Enlarged Male Breasts: 5 Causes Of Gynecomastia (Man Boobs)

No need a college of medicine to figure out the signs and symptoms of enlarged male breasts! We’ve done research just for you. Here are the gynecomastia tissue growth factor that you need to know

gynecomastia man boobs

Enlarged male breasts or man boobs in medical term is called Gynecomastia. It is a common affliction that affects 30 to 50% of all males.

If may affect only one breast, or both, and feels like a button growth under the nipple area. The concentric enlargement in the areola has a certain structure of male breast tissue palpable.

There can be many reasons why you have enlarged male breasts. Here is a full list and explanation of all the known causes of enlarged breast growth in males:

1. Endocrine Abnormalities / Hormone Imbalance

Most males will lose their man boobs naturally. This is because young boys until they go through puberty, will have a small amount of breast tissue under the nipples or the areola area.

Upon puberty, testosterone level produced by the testicles will prevent further growth of the breast tissue. Any physiologic gynecomastia that develops during puberty usually resolves within 6 months to 2 years.

A survey of 279 Gynecomastia sufferers showed that in 85% of the cases, their enlarged male breasts appeared before they were 17 years old.

Unfortunately, the man boobs condition appeared during puberty continues into adulthood. And in 15% of the cases, appears into adulthood. Most likely due to hormone imbalances. Such as underproduction of testosterone, over-production of estrogens or a mix of both.

Indeed, the imbalance between estrogen level to androgen at the breast tissue appears to be the main cause of gynecomastia.

Here are the main manifestations of hormonal imbalance:

A. Androgen resistance syndrome

This is a condition that results in the partial or complete inability of the cell to respond to androgens (male hormones).

This means the testosterone hormones cannot bind to androgen receptors. This can impair or prevent the development of male secondary sexual characteristics at puberty. This syndrome is largely genetic.

B. Hyperprolactinemia

Hyperprolactinemia is the presence of abnormally high levels of prolactin in the blood (more than 450-500 mlU/L for men).

Prolactin is actually a hormone created by the anterior pituitary gland. It plays a central role in breast gland development. Most commonly associated with lactation for pregnant women. Prolactin over-production in men would, therefore, explain the enlarged male breasts.

A blood test might reveal abnormal levels! Some medication like cabergoline or bromocriptine usually cures hyperprolactinemia.

C. Hyperthyroidism

Do you suffer from tremor, heat intolerance, diarrhea, tachycardia, goiter or exophthalmos?

Then you might have hyperthyroidism. A common condition is also known as the “overactive thyroid“. Which mean the thyroid gland makes too much thyroid hormone.

Thyroid hormones promote the liver to supply sex-hormone-binding globulin (SHBG). Results in a higher binding of testosterone compared to estradiol.

This makes a reduction in free testosterone compared to estrogen. There’s also increased aromatization (by aromatase) of testosterone to estradiol.

Thyroid function tests will help diagnose this.

D. Hypogonadism

Hypogonadism is a common cause of gynecomastia. It describes the diminished functional activity of the gonads. In men, testosterone biosynthesis is impaired.

In its postpubertal onset, hypogonadism is indicated by…

  • decreased libido
  • erectile dysfunction
  • mood changes
  • decreased muscle
  • increase fat mass
  • osteopenia
  • testicular atrophy and
  • mild cognitive changes

You would need to have your FSH, LH and testosterone levels checked.

Hypogonadism is a usual effect of Klinefelter’s syndrome (or XXY syndrome).

A situation with more X chromosome (like a female). Not all men affected with XXY syndrome will develop man boobs (a third do).

Gynecomastia traits in these men will usually become evident around puberty if they do arise.

E. Hypergonadism

At the complete opposite of hypogonadism is hypergonadism. It can go both ways: over-production of testosterone or over-production of estrogen.

You would think the former is largely associated with men while the latter would be associated with women.

But men also suffer from what is called hyperestrogenism.

A medical disorder is known as a lot of estrogenic action in your body. This may come from genetic conditions. Such as excess production of aromatase. Or it might be overconsumption of exogenous sources of estrogen.

The latter a common side effect of taking certain drugs or being exposed to estrogens/estrogen-like drugs (oral contraceptives, diethylstilbestrol, estrogen-containing cosmetics, phytoestrogen).

Keep on reading to learn more.

2. Drugs

Gynecomastia in adult males can also be a side effect of commonly prescribed medicines.

Some of which are for treatment of ulcers, heartburn, heart diseases, and high blood pressure.

The health information very important. We recommend the symptom checker with your doctor whether your condition is caused by these medications.

Many drugs are implicated. Due to their chemical structures, different drugs result in different modes of gynecomastia development.

Drugs that cause enhancement of estrogen formation

Either by increased aromatase activity or increased precursors:

  1. Clomiphene
  2. Gonadotropins
  3. hCG administration
  4. Anabolic steroids
  5. Testosterone replacement therapy (TRT). The alternative healthcare for low testosterone level patient

Drugs that cause inhibition of testosterone action/synthesis

By blocking receptors of androgens for example (Bicalutamide, used in the treatment of prostate cancer):

  • cimetidine
  • ranitidine
  • ketoconazole
  • metronidazole
  • spironolactone
  • alkylating agents
  • cisplatin
  • etomidate
  • flutamide
  • cyproterone acetate
  • finasteride
  • busulfan
  • heroin
  • methadone
  • alcohol

Drugs with unknown mode of action

  1. methyldopa
  2. calcium-channel blockers
  3. captopril
  4. tricyclic antidepressants
  5. diazepam
  6. penicillamine
  7. isoniazid
  8. phenothiazines
  9. amiodarone
  10. phenytoin
  11. omeprazole
  12. highly active antiretroviral therapy (HAART) for HIV

Even though drugs are in charge of under 20% of most instances of gynecomastia! There is a long list of medications that have been identified as potential causes of enlarged male breasts.

Here is a further rundown of drugs that have been linked with Gynecomastia

Drugs that have estrogen effects:

  • methyldopa (for blood pressure)
  • cimetidine (for peptic ulcers)
  • diazepam (Valium)
  • antidepressants
  • spironolactone (a diuretic)
  • flutamide
  • digoxin
  • spironolactone

Estrogens are also given to men to treat prostate cancer.

Drugs that inhibit androgen synthesis or activity:

  • cyproterone
  • ketoconazole
  • dutasteride
  • finasteride
  • flutamide
  • bicalutamide
  • enzalutamide
  • nilutamide (antiandrogens used to treat prostate cancer)

Antimicrobials:

  • efavirenz
  • ethionamide
  • isoniazid
  • ketoconazole
  • metronidazole

Antineoplastic drugs:

  • alkylating drugs imatinib
  • methotrexate
  • vinca alkaloids

Cardiovascular drugs:

  • ACE inhibitors (eg. Captopril, enalapril)
  • amiodarone
  • nifedipine
  • diltiazem
  • methyldopa
  • reserpine
  • spironolactone

CNS-acting drugs:

  • diazepam
  • haloperidol
  • methadone
  • phenothiazines
  • tricyclic antidepressants

Antiulcer drugs:

  • cimetidine
  • ranitidine
  • omeprazole

Hormones:

  • androgens
  • anabolic steroids
  • estrogens
  • human growth hormone

Recreational drugs:

  • amphetamines
  • ethanol
  • heroin
  • marijuana (the jury’s still out on this one)

OTC herbal drugs:

  • lavender oil
  • tea tree oils. A recent study reported cases of cause gynecomastia by the topical application of products containing lavender oil and/or tea tree oil. It is believed that both of these agents have estrogenic and anti-androgenic activity.

Other drugs:

  • auranofin
  • diethylpropion
  • domperidone
  • metoclopramide
  • phenytoin
  • penicillamine
  • sulindac
  • theophylline

As a diagnosis, try stopping the use of that drug and see if your enlarged male breasts come into the healing progress.

3. Systemic disorders

When the normal hormone production organs are working properly, some issues may still happen in other places.

The liver will be the principle chemical production within the body. Some other body parts such as thyroid and kidneys equally impact chemical systems.

In case these areas are infected, a compound imbalance may end up changes the production process.

Here are the most common of these systemic disorders:

A. Chronic kidney disease

If your family has a history of chronic kidney disease, there are reasons to believe you might have too. This type of disease can be diagnosed by urinalysis.

B. Chronic liver disease/Cirrhosis

In most cases, men with the liver cirrhosis produce Gynecomastia through enhancing the estrogen process

If your family has a history of liver disease, alcohol use or both, or if you have ascites, spider angiomas (red spots on the skin surface with reddish extensions, like a spider’s web), or dilated abdominal veins.

A cirrhosis can be diagnosed by routine laboratory testing and/or liver biopsy.

C. Obesity

Obesity causes increased Extraglandular aromatase activity. Aromatase is the enzyme responsible for the synthesis of testosterone into estrogen.

Increased activity will, therefore, cause an over-production of estrogen level in your body, which will likely cause enlarged male breasts.

D. Feeding after undernutrition

Muscle and fat wasting, hair loss, skin changes, frequent infections, fatigue and signs of vitamin deficiencies are all common symptoms of this.

Feeding after undernutrition might cause over-production of aromatase, which explains the increased synthesis of estrogen, and breast growth. A good intake of nutrients is very important for the mens health

4. Neoplasms

Gynecomastia breast enlargement can be the first sign of an adrenal, liver, lung or testicular tumor.

Many types of tumors can stimulate the production of human chorionic gonadotropin (hCG), which in turn can increase the estrogen-androgen ratio.

Lung cancer, for example, is known to increase estrogen. Conversely, Gynecomastia may increase the risk of other types of cancer, although the risk is small.

Because men don’t think about having it checked, they might for example in the advanced stage of their gynecomastia develop breast cancers, as women do.

Neoplasms are a less common cause of gynecomastia but include:

  • Feminizing adrenocortical tumor, indicated by a palpable mass and testicular atrophy. An MRI will help diagnose this.
  • Paraneoplastic ectopic production of human chorionic gonadotropin (hCG): if there are signs of primary tumor or symptoms and signs of hypogonadism, then you might have this affliction. Ectopic hCG production might be caused by germ cell tumors or bronchogenic carcinoma (tumor in the lungs). You should go through an evaluation for the suspected primary tumor
  • Testicular tumors: have it check with an ultrasonography. If you have a testicular tumor, you might have the same symptoms as hypogonadism.
  • Renal failure

5. Idiopathic

Idiopathic gynecomastia is the most common. If the evaluation reveals no cause for enlarged male breasts, it is considered idiopathic.

The cause may not be found because there is no longer any evidence of the inciting event. You should still have your serum testosterone level checked, and go through a clinical evaluation in 6 months.

gynectrol gynecomastia pills

Treatment to consider

  1. Gynecomastia surgery. This is probably the most common option. But, as you know, go to a plastic surgeon to remove man boobs really expensive.
  2. Gynecomastia Pills. An alternative way to spend less and save money. A lot of gyno pills out there, Gynectrol for example. One of the popular tablets to reduce glands produce enlarged male breasts
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