Author: Dott.ssa Basile M. Gaetana (Tania)

Date: 10/06/2020

Male gynecomastia is the enlargement of male breast tissue.
It is common in men and boys at different stages of development and in other cases in association with certain medical conditions.
True male gynecomastia refers to the glandular tissue enlarged by hormonal causes rather than fat in the tissue.
The presence of fatty tissue in the breast is known as pseudogynecomastia or false gynecomastia.

The causes of male gynecomastia

In general, the cause is a hormonal imbalance.
All normal human beings have both male and female hormones.
Male gynecomastia occurs when male hormones (androgens) are relatively low compared to the level of female hormones (oestrogens) in the body.
This problem can occur temporarily during normal child growth, resulting in gynecomastia in newborns or during puberty.
In these cases, gynecomastia usually resolves itself when hormone levels return to normal.

Pathologies associated with male gynecomastia

In other cases, as in some diseases or when certain medical treatments are followed, the conditions that cause the onset of male breast enlargement can be established. Some diseases that can be associated include:

  • Cirrhosis of the liver
  • Malnutrition
  • Chronic kidney disease
  • Testicular disorders (infections, trauma, congenital pathologies)
  • Ageing
  • Testicular cancer
  • Anti-androgen treatments for prostate cancer
  • Hyperthyroidism

Drugs associated with male gynecomastia

A wide range of drugs have been associated with the onset of male gynecomastia. Among them, are:

  • Spironolactone, diuretic type
  • Calcium channel blockers
  • Ace inhibitors, drugs used to treat hypertension
  • Antibiotics
  • Anti-ulcer medications
  • Steroids, such as prednisone or dexamethasone
  • Anxiolytics and antidepressants
  • Antiretroviral therapy 

Other substances associated with male gynecomastia

Certain substances, for example:

  • Alcohol
  • Cannabis
  • Heroin
  • Anabolic steroids
  • Methamphetamines

Symptoms of male gynecomastia, how to recognise it

The enlargement of the breasts due to gynecomastia is usually symmetrical, but the consistency of the tissue is rubbery.
Both breasts are generally affected, although it can develop in only one.
Gynecomastia is not accompanied by pain, but can cause greater sensitivity of the area affected.

When to seek medical attention? Remedies If an adult male has gynecomastia, he should see a doctor.
A doctor will be able to prescribe all the tests required to determine the cause of gynecomastia and rule out any serious illnesses, such as male breast cancer.

Such tests are laboratory tests and are not required for diagnosis. Male gynecomastia is usually diagnosed by a physical examination. In addition to a physical examination, a thorough medical history is also important to help assess the cause of gynecomastia. Only after the results of the preliminary examinations will more detailed diagnostic tests be used.

Male gynecomastia treatment

The treatment of male gynecomastia is not always necessary because as in transient gynecomastia, which occurs during puberty, it usually resolves itself.
If it is drugs that are inducing gynecomastia, discontinuation of the drug may be effective in reducing gynecomastia.
The treatment of any disease is also important.
If treatment is to be used, this can be both pharmacological and surgical.

Pharmacological treatment of male gynecomastia

Medications are most effective when used in the early stages of male gynecomastia.
However, to date, there are no reliable studies that can provide data demonstrating the effectiveness of pharmacological treatments for male gynecomastia.

Male gynecomastia surgery

When medical treatment is not effective, surgical removal of the breast tissue is used to treat male gynecomastia.
Both liposuction and other techniques can be used.
In the case of excess fatty tissue and an enlarged breast gland, a combined surgery to remove glandular tissue and liposuction to reduce excess fat can be used.
Surgery is generally safe, but as with any type of surgery there are risks and complications that can include infection, bleeding and reactions to the anaesthetic.
The costs of surgery can vary from case to case.

Prevention of male gynecomastia

Male gynecomastia, which originates from diseases or substances, can only be avoided to the extent that the disease responsible can be prevented. If there is excess weight, the reduction of fat could improve the appearance of the breasts with a consequent reduction in volume.

Male gynecomastia due to hormonal imbalances growing up or ageing can generally not be prevented. 

Dott.ssa Basile M. Gaetana (Tania)


Dott.ssa Basile M. Gaetana (Tania)

Medico Chirurgo - N. Iscrizione all' ordine: 8309 - Cosenza

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