Gynecomastia (patient information)
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2], Aarti Narayan, M.B.B.S [3]
Overview
Gynecomastia is a condition of large breasts in men. It is due to increased levels of estrogen (female hormone) than testosterone (male hormone) in the males. The condition is commonly seen in newborns, in adolescence and in elderly and usually goes away on its own. Gynecomastia usually doesn't require any testing, however, blood hormone levels, ultrasound or mammogram can be done in certain situations to rule out other diseases.
What are the symptoms of Gynecomastia?
- Breast enlargement
- Breast pain
What causes Gynecomastia?
- All men have both androgens and estrogens in fix levels. Androgens are hormones that create male characteristics, such as hair growth, muscle size, and a deep voice. Estrogens are hormones that create female characteristics.
- Changes in the levels of these hormones, or in how the body uses or responds to these hormones can cause enlarged breasts in men.
Common causes include
- Infancy
- Puberty
- Aging
- Chronic liver disease
- Exposure to anabolic steroid hormones
- Exposure to estrogen (female hormone)
- Kidney failure and dialysis
- Lack (deficiency) of testosterone (male hormone)
- Marijuana use
- Hormone treatment for prostate cancer
- Radiation treatment of the testicles
- Side effects of some medications (ketoconazole, spironolactone, cimetidine etc)
- Overactive thyroid
Rare causes include
Signs that may suggest breast cancer include
- One-sided breast growth
- Firm or hard breast lump that feels like it is attached to the tissue
- Skin sore over the breast
- Bloody discharge from the nipple
When to seek medical care?
- Call your health care provider if:
- You have recent swelling, pain, or enlargement in one or both breasts.
- There is dark or bloody discharge from the nipples.
- There is a skin sore or ulcer over the breast.
- A breast lump feels hard or firm.
Treatment options
Home care
- Apply cold compresses and use pain relievers ( analgesics) as your health care provider recommends if swollen breasts are also painful.
- Stop taking all recreational drugs, such as marijuana
- Stop taking all nutritional supplements or any medications you are taking and consult your doctor.
What to expect from your Office visit?
- Your health care provider will take a medical history and perform a physical examination.
- Medical history questions may include:
- Is one or both breasts involved?
- What is the age and gender of the patient?
- What medications is the person taking?
- How long has gynecomastia been present?
- Is the gynecomastia staying the same, getting better, or getting worse?
- What other symptoms are present?
- Testing may not be necessary, but the following tests may be done to rule out certain diseases:
- Blood hormone levels
- Breast ultrasound
- Liver and kidney function tests
- Mammogram
Intervention
- If an underlying condition is found, it is treated. Your physician should consider all medications that may be causing the problem. Gynecomastia during puberty and in newborns usually goes away on its own.
- Breast enlargement that is extreme, uneven, or does not go away may be embarrassing for an adolescent boy.
- Treatments that may be used in rare situations are:
- Hormone treatments that block the effects of estrogens.
- Breast size reducing surgery.