Gynecomastia – Enlarged Breasts in Men

GYNECOMASTIA

ENLARGED BREASTS IN MEN

Gynecomastia presents with a swelling of the breast in males due to an imbalance of the hormones. Gynecomastia can affect one or both breasts, sometimes unevenly.

Although gynecomastia is not a serious disease, many boys and men may find difficoult to cope with the condition in their personal and social life and therefore seek my help.

Newborns may be affected as a result of physiologic changes in hormon levels. In this case gynecomastia may go away on its own by the age of 20 (timing is subjective).  If it persists, you might benefit from medications or surgery.

Symptoms:

  • Swollen breast
  • Breast tenderness
  • Pain
  • Nipple discharge in one or both breast

Natural changes with time

  • Gynecomastia in infants. During the last trimester of pregnancy the mother’s estrogen pass to the baby, male and female thus, more than 50% of male new born presents enlarged breast. The condition disappear with 3 to 4 weeks after birth.
  • Gynecomastia in puberty. Gynecomastia caused by hormone changes during puberty is frequently seen. Generally, the condition disappear with 2 to 3 years after puberty.
  • Gynecomastia in men. The prevalence of gynecomastia peaks again between the ages of 50 and 69. It is estimated that 1 in 4 men in this age group are affected.

Medications

Several medications may cause gynecomastia. This is the most frequent cause within young or adults men.  These include:

  • Anti-androgens used to treat prostate enlargement, prostate cancer and some other conditions. Examples include flutamide, finasteride (Proscar, Propecia) and spironolactone (Aldactone).
  • Anabolic steroids and androgens.
  • Gynecomastia can develop in HIV-positive men who are receiving a treatment with antiretroviral therapy (HAART). Efavirenz (Sustiva) is more commonly associated with gynecomastia than are other HIV medications.
  • Anti-anxiety medications, such as diazepam (Valium).
  • Tricyclic antidepressants.
  • Some antibiotics.
  • Ulcer medications, such as cimetidine (Tagamet HB).
  • Chemotherapy for cancer.
  • Heart medications, such as digoxin (Lanoxin) and calcium channel blockers.
  • Gastric motility medications, such as metoclopramide (Reglan).

Alcohol and Drugs

  • Alcohol
  • Methadone
  • Heroin
  • Marijuana
  • Amphetamines

Health conditions

Several health conditions can cause gynecomastia by affecting the normal balance of hormones. These include:

  • Hypogonadism. Any of the conditions that interfere with normal testosterone production, such as Klinefelter’s syndrome or pituitary insufficiency, can be associated with gynecomastia.
  • Ageing. Hormone changes that occur with normal aging can cause gynecomastia, especially in men who are overweight.
  • Tumors. Some tumors, such as those involving the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.
  • Hyperthyroidism. In this condition, the thyroid gland produces too much of the hormone thyroxine.
  • Kidney failure. About half the people being treated with regular hemodialysis experience gynecomastia due to hormonal changes.
  • Liver failure and cirrhosis. Hormonal fluctuations related to liver problems as well as medications taken for cirrhosis are associated with gynecomastia.
  • Malnutrition and starvation. When your body is deprived of adequate nutrition, testosterone levels drop, but estrogen levels remain constant, causing a hormonal imbalance. Gynecomastia can also occur once normal nutrition resumes.

Gynecomastia has few physical complications, but it can cause psychological or emotional problems caused by appearance.

INCISIONS: Varies (2 small or around the nipple)

LENGHT OF STAY: day case or 1 night

THEATRE TIME: 1-2 HOURS

TIME OFF-WORK: 1-2 weeks