Common Causes of Gynecomastia (Male Breasts)

Enlarged male breasts, also known as gynecomastia, can be a source of embarrassment and self-consciousness. You may feel uncomfortable taking your shirt off or find yourself avoiding certain social situations. But if you have gynecomastia, you are not alone. Studies have shown that 36 percent of young adult men and 57 percent of older men in the U.S. will experience gynecomastia, which can affect one or both breasts.

Gynecomastia is the result of changes in the body’s hormone levels. In people assigned male at birth, the body mainly creates the sex hormone testosterone, as well as small amounts of the hormone estrogen. Gynecomastia can occur when the body’s level of estrogen is higher than the level of testosterone.

As a board-certified plastic surgeon, Dr. Jeffrey Ditesheim is familiar with the emotional difficulties experienced by gynecomastia patients in Charlotte, NC, and nearby areas. If you are dealing with this condition, you may wonder what caused it. Below are some of the most common causes of gynecomastia (male breasts).

Natural Hormonal Changes

Aging can lead to hormonal changes, particularly in people who are overweight. Puberty can also result in hormonal fluctuations. In teenagers, enlarged breast tissue often goes away on its own within six months to two years.

Male infants may also be born with swollen breasts because of the effects of estrogen during pregnancy, but it typically goes away within a month of birth.

Medications

Medications that cause hormonal changes include:

• Anti-androgens, used to treat conditions including enlarged prostate and prostate cancer
• Some antiretroviral medicines with estrogen-like properties
• ADHD medicines like Adderall that contain amphetamines
• Certain anti-anxiety medications and tricyclic antidepressants
• Some antibiotics
• Opioids for chronic pain
• Ulcer medicines, including cimetidine and omeprazole
• Heart medicines, including digoxin and calcium channel blockers

If your gynecomastia is caused by a medication you are taking, your prescribing physician may recommend an alternate course of treatment.

Health Conditions

Certain medical conditions lower your body’s amount of testosterone or increase the level of estrogen. These include:

• Disorders like Klinefelter syndrome and pituitary insufficiency, which decrease the amount of testosterone produced by the body
• Hyperthyroidism, which results in the thyroid gland making an excess of the hormone thyroxine
• Liver failure, which can cause changes in hormone levels
• Kidney failure, because of hormonal changes brought on by dialysis treatment
• Certain tumors, particularly in the testes, adrenal glands, or pituitary gland
• Malnutrition and starvation, since proper nutrition causes testosterone levels to drop while estrogen levels stay the same

If you’re dealing with one of these conditions and think it may be causing gynecomastia, talk to your doctor to determine the next steps and options for treatment. An experienced cosmetic surgeon can reduce gynecomastia through surgery.

Recreational and Illegal Drugs

Anabolic steroids used to build muscle, amphetamines, marihuana, heroin, methadone, and alcohol have been linked to gynecomastia. Additionally, studies have found that alcohol can suppress testosterone levels in the blood.

Treatment Options

In some cases, gynecomastia may go away on its own—particularly in teenagers. But if it persists, several options are available depending on its source. If you’re experiencing gynecomastia as a result of medication, your healthcare team will discuss what options are available, including switching to a different prescription.

Your doctor may recommend medications used for breast cancer to treat gynecomastia. These medicines include Tamoxifen (Soltamox), Raloxifene (Evista), and Anastrozole (Arimidex).

Surgery to remove extra tissue is also an option for treating gynecomastia. During your initial consultation, Dr. Ditesheim will determine if surgery is an appropriate treatment option and create a customized care plan for your unique needs.

Schedule an appointment with us today to learn more about what may be causing your gynecomastia (male breasts) and options for treatment.