10 Possible Causes of Gynecomastia

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Gynecomastia is a medical condition characterized by enlargement of the male breast tissue. It is an extremely common condition that can afflict men of all ages, even infants. In itself, gynecomastia is not a serious medical concern as it is a result of natural hormonal imbalances caused during puberty and aging and because of unhealthy lifestyle practices. However, in other cases, its presence is indicative of serious health issues like cancer, liver failure, and autoimmune diseases. In this article, we will delve into the 10 possible causes of gynecomastia. By focusing on these causes, we hope to bring clarity to this condition. 

10 Possible Causes Of Gynecomastia

The following is a list of 10-most common causes of gynecomastia in men- 

Natural Hormone Changes

Gynecomastia in men is triggered by natural hormonal changes. Let us check them out. 

• Gynecomastia in infants

Gynecomastia in infants or pediatric gynecomastia refers to breast enlargement in babies. Pediatric gynecomastia causes mild swelling or lump formation under the nipple. This condition is considered benign, and in most cases, it is caused by exposure to high levels of maternal hormones in the womb. It is believed that the hormones which stimulate the milk glands during and after pregnancy in women cause gynecomastia. 

This form of gynecomastia is short-term and doesn’t require to be treated as the breast tissue starts to shrink once the baby is no longer exposed to the maternal hormones. Parents are advised not to touch or squeeze the affected area, as it can be irritating for their child and cause a bacterial infection. Squeezing and massaging the area does not aid the normal shrinking process whatsoever. 

However, you must speak to your pediatrician if the swelling doesn't subside, the breast seems red, painful, and there is discharge. If your child is also running a fever, then the gynecomastia could be attributed to neonatal mastitis. Mastitis is a common bacterial infection among breastfeeding women. Infants under the age of 5 weeks old can get this infection as well.

• Gynecomastia during puberty

Hormonal changes during puberty are the main cause of gynecomastia amongst adolescent boys. It is extremely common amongst boys between the ages of 12 - 16 to experience swelling of breasts in either one or both breasts. Usually, gynecomastia amongst pubescent boys subsides within a couple of years. In most cases, neither gynecomastia surgery nor medicines are required. Since it can cause immense emotional and psychological distress to boys, many opt for gynecomastia surgery. 

Gynecomastia in pubescent boys is rarely caused by other medical conditions like tumor growth or cancer treatment. Apart from hormonal changes during puberty, gynecomastia can be exacerbated by obesity, genetics, and consumption of illicit drugs and alcohol. Pubescent boys who partake in the consumption of illicit drugs, like heroin, amphetamines, and marijuana, are at risk of gynecomastia. Furthermore, the unregulated use of anabolic steroids to build muscles and strength can cause it, too. 

• Gynecomastia in adults

As we grow older and our body starts to decay, the production of hormones becomes less than optimal. Production of hormones can also be affected due to certain illnesses, cancers, and lifestyle. So, adult men with less than optimal production of testosterone can develop gynecomastia.

Medicines

Consuming the following medicines can cause gynecomastia- 

• Cancer treatment drugs

Several drugs used during chemotherapy cause hormonal imbalances. For instance, drugs used to treat enlarged prostates and prostate cancer can lead to gynecomastia. This is because these drugs treat the issue by blocking testosterone, which can offset the balance between estrogen and testosterone levels. 

• Antiretroviral medicines

Some antiretroviral drugs are linked with breast enlargement in men. This is because these drugs cause estrogen levels to increase in men as well as change the adipose tissue distribution throughout the body. 

• Medicines used to treat ulcers

Ulcer medications, in particular cimetidine, are linked with gynecomastia. Studies suggest that this could be because the medicine affects the way the body absorbs certain nutrients, thereby affecting the hormone levels that contribute to gynecomastia. 

• Anti-anxiety and depression medication

Many men report gaining weight and developing gynecomastia after taking anti-anxiety and anti-depression medication. This could be because tricyclic antidepressants and selective serotonin reuptake inhibitors affect the estrogen receptors in the breast tissues. 

Recreational Drugs And Alcohol Consumption

Excessive consumption of alcohol and recreational or illicit drugs contribute to gynecomastia in several ways. Consuming these harmful substances disrupts the normal production of hormones. It affects the proper functioning of the liver as well. The liver plays a crucial role in metabolizing hormones in men, especially estrogen. When the liver stops functioning properly, the male body stops metabolizing estrogen properly, causing a build-up of estrogen, which triggers gynecomastia. 

Obesity

Obesity can trigger gynecomastia in many different ways. Firstly, obesity triggers hormonal imbalance in men leading to an increase in estrogen levels due to high body fat composition. This stimulates the growth of breast tissue. Secondly, obese men develop insulin resistance in the body. The inability of the body to use insulin properly also stimulates the production of estrogen, which contributes to gynecomastia. 

Finally, obesity causes low-grade inflammation in the body, which disrupts hormonal balance and subsequently triggers gynecomastia. Some men, despite losing weight, are unable to resolve this issue and have no choice but to opt for surgery. Gynecomastia surgery cost, in this case, ranges between Rs. 50,000 to 1,00,000. 

Aging

While gynecomastia can happen to any man throughout their lifetime, it is extremely common amongst older men between 50 - 80. This is because the levels of testosterone decrease as men grow older, but the levels of estrogen tend to remain stable. In some men, the levels of estrogen can even increase as they grow older due to changes in fat composition. 

The imbalance in the ratios of estrogen and testosterone in men can trigger the development of breast tissue, subsequently leading to gynecomastia. Gynecomastia is further exacerbated by the increase in body fat and a decrease in muscle mass in older men. Gynecomastia caused by aging can be treated with testosterone replacement therapy, a healthy diet, and exercise. 

Liver and Kidney Failure

Liver cirrhosis is the severe scarring of the liver. Cirrhosis is caused by long-term alcohol abuse, viral hepatitis infection, fatty liver disease, biliary cholangitis, and autoimmune hepatitis. Liver cirrhosis goes unnoticed for a long time until the damage to the liver becomes severe. However, one can experience fatigue, nausea, easy bruising, loss of appetite, swelling of limbs, yellow discoloration of the skin, and itchy skin, along with gynecomastia in men, amongst other symptoms. 

Cirrhosis of the liver causes gynecomastia because damage to the liver disrupts the body’s normal metabolic process and hormone regulation. Several studies conducted on men with liver cirrhosis have indicated that these men show higher levels of estrogen and low levels of serum-free testosterone. Some theories suggest that this is because the body is unable to process estrogen properly due to liver damage. This causes the estrogen to accumulate in the body, which contributes to the development of gynecomastia.

Kidney failure is another contributing factor to gynecomastia in men. As the kidneys start to fail, the body becomes incapable of synthesizing and metabolizing androgen, resulting in hypogonadism. In men, hypogonadism disrupts the body’s ability to produce male sex hormones that play a vital role in regulating masculine growth and development. This causes hormonal imbalance, which leads to gynecomastia. 

In the case of kidney and liver failure, gynecomastia is caused not only because of hormonal imbalances but also by increased fluid retention. The entire body seems bloated because of increased fluid retention which changes the body’s electrolyte balance, further exacerbating gynecomastia. It is extremely important to seek medical intervention when dealing with liver and kidney failure as these conditions are life-threatening.

Thyroid Disorders

Gynecomastia is an extremely common symptom of hyperthyroidism among men. Studies show that over 25% of men with hyperthyroidism suffer from gynecomastia. Hyperthyroidism is a thyroid disorder in which the thyroid gland is underactive. Since the thyroid gland isn’t able to produce enough thyroid hormones for optimal metabolic function, it results in hormonal imbalance, especially disrupting the production of estrogen and testosterone. 

Additionally, even hypothyroidism can contribute to gynecomastia. Hypothyroidism is a common thyroid disorder characterized by an overactive thyroid gland. Men with hypothyroidism experience rapid weight gain and changes in the body’s fat composition, especially around the breasts. In such a case, treating the thyroid disorder should bring gynecomastia under control. 

Malnutrition And Starvation

While it might seem odd, malnutrition and starvation are two major causes of gynecomastia in men. When our body is deprived of essential nutrients either because of extreme dieting, starvation, or poor eating habits, then that can disrupt the normal production of hormones. This leads to hormonal imbalance. 

In men, inadequate intake of vital nutrients like protein, carbohydrates, iron, magnesium, and other micro and macronutrients can significantly impair the functioning of the endocrine system. The endocrine system is a network of glands that create and release hormones that are responsible for managing the body's growth, development, reproduction, metabolism, and energy. In such a situation, to ensure survival, the male body tends to conserve energy over optimal hormone production. 

Herbal Products

Just because something is natural doesn't make it harmless. To build muscles and gain strength, many men opt for herbal products because they are easier to procure than steroids. However, these herbal products do not go through rigorous testing and approval processes. Sadly, most performance-enhancing herbal products are found to be adulterated with androgens and phytoestrogens. 

Both of these plant-derived compounds mimic the effects of estrogen in the body. Thereby creating hormonal imbalance by unwanted increases in levels of estrogen. The presence of high levels of estrogen over testosterone in men leads to gynecomastia, amongst other physical issues. Surgery for gynecomastia and abstaining from consuming these herbal products can resolve gynecomastia. Gynecomastia surgery cost tend to be low, and recovery is fast in this case, especially when there are no other underlying issues causing gynecomastia. 

Tumors of the Adrenal Or Pituitary Glands

Tumors refer to the abnormal formation of tissue due to unwanted growth of cells that did not die when they should have. Tumorous growth tends to interfere with the proper functioning of the body part, muscle, gland, or organ where they are present. Both the pituitary and adrenal glands are responsible for the production and synthesis of important hormones in the body, like estrogen and androgen; tumors of these glands in men can result in hormonal imbalances, which cause gynecomastia. 

Conclusion

In conclusion, gynecomastia in men has several causes, including drug abuse, overconsumption of alcohol, cancer, using herbal products, and liver failure, amongst a few. Gynecomastia should not be overlooked as it can indicate a serious health problem and also have detrimental effects on the emotional and physical self-esteem of the person. Getting regular medical examinations and making responsible lifestyle changes can help mitigate the effects of gynecomastia.

Frequently Asked Question

Can Gynecomastia go away?

Gynecomastia in infants and adolescent boys usually subside as they grow older and their body achieves hormonal balance. However, in many cases, it may require lifestyle changes, medicinal treatment, or even gynecomastia surgery to reduce swelling. For instance, gynecomastia caused by obesity and poor diet can be treated by making lifestyle changes, such as eating nutritional foods and losing weight. 

What is gynecomastia surgery cost?

Gynecomastia surgery cost tends to depend on various factors like the surgeon’s experience, the extent of the procedure, where it is performed, and your geographical location. In India, gynecomastia surgery costs range between Rs 50,000 to Rs. 1,00,000. India is a popular medical destination amongst foreigners since the cost of surgery is low in comparison to other countries. 

Is gynecomastia surgery permanent?

Procedures like liposuction or mastectomy to remove gynecomastia tend to have long-term results. However, its effects are not permanent, especially when lifestyle changes are not made. So, if after the surgery, you continue to eat fatty foods that are devoid of nutrients, do not exercise regularly, and regularly consume alcohol and drugs, then there are chances of resurgence. 

How can I get rid of gynecomastia naturally?

Whether you can reduce swelling caused by gynecomastia depends heavily on the cause of gynecomastia. For instance, if the root cause of gynecomastia is liver failure, testicular cancer, or tumorous growth, then you need medical intervention. However, gynecomastia caused by malnutrition and consumption of illicit drugs and alcohol can be mitigated by avoiding alcohol and illicit drugs and maintaining a healthy diet. 

How do you treat gynecomastia in men?

Treatment for gynecomastia varies amongst men based on severity and cause. Therefore, it is imperative to consult a medical professional to get sound medical advice. Gynecomastia treatment usually entails treating underlying conditions for gynecomastia, hormone therapy, lifestyle modifications, surgery, and medications.