By Ari S. Hoschander, M.D., F.A.C.S.

Gynecomastia is a medical condition characterized by the development of abnormally large breasts in men. While both men and women have breast glands, swelling and enlargement of breast tissue is not a normal occurrence for men.

Testosterone is the dominant hormone in males and estrogen in females. In a broader sense, gynecomastia is caused by an imbalance between the hormones testosterone and estrogen. The levels of testosterone fall, while estrogen rises, resulting in swollen breasts – which is a primarily a female characteristic. Such hormonal imbalance can be triggered due to a variety of factors.

Some of the possible causes are:

  1. Transitional phases of life: It is normal for hormones to go haywire when a person transitions from one stage of life to another. Many cases of gynecomastia fall in one of the following stages:
  2. Infancy: A newborn infant is very likely to have a case of swollen breast tissue. This is due to the transmission of excess estrogen from the mother’s milk. The levels of estrogen are usually back to normal within a few weeks, and the swelling disappears.

    Puberty: This particular stage of life brings about a lot of changes, and hormones are the first to go all over the place. Most of the cases of gynecomastia are observed due to the changing rhythms of hormones while ushering into puberty. The hormones establish a balance as things settle, and the condition is likely to resolve itself.

    Andropause: As men reach a certain age, the levels of testosterone are expected to fall, thereby increasing the chances of a rise in estrogen level. Due to this reason, aging men often exhibit enlarged breasts.

  3. Existing Medical conditions: Certain ailments, which may affect testosterone levels, put men at an additional risk of developing gynecomastia.
  4. Diseases such as liver cirrhosis and kidney failure can affect the optimum production of hormones. The functioning of the liver and the kidney are essential to maintain a balance between Estrogen and testosterone.

    Hypothyroidism is a condition resulting from compromised hormonal health, which can increase the chances of gynecomastia.

    Testicular tumors can directly affect the level of testosterone in the body, and may be related to the development of gynecomastia.

  5. Medications: Prescribed medicines for some conditions, as mentioned below, can affect the health of hormones as a side effect. Male breasts can be an extension of such side effects.
  6. Medications for hypertension and anxiety which alter hormones in the body to provide relief.
    Chemotherapy and cancer medicines.
    Medicines prescribed for mental health issues such as depression, stress, and exhaustion.

  7. Drug and alcohol abuse: Consumption of drugs such as heroin, marijuana, and steroids can sometimes lead to gynecomastia. Excessive alcohol drinking can also lead to the condition.
  8. Nutritional deficiency: Hormones are affected in a malnourished or nutritionally-deficient person, which increases the likelihood of developing the condition.
  9. Physical Injuries: Any physical injuries that compromise the functioning of testicles and the production of testosterone can be a potential cause of gynecomastia.
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