Gynecomastia (Enlarged Male Breasts)

Men also have breasts, but women definitely prefer well-formed pectoralis in place of the softness of breast tissue. However, at some point in time, men may have recognizable outgrowth similar to breast or even form real breasts. This is called gynecomastia.

Gynecomastia is the enlargement of male breast tissue and it can happen in males of any age or weight. Obese men can look like they have this condition as they have fat tissue all over the body including the breasts; however, this is not true gynecomastia.

All males have the male sex hormone testosterone as well as low levels of the female hormone estrogen, which controls breast tissue growth. When the ratio of testosterone to estrogen changes (that is, there is an imbalance in the levels of these two hormones with relatively higher amounts of estrogen), breast tissue can grow. Some men with gynecomastia have higher than normal estrogen levels.

Also, as men get older there is often a gradual decrease in testosterone levels (and therefore the ratio of estrogen relative to testosterone goes up) and this can lead to gynecomastia.

Gynecomastia can also be caused by genetic problems, chronic diseases (especially kidney and liver disease) or some medicines. Men who take anabolic steroids for sporting performance or body building often develop gynecomastia. In rare cases, gynecomastia can be caused by a tumor in the testis or adrenal glands that produce large amounts of estrogen.

Medicines that can cause breast growth in men include;

  • Some antidepressants
  • Some antihypertensives
  • Tuberculosis medications
  • Chemotherapy agents
  • Some antibiotics
  • anti-ulcer medicine (cimetidine)
  • Alcohol and marijuana

Gynecomastia frequently presents social and psychological difficulties such as low self-esteem or shame for the sufferer and people with this condition are at an increased risk of breast cancer.

  • Breast cancer is only diagnosed in around 1% of cases of male breast enlargement, the mean age of male breast cancer is 65 years – but it can occur at any age.
  • Red flags which increase suspicion of breast cancer in men also similar to women include:
    Unilateral enlargement.
    Hard or irregular breast tissue.
    Rapidly enlarging.
    Recent onset.
    Fixed mass.
    Nipple or skin abnormalities.
    Painful.
    Axillary lymphadenopathy > 5cm

If you feel your breasts are bigger than expected, consulting a doctor becomes imperative in order to rule out chronic diseases or change a medication you might have been prescribed recently.

That you have a little breast tissue as a man doesn’t mean you aren’t masculine, you can exercise your masculinity in other ways.

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Author: Dr Ahmad Abdullah, MBBS, MSc Clinical Pathology

Ahmad is a father, a husband and a poet. He was born and raised in Lagos, Nigeria. He earned his medical degree from the University of Juba, currently in South Sudan. He is interested in medical research and currently practicing in Lagos, Nigeria.

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