Understanding Gynecomastia: Types, Symptoms, and Prevention
Table of Content
Gynecomastia is the abnormal enlargement of male breast tissue. The condition results from an imbalance between testosterone, the male hormone and oestrogen, the female hormone. Though it is normal to have small amounts of oestrogen in men, an increase in oestrogen level or a decrease in the level of testosterone will lead to excessive growth of the breast tissue.
Most people confuse gynecomastia with just a matter of being overweight, but this is not necessarily so. While obesity will make breasts look bigger due to the storage of fat, actual gynecomastia is an increase in glandular breast tissue, not just an increase in fat.
Gynecomastia is a condition that affects millions of men worldwide. It is usually a source of physical discomfort and emotional distress, leading many to seek medical attention. Although it is widespread, gynecomastia is frequently misunderstood, and some stigma is attached to it.
If you or someone you know suffers from gynecomastia, the first step towards relief is understanding the condition.
Types of Gynecomastia
Various types of gynecomastia can be distinguished by the cause and magnitude of growth of breast tissue. Establishing whether any of these types of breast enlargement is necessary, for that constitutes the basis of the applicability of the treatment process.
1. Physiological Gynecomastia
The most common type is physiological gynecomastia; this occurs in the normal course of a male's life, is transitory, and needs no therapy since it reduces over time.
Newborn Gynecomastia: About 60-90% of boys are born with some degree of breast tissue swelling, due to the effect of exposure to their mother's oestrogen in utero. It usually resolves in a few weeks after birth.
Pubertal Gynecomastia: It is estimated that 50-60% of adolescent boys will develop some degree of gynecomastia during puberty. This occurs as a result of temporary hormonal imbalances while the body is adjusting to rising levels of testosterone. In most cases, it disappears within 6 months to 2 years without treatment.
Age-Related Gynecomastia: Older men undergo natural declines in the production of testosterone. Consequently, this results in a hormonal imbalance between the levels of oestrogen and testosterone. This form of gynecomastia is widespread among men above the age of 50 years.
2. Pathological Gynecomastia
Pathological gynecomastia takes place due to an underlying disease that affects the hormonal balance. Some of the conditions responsible for this type of gynecomastia include:
Liver Disease: The liver plays a part in the metabolism of hormones. Impaired liver function, as in cirrhosis, may result in abnormal metabolism and cause gynecomastia.
Kidney Failure: Long-term damage to the kidneys could also lead to hormonal imbalances, causing the enlargement of the breast tissues.
Hyperthyroidism: Overproduction of thyroid hormones causes an imbalance in testosterone and oestrogen.
Testicular Disorders: Tumours and infections are some of the abnormal conditions within the testes that could disturb normal hormone production and result in gynecomastia.
3. Pseudogynecomastia
Pseudogynecomastia is a condition closely related to but often confused with true gynecomastia. It is not caused by glandular breast tissue growth. It is, however, a condition resulting from excess fat accumulation in the chest area. It is quite common among overweight or obese people.
Unlike true gynecomastia, which can sometimes be treated with medication, pseudo-gynecomastia generally responds well to weight loss, exercise, and lifestyle changes. That being said, many men with pseudo-gynecomastia eventually turn to cosmetic surgery to remove chest fat.
4. Unilateral versus Bilateral Gynecomastia
Gynecomastia can occur in either one or both breasts:
Unilateral Gynecomastia: This is when only one breast is enlarged. This is less common but can occur due to an uneven hormonal response or a medical condition affecting one side of the body.
Bilateral Gynecomastia: This is the most common form of gynecomastia, where both breasts are enlarged.
Understanding the type of gynecomastia a person has is important for deciding the best approach toward treatment.
Symptoms of Gynecomastia
Gynecomastia can be easily recognised through visual changes in the chest area, although symptoms may vary according to the level and the cause. Most men come to know about gynecomastia when they feel or observe something different in their chest; however, some symptoms include tenderness and soreness. Here are some common symptoms of gynecomastia:
Enlarged Breast Tissue: The most evident symptom of gynecomastia is the formation of extra breast tissue. This can either affect one or both breasts and may constitute subtle swelling to great enlargement.
Tenderness or Sensitivity: Some men feel tenderness or slight pain in the involved area. The chest might feel sore, especially if touched or pressed.
Rubbery or Firm Breast Tissue: The breast tissue caused by gynecomastia is typically firmer compared to normal fat. It will be a small, rubbery lump underneath the nipple.
Asymmetry: Sometimes, gynecomastia can cause one breast to become more affected than the other, giving a misshapen or asymmetric appearance.
Nipple Changes: The nipples may become more raised, puffy, or swollen. In some cases, the areola (the dark area around the nipple) will grow.
Skin Tightness or Stretching: As breast tissue grows, some men will experience the skin stretching, which can be painful.
How to Prevent Gynecomastia?
Certain gynecomastia cases are uncontrollable, such as puberty or ageing. However, there are many lifestyle changes that you can take to minimise the risk of incurring the condition.
1. Maintain a Healthy Weight
Obesity is one of the leading risk factors for gynecomastia. Excess fat increases oestrogen levels, which can stimulate breast tissue growth.
Maintaining a balanced diet and engaging in regular exercise can help keep hormones in check.
2. Exercise Regularly
Strength Training – Exercises that build muscle (like bench presses, push-ups, and weight lifting) can help reduce chest fat and improve overall body composition.
Cardio Workouts – Running, swimming, or cycling can help in burning fat and maintaining a healthy weight.
Beware of Spot Reduction Myths – Exercises do help, but they are not capable of directly reducing the gynecomastia that is caused by the growth of glandular tissue.
3. Eat a Hormone-Balanced Diet
Reduce the intake of processed foods, refined sugar, and unhealthy fats, which can cause obesity and lead to hormone imbalances.
Include foods that are rich in zinc like nuts, beans, and seafood to help produce testosterone.
Reduce intake of soy-based products as they contain phytooestrogens, which behave like oestrogen.
4. Avoid Anabolic Steroids and Hormonal Supplements
One of the most common causes of gynecomastia among bodybuilders and athletes is steroid use.
If muscle-building supplements or testosterone boosters are used, they should be taken under medical supervision to avoid unwanted side effects.
5. Limit Alcohol and Recreational Drugs
Alcohol, especially when consumed in large amounts, harms the liver, which in turn results in high oestrogen levels.
Avoid recreational drugs like marijuana, heroin, and amphetamines as they have been reported to disrupt hormone balance.
6. Consult with Your Doctor about Medications
If you are on medications that are reported to cause gynecomastia, consult with your doctor if there can be other alternative medications.
7. Lower Your Stress and Get Enough Sleep
When a person has high-stress levels, hormones become imbalanced; high cortisol levels can decrease the level of testosterone. Prioritise sleep – Poor quality sleep has been associated with low testosterone. Get 7–9 hours of sleep at night.
8. Check Hormone Levels
If you have developed any unexplained breast enlargement, consult a doctor to test your hormone levels.
In case of a family history of hormonal disorders, it is necessary to go for regular check-ups.
