Body builders defined as men, any age but mostly 20-40 who want to really define and bulk up their chest muscles. Three categories:
Gyn in body builders can be from puberty. Puberty gynecomastia is far and away the most common. Gyn began during puberty and persisted: can be small acorn sized mass under the nipple, can be small mass causing nipple puffiness or can be fuller mass giving a breast like shape on top of the chest muscle. ( look under gynecomastia treatment muscular males in gallery)
But specific to body builders and really #2 and #3 above: taking steroids (anabolic) ( which is very uncommon in my practice) but more commonly “gym supplements” or “prohormones” can stimulate the small native male breast tissue to grow very dramatically. Often these body builder buys will take blockers to minimize the estrogen effect on the male breast tissue. There are good pictures of gynecomastia after prohormomes.
Gyn after prohormones ( or other similar gym supplements) is different from pubertal gynecomastia: The stimulation of the breast tissue can be very dramatic, can grow very large. The stimulated breast tissue may not respond to “blockers”. The breast tissue often will not regress when prohormones are stopped. The breast tissue for these guys can be painful. Note testosterone replacement or exogenous testosterone treatment does not cause gynecomastia. Also, in surgery, the male breast tissue after taking prohormones or other gym supplements is very dense and sticky, like an inflammatory reaction. Normally, gynecomastia is isolated in a central cylinder immediately and connected to the nipple. There is a defined zone that is physically and anatomically distinct from the fatty tissue and skin of the chest. With pro-hormone gynecomastia, these tissue planes are not clearly separate, suggesting an inflammatory process. This is only seen with prohormone etiology. Also, the very dense glandular tissue that characterizes prohormone gynecomastia can only be removed surgically. Not with liposuction. On the site there are pictures of prohormone gyn one is a 14yr teen boy who had it on one side and the other is a recent post but it will say Pro hormones. There is also some content on the site about which drugs are involved.