Avoid illegal drug useAvoid illegal drug use.
A number of medications may contribute to GM, and this needs to be discussed with the prescribing physician. 

In the case of drugs such as heroin, methadone, marijuana, steroids, and amphetamines, avoiding these may offer a resolution. 

Alcohol can also be added to this list.

Avoid essential oils. Some plant oils, such as lavender and tea tree can affect oestrogen levels. Avoid using products topically for extended periods of time.  Australia’s best online discount chemist


EAA clinical practice guidelines-gynecomastia evaluation and management

Causes and Metabolic Consequences of Gynecomastia in Adult Patients

Gynaecomastia in 786 adult men: clinical and biochemical findings

Gynecomastia: Clinical evaluation and management

Gynecomastia: Etiology, Diagnosis, and Treatment

Curcumin: A Review of Its’ Effects on Human Health

Estrogen in the male: a historical perspective†

Effect of 1 Week of Sleep Restriction on Testosterone Levels in Young Healthy Men

Physically active men show better semen parameters and hormone values than sedentary men

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