Breast enlargement in males — causes and treatment


Gynecomastia is a condition that affects men only. It is enlargement of the gland tissue of the male breast and can affect one or both breasts. Normally, male mammary glands are an undeveloped organ consisting of a nipple and a system of reduced ducts surrounded by a fatty tissue.

Classification

Unilateral and bilateral gynecomastia are distinguished. In 80% cases, enlargement occurs symmetrically but there are exceptions. Asymmetrical gynecomastia may be a bilateral as well and in this case one of the glands is enlarged more.

By the mechanism of development two types of the disease are distinguished:

  • True (enlargement is due to the growth of glandular and connective tissues);
  • Pseudogynecomastia in men (fatty tissues growth).

There is also a combined type of gynecomastia, when in addition to glandular tissue growth fatty tissues grow as well.

Physiological enlargement of mammary glands

  • In newborns. Enlargement of this part of a baby’s body on the first day of its life is caused by female hormones which circulate in a baby. Usually by the second month breast buds tend to go away.
  • In teen boys. At the the age of 13 boys may experience some increase in breast size which relates to a hormonal imbalance typical for this period of development. Puberty is characterized by male/female hormones imbalance, so gyno in teenagers is caused by the natural dominance of a female hormone estrogen. In the majority of cases the problem is resolved in a couple of years.
  • In elderly men is the most common type of the disorder. It usually relates to a significant decrease in testosterone production. Due to this, the level of estrogen increases and causes the breast ducts to enlarge.

These types do not require any additional therapy as they are considered to be a norm and the problem resolves itself as a result of physiological processes.

Causes

  • Kleinefelter syndrome (it is a chromosomal genetic condition related to the X chromosome and it leads to the increase of female hormones and some other disorders);
  • Testicular feminization (in this case, a Karyotype of a patient is absolutely normal, but externally there are some female signs including gynecomastia in men );
  • Hormone-producing testicular tumors and tumors of the adrenal glands;
  • Chorioepithelioma (a malignant tumor producing a hormone responsible for the elevated level of testosterone in the thyroid);
  • Thyroidal hormonal disorders;
  • Chronic hemodialysis (decreases the level of testosterone in blood and consequently leads to the symptoms gynecomastia );
  • Liver disorders (due to any pathologies affecting liver functions, excessive amounts of testosterone are not very well processed and gradually it is translated into estrogen);
  • Bronchogenic cancer (a tumor syndrome causing the development of gyno symptoms );
  • A long-term use of the medications (hormonal drugs, some diuretics, cytostatic drugs, calcium-channel blockers, psychotropic substances and some antibiotics);
  • Too much eating after long-term restrictions of food.

Gynecomastia in bodybuilders

Mammary glands enlargement in men who are very active in sports occurs quite often. Pathological condition is caused not by physical training itself but by the products which sportsmen usually consume.


Negative influence of anabolic steroids on a male body:

  • increased production of estrogen because of excess amount of testosterone;
  • as a lot of hormones penetrate blood externally, natural production of these hormones is inhibited;
  • Testosterone excess is processed and translated into estrogens.

gynecomastia
It should be noted that gynecomastia treatment in men who used anabolics for a long time, does not only mean to stop taking these substances. For this reason, men should be very careful with taking anabolics but it is better to refrain from their usage.

Signs of gynecomastia in men

Mammary glands enlargement may be minor (2 cm) and very prominent (up to 15 cm). Nipple discharge occurs rarely and may relate to true gynecomastia . Men may have large nipples . Often the patients have other complaints:

  • discomfort when wearing clothes;
  • feeling of spreading and squeezing;
  • pain;
  • increased sensitivity of nipples;
  • sexual function decrease, including erectile dysfunction;
  • infertility;
  • CNS disorders.

There are several stages in the development of the disorder:

  1. Proliferation. This stages lasts for several months from the onset and is characterized by an active growth of glandular and fatty tissues. Any transformations ate this stage are fully reversible. At the proliferation state there are all the chances to cure gyno in men without surgery with further complete recovery.
  2. Intermediate. The duration of this stage is about a year. This is the phase of glandular maturation when it is almost impossible to reverse the situation.
  3. Fibrous. It is a complete termination of the glandular development and the growth of connective-tissue fibers. It means that regression of the process is absolutely impossible. The second and the third stages require surgical interference to eliminate gynecomastia .

Diagnosis of the disease

Patients with this pathology are usually at a loss and do not know what doctor they should visit. Despite the fact that this disease affects only one part of the body, it is closely connected with the whole body and its systems. Typically, men having gyno consult these doctors:

  • thyroid specialist;
  • surgeon;
  • oncologist;
  • senologist;
  • urologist.

Each specialist examines his or her area and thus a patient gets a complete picture about the mechanism of disease development and the doctors choose the most optimal complex gynecomastia treatment .





The main aspects of diagnosis are detection of the level of sex hormones, detection of the tumors in different parts of the body, determination of a patient’s karyotype, identification of a family and individual medical history.

Treatment without surgery

Therapy excluding surgical interference can be performed only at the first stage of the disease, in some cases on the second stage as well when proliferation in the body is still can be reversed. Medications to treat gynecomastia should impact the etiology of the disease and the mechanisms of its development.

  • Breast enlargement caused by poor nutrition disappears without any additional measures except changing eating habits.
  • If the cause of the disease is iatrogenic (due to drugs), frequently it is enough just to stop taking the drugs.
  • Hormonal imbalance caused by inadequate glandular function is restored by administering sex hormones.
  • Gynecomastia caused by thyroid disorders or liver dysfunction is cured by eliminating the primary pathology and does not require any additional measures.
  • In the increased estrogen production, medications aimed at inhibiting female hormone production are indicated.

It is important to understand, that conservative home treatment in men is effective only within the first 6 years. If there are no results from the treatment or it is a late-onset disease, then surgical interference is required.

Surgery

Surgical manipulations in case with this disease pose a minimal risk of complications. The patients after the operation do not need extended hospital stay and rarely stay at hospital for more than 2 days.

Types of surgical interference:

  1. Endoscopic mastectomy (indicated for minor enlargement);
  2. Subcutaneous mastectomy with conservation of a nipple-areola (hypertrophied glands are removed but the nipple-areolas are left untouched);
  3. Subcutaneous mastectomy with liposuction (in addition to the gland removal, some fatty tissue is also removed).

To completely eliminate all the symptoms of gynecomastia after operation, it is necessary to wear special bandages for some weeks. The bandages help to restore the skin and proper muscle contour.

In general, patients with timely diagnosis and adequate treatment have a favorable prognosis. However you should be aware that gynecomastia may be caused by the tumor. Do not ignore the problem, otherwise the growth of glandular tissue may lead to malignant tumor and gynecomastia will be transferred into breast cancer.