GYNECOMASTIA
Gynecomastia is the enlargement of the breast tissues in boys or men. Gynecomastia can affect one or both breasts. The excess of the breast may be equal in both breasts or may be uneven.
- Gynecomastia can be common during infancy, puberty and in middle-aged to older men.
- More than half of male infants are born with enlarged breast due to the effects of their mother’s estrogen. the enlarged breast tissue goes away within 2-3 weeks after birth
- The condition affects about 1 in 4 men between ages 50 and 69.
- Gynecomastia is not usually harmful or serious but it can be tough to cope with the condition.
- In some cases, it can result in sore breast tissue or pain, swelling and nipple discharge in one or both nipples. Seek immediate medical care if you experience this
- Men and boys with gynecomastia may feel embarrassed and this may cause psychological and emotional problems.
CAUSES
Gynecomastia is triggered by an imbalance of the hormones estrogen and testosterone. The male body produces both estrogen and testosterone, although estrogen is normally found in small quantities. The hormone testosterone and estrogen are responsible for the development of sex characteristics in both men and women. Testosterone controls muscle mass, body hair and also affects a man’s sex drive and mood. Estrogen controls female trait such as breast development. Larger breast may develop in a man if the levels of testosterone are especially low in comparison to estrogen.
This decrease may be caused by natural hormone changes, medications, or conditions that reduce testosterone level or increases estrogen level.
Natural hormone changes such as is seen in infants, puberty and aging men
Medications that can cause the condition include:
- Drugs of abuse such as amphetamines, marijuana, heroin, methadone
- Cancer chemotherapy
- Anti-androgen such as flutamide, finasteride used in treating prostate cancer, and some other conditions
- Herbals such as lavender, tea tree oil
- Some antibiotics such as isoniazid, metronidazole (Flagyl)
- Anti-ulcer drugs such as cimetidine ( Tagamet HB)
- Heart medication such as digoxin (Lanoxin)
- Calcium channel blocker for treating heart attack
- A tricyclic antidepressant such as amitriptyline
- Anti-anxiety medication such as diazepam
Health conditions that can cause the condition include:
- Tumors such as those affecting the testes, adrenal glands or pituitary gland
- Kidney failure
- Malnutrition and starvation
- Liver failure and cirrhosis
- Hyperthyroidism
SYMPTOMS
- Breast tenderness
- Swollen breast gland tissue
DIAGNOSIS AND TREATMENT
To diagnose gynecomastia, a careful medical history including your drug use, medical and family history may be important.
In most cases, diagnosis is made by a physical examination that may include careful assessment of your breast tissue, abdomen and genital.
To establish the cause of the condition in certain cases, initial tests may be recommended.
These may include a blood test to examine the liver, kidney and thyroid function
If cancer is suspected, a mammogram may be ordered by the doctor
Further testing may be required depending on the initial test result, such as CT scans, MRI scans, tissue biopsies and a testicular ultrasound.
TREATMENT
Most cases of the condition especially in pubertal males relapse over time with no treatment.
If your condition is caused by an underlying medical condition such as malnutrition, or cirrhosis, such condition may need treatment
Your doctor may recommend stopping or substituting any medication you are taking if that is the cause of your condition.
Breast cancer medication such as aromatase inhibitors (Arimidex), tamoxifen (Soltamox) may be helpful for some. These medications are approved by the FDA to treat breast cancer, not gynecomastia
If significant breast enlargement still exists after initial treatment, your doctor may suggest surgery. Liposuction and mastectomy are the two gynecomastia surgical options.
Liposuction procedure involves removing the breast fats and not the breast gland tissue, in mastectomy, the breast gland tissue is removed
For coping and support, you may go for counseling, talk to your friends and family, or connect with other people with the condition