Gynaecomastia (often referred to as ‘man boobs’) is the enlargement of male breast tissue. Gynaecomastia appears as a rubbery or firm mass that starts from underneath the nipple and then spreads outwards over the breast area. The tissue is enlargement of glandular tissue, not fat tissue. In about half of cases, enlargement is found in both breasts; in the other cases it only affects one breast.
Gynaecomastia can happen in males of any age or weight. Obese men can appear to have man boobs as they have fat tissue all over the body including the breasts; this is not true gynaecomastia.
The growth of breast tissue can be painful or tender. This should always be checked by a doctor. Gynaecomastia can appear as a small lump that becomes tender as the mass becomes larger.
How common is gynaecomastia?
Gynaecomastia is very common in boys going through puberty, happening in more than half of all normal adolescent males, and usually goes away over time. In older men, enlargement of the breast tissue happens in about one-third of men.
What causes gynaecomastia?
Gynaecomastia commonly appears during infancy, puberty and older age. All males have the male sex hormone testosterone as well as low levels of the female hormone oestrogen, which controls breast tissue growth. When the testosterone to oestrogen ratio changes (that is, there is an imbalance in the levels of these two hormones with relatively higher amounts of oestrogen), breast tissue can grow.
Some men with gynaecomastia have higher than normal oestrogen levels.
Many newborn male babies have enlarged breast tissue because of transfer of oestrogen from the mother during pregnancy. The oestrogen goes down after birth so this type of gynaecomastia is temporary.
During mid to late puberty more oestrogen than testosterone is made by the maturing testis until the time when the testes start to make testosterone at adult levels. Gynaecomastia starting during puberty often goes away, but in less than one in 20 adolescent boys it continues into adulthood.
As men get older there is often a gradual decrease in testosterone levels (and therefore the ratio of oestrogen relative to testosterone goes up) and this can lead to gynaecomastia.
Gynaecomastia 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 gynaecomastia. In rare cases, gynaecomastia can be caused by a tumour in the testis or adrenal glands that makes large amounts of oestrogen.
What genetic problems cause gynaecomastia?
Klinefelter’s syndrome (KS), a chromosomal problem that affects one in every 650 males, is the main genetic cause of gynaecomastia. Men with KS have an extra X chromosome and do not make enough testosterone for the body to function normally. Male physical and reproductive development is affected and men with KS have small testes, are almost always infertile and often develop gynaecomastia.
Men with KS have an imbalance in their oestrogen to testosterone ratio because they have low testosterone levels. Testosterone therapy brings the ratio back to normal and helps prevent (when started at puberty) or improve the gynaecomastia, but it may not completely fix it and plastic surgery may be needed.
How can medicines or drugs cause gynaecomastia?
Medicines that can cause breast growth in men include certain antidepressants, medicines used for high blood pressure and tuberculosis, and some chemotherapy agents. Antibiotics, anti-ulcer and cardiovascular medicines have sometimes been found to change the balance of hormones in the body.
Drug abuse, especially the use of anabolic steroids, but also marijuana, opioids and excessive alcohol intake (that has caused chronic liver disease) can cause gynaecomastia.
Medicines that block the effects of testosterone are used in the treatment of prostate cancer and can lead to gynaecomastia.
In rare cases, the partners of women using topical oestrogen cream or gel for hormone replacement therapy may absorb enough oestrogen through regular, prolonged contact to cause gynaecomastia.
Gynaecomastia can happen in males of any age or weight. Obese men can appear to have man boobs as they have fat tissue all over the body including the breasts; this is not true gynaecomastia.
The growth of breast tissue can be painful or tender. This should always be checked by a doctor. Gynaecomastia can appear as a small lump that becomes tender as the mass becomes larger.
How common is gynaecomastia?
Gynaecomastia is very common in boys going through puberty, happening in more than half of all normal adolescent males, and usually goes away over time. In older men, enlargement of the breast tissue happens in about one-third of men.
What causes gynaecomastia?
Gynaecomastia commonly appears during infancy, puberty and older age. All males have the male sex hormone testosterone as well as low levels of the female hormone oestrogen, which controls breast tissue growth. When the testosterone to oestrogen ratio changes (that is, there is an imbalance in the levels of these two hormones with relatively higher amounts of oestrogen), breast tissue can grow.
Some men with gynaecomastia have higher than normal oestrogen levels.
Many newborn male babies have enlarged breast tissue because of transfer of oestrogen from the mother during pregnancy. The oestrogen goes down after birth so this type of gynaecomastia is temporary.
During mid to late puberty more oestrogen than testosterone is made by the maturing testis until the time when the testes start to make testosterone at adult levels. Gynaecomastia starting during puberty often goes away, but in less than one in 20 adolescent boys it continues into adulthood.
As men get older there is often a gradual decrease in testosterone levels (and therefore the ratio of oestrogen relative to testosterone goes up) and this can lead to gynaecomastia.
Gynaecomastia 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 gynaecomastia. In rare cases, gynaecomastia can be caused by a tumour in the testis or adrenal glands that makes large amounts of oestrogen.
What genetic problems cause gynaecomastia?
Klinefelter’s syndrome (KS), a chromosomal problem that affects one in every 650 males, is the main genetic cause of gynaecomastia. Men with KS have an extra X chromosome and do not make enough testosterone for the body to function normally. Male physical and reproductive development is affected and men with KS have small testes, are almost always infertile and often develop gynaecomastia.
Men with KS have an imbalance in their oestrogen to testosterone ratio because they have low testosterone levels. Testosterone therapy brings the ratio back to normal and helps prevent (when started at puberty) or improve the gynaecomastia, but it may not completely fix it and plastic surgery may be needed.
How can medicines or drugs cause gynaecomastia?
Medicines that can cause breast growth in men include certain antidepressants, medicines used for high blood pressure and tuberculosis, and some chemotherapy agents. Antibiotics, anti-ulcer and cardiovascular medicines have sometimes been found to change the balance of hormones in the body.
Drug abuse, especially the use of anabolic steroids, but also marijuana, opioids and excessive alcohol intake (that has caused chronic liver disease) can cause gynaecomastia.
Medicines that block the effects of testosterone are used in the treatment of prostate cancer and can lead to gynaecomastia.
In rare cases, the partners of women using topical oestrogen cream or gel for hormone replacement therapy may absorb enough oestrogen through regular, prolonged contact to cause gynaecomastia.
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