The development of prominent breast tissue in the male.

General information about Gynecomastia

The most common cause of gynecomastia in the male is puberty. The condition may occur in one or both breasts and begins as a small lump beneath the nipple, which may be tender. The breasts often enlarge unevenly. Gynecomastia during puberty is not uncommon, is self-limiting, and usually goes away over a period of months.

In newborns, breast development may be associated with milk flow (galactorrhea). This condition usually lasts for a couple of weeks and in rare cases may persist until the child is two years old. It is caused by exposure to maternal hormones.

Other causes of gynecomastia include chronicliver disease, kidney failure, and exposure to estrogens, androgens (often taken secretly for body building). marijuana, and some medications. Rare causes include tumors, genetic defects, and an overactive thyroid

Causes of Gynecomastia

• puberty
• exposure to estrogen hormone
• exposure to androgen hormones
• marijuana use
• tumors
• genetic disorders
• chronic liver disease
• kidney failure
• side effects of some medications

Breast growth is directed exclusively by female hormones--estrogens. Although men have some estrogen in their system, it is usually insufficient to cause much breast enlargement because it is counterbalanced by male hormones--androgens. Upsetting the balance, either by more of one or less of the other, results in the male developing female characteristics, breast growth being foremost.

At birth both male and female infants will have little breast buds from their mother's hormones. These recede until adolescence, when girls always, and boys sometimes, have breast growth. At this time, the boy's breast growth is minimal, often one-sided and temporary.

Extra or altered sex chromosomes can produce intersex problems of several kinds. Breast growth along with male genital development is seen in Klinefelter syndrome--the condition of having an extra X (female) chromosome--and a few other chromosomal anomalies. One of the several glands that produce hormones can malfunction for reasons other than chromosomes. Failure of androgen production is as likely to produce gynecomastia as overabundant estrogen production. Testicular failure and castration can also be a cause. Some cancers and some benign tumors can make estrogens. Lung cancer is known to increase estrogens.

If the hormone manufacturing organs are functioning properly, problems can still arise elsewhere. The liver is the principle chemical factory in the body. Other organs like the thyroid and kidneys also effect chemical processes. If any of these organs are diseased, a chemical imbalance can result that alters the manufacturing process. Men with cirrhosis of the liver will often develop gynecomastia from increased production of estrogens.

Finally, drugs can also cause breast enlargement. Estrogens are given to men to treat prostate cancer and a few other diseases. Marijuana and heroin, along with some prescription drugs, have estrogen effects in some men. On the list are methyldopa (for blood pressure), cimetidine (for peptic ulcers), diazepam (Valium), antidepressants, and spironolactone (a diuretic).

Diagnosis of Gynecomastia

Carefully feeling the area beneath the nipple of an adolescent boy with breast enlargement will reveal a discreet and sometimes tender lump the size of a fat nickel or quarter. For more serious gynecomastia, the underlying disease will require evaluation, if it is not already well understood.

Treatment of Gynecomastia

This condition is usually not treated. If it is the result of endocrine disease, hormone manipulations may reduce the effects of the imbalance. There are a number of medical and surgical interventions possible. Radiation of misbehaving organs and cancers is considered an effective treatment.