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Gynecomastia is a condition in which males develop enlarged breast tissue due to an increase in glandular tissue. It is a benign (non-cancerous) condition and is different from chest fat. When the swelling is caused by excess fat and not glandular growth, it is referred to as pseudo gynecomastia.
Male gynecomastia can affect individuals at different stages of life, including newborns (gynecomastia in infants), adolescents (gynecomastia in puberty), and older men. This condition is quite common and is estimated to affect over half of all males at some point in their lives.
Gynecomastia typically appears as a firm, rubbery lump of tissue beneath the nipple area. It may feel like a button-sized swelling that can be tender or slightly painful to touch. In some cases, the lump may move slightly within the breast tissue. This can happen on one side (unilateral gynecomastia) or both sides of the chest.
In male gynecomastia, the enlargement is caused by an increase in glandular tissue, not just fat. However, if the swelling is due to excess fat, especially in individuals with obesity, it is called pseudo gynecomastia. This usually feels softer and looks like a general increase in chest size, without a distinct lump.
The symptoms of gynecomastia may develop gradually and vary depending on age and cause. Common signs include:
Consult a doctor if you notice:
Gynecomastia occurs when there is an imbalance between the hormones, testosterone and oestrogen. In men, testosterone controls male traits like muscle mass and body hair, while oestrogen, though present in small amounts, controls breast tissue growth. When oestrogen levels increase or testosterone levels drop, male breast development can occur.
Several factors can affect this hormone balance:
Certain medications may lead to gynecomastia by affecting hormone levels. These include:
Use of the following can be a gynecomastia cause:
Several medical conditions may lead to glandular tissue gynecomastia, including:
Products containing tea tree or lavender oil, often found in shampoos or lotions, have been linked to small gynecomastia cases. These oils may mimic oestrogen or interfere with testosterone.
Gynecomastia in men can be of two main types:
True Gynecomastia: This involves an increase in glandular tissue beneath the nipple, often due to hormonal imbalance. It feels like a firm or rubbery lump and may affect one or both sides of the chest. It’s common during puberty, infancy, and older age.
Pseudo Gynecomastia: This is caused by fat tissue, not glandular growth. It is usually linked to obesity and results in soft, enlarged male breasts without a central lump.
The severity of male breast development is classified into four grades based on the extent of tissue growth and skin excess. Understanding these grades helps in identifying the stage of male gynecomastia and guiding treatment decisions.
At this stage, there is only slight breast development in men. A small amount of glandular tissue forms around the areola (the darker area around the nipple), creating a soft or firm button-like swelling. The chest remains flat in appearance when dressed, and the swelling may not be noticeable through clothes. This grade is often seen in gynecomastia in puberty and may resolve on its own.
Here, the male breast tissue expands more broadly across the chest, covering most of the pectoral muscles. However, there is still no sagging or extra skin. This stage is more noticeable than Grade 1 and may cause emotional distress or self-consciousness. Unilateral gynecomastia (affecting one side) may also become more obvious at this point.
This grade involves a visible increase in breast size, along with some sagging due to excess skin. The glandular tissue in gynecomastia becomes firmer and more prominent. The chest shape may resemble female breasts, and the condition is noticeable even under clothing. Men at this stage may experience discomfort and psychological impact due to their appearance.
Grade 4 represents the most advanced stage of gynecomastia in men. There is a large amount of glandular and fatty tissue, along with pronounced sagging of the skin. The breasts appear similar to those of a woman and may cause back pain or postural issues. Men might slouch to hide the chest area, and if left untreated, it can lead to physical and emotional complications. In some cases, there may be left gynecomastia or one-sided gynecomastia, making it harder to balance the chest appearance.
Gynecomastia is primarily caused by hormonal imbalances. These changes can occur naturally during puberty, ageing, or certain health conditions, making complete prevention difficult in many cases.
However, there are several controllable factors that may help lower the risk of gynecomastia or prevent it from worsening:
Lifestyle and Health Choices
Gynecomastia can develop either gradually or quite suddenly, depending on the cause. Hormonal shifts, especially during puberty or due to medication use, can lead to noticeable male breast development over a short period. In other cases, it may progress slowly, making it less obvious at first.
While weight loss can reduce chest fat, it may not eliminate true gynecomastia, which involves glandular tissue rather than fat. This is why some men notice persistent breast enlargement despite losing excess weight, especially in cases of small gynecomastia.
One-sided or unilateral gynecomastia can occur due to uneven hormonal activity or localised sensitivity in the breast tissue. Though it may appear unusual, one-sided breast enlargement in men is not uncommon and is usually benign.
Gynecomastia itself does not affect fertility or sexual function. However, if it is linked to a hormone imbalance or an underlying condition like hypogonadism, it could potentially impact reproductive health. It is important to assess hormone levels if concerns arise.
Yes, gynecomastia can recur if the factors that caused it in the first place, such as hormonal shifts, medication use, or substance intake reappear. This is more likely in cases where the underlying cause was not fully resolved.
Yes, gynecomastia in newborns is normal and usually temporary. It occurs due to maternal hormones that pass to the baby before birth. The swelling usually disappears within a few weeks and does not require treatment.
Yes, gynecomastia can vary in size, texture, and the type of tissue involved. It can be purely glandular, purely fatty (pseudo gynecomastia), or a mix of both. The condition can also be classified based on the stage or extent of male breast development.
Yes, older men are at a higher risk of developing gynecomastia due to natural declines in testosterone levels. Age-related hormonal changes, along with certain health conditions or medications, can lead to late-onset gynecomastia.
Generally, gynecomastia causes smooth, rubbery, and mobile tissue beneath the nipple. Male breast cancer, though rare, tends to feel firmer, may be fixed in place, and is sometimes accompanied by skin changes or nipple discharge. Any unusual signs should be medically checked.
Yes, in some cases, gynecomastia may not cause obvious swelling or discomfort. It might involve only a small amount of glandular tissue that isn’t visibly noticeable but can be detected during a physical exam. This subtle form, sometimes referred to as small gynecomastia, may go unnoticed unless actively examined.