Gynecomastia in adults can result in many things: feelings of discomfort, a lack of confidence, and an overall upset at the shape of your body. Adult males with this condition have excess fatty tissue on their breasts, which emerges without their own doing and, at times, out of nowhere.
Not only will we cover why some may develop gynecomastia, but we’ll also learn how this condition can be appropriately diagnosed, managed, and treated to get you feeling confident in your body in no time.
Understanding Gynecomastia
Gynecomastia, a condition that leads to breast enlargement in adult males, is indicated by the development of excess glandular tissue in one or both breasts.
This condition differs from the usual breast enlargement that can be attributed to factors like obesity, distinguishing itself through palpable, distinctly firm breast tissue.
While often linked to benign origins, it’s crucial to differentiate gynecomastia from male breast cancer through a careful breast examination, given the potential for overlapping symptoms.
Types of Gynecomastia
- Pubertal Gynecomastia: Affects many adolescent males and usually becomes resolved without any interference as hormone levels stabilize post-puberty. This type is a natural response to the fluctuations in hormone levels experienced during adolescence, when enlarged breasts may be more common.
- Persistent Pubertal Gynecomastia: In some cases, the enlarged breast tissue does not regress after puberty as expected. This condition results in continued breast enlargement into adulthood, often requiring medical or surgical intervention to address the impacts.
- Idiopathic Gynecomastia: This type presents a challenge, as the cause of the enlarged breast tissue cannot be pinpointed even after thorough clinical evaluations. Patients with idiopathic gynecomastia may undergo various tests to rule out common triggers such as hormonal imbalances, medication side effects, or underlying health conditions.
Causes Of Adult Gynecomastia 
Understanding the root of what may cause gynecomastia is essential for effectively diagnosing and treating any illness.
There are several reasons someone may have or develop gynecomastia, the most common of which are listed below.
Hormonal Imbalances
- Primary Hypogonadism: A condition where the testes do not produce sufficient levels of testosterone, the hormone responsible for male physical characteristics.
- Secondary Hypogonadism: Arises from problems with the pituitary gland or hypothalamus affecting testosterone production.
- Estrogen Excess: Increased estrogen production can be associated with gynecomastia, especially in tandem with testosterone secretion.
- Decreased Testosterone Production: This can be due to aging, injury, or diseases affecting the testes, leading to an imbalance between testosterone and estrogen.
Medical Conditions
- Testicular Tumors: Tumors such as Leydig cell tumors and Sertoli cell tumors can produce hormones that lead to gynecomastia.
- Adrenal Tumors: May secrete estrogen or estrogen precursors, contributing to hormonal imbalance.
- Thyroid Disease: Abnormal thyroid function can disrupt hormone balance, potentially causing gynecomastia.
- Renal Failure: Males with renal disease can have reduced testosterone and elevated gonadotropin values. An apparent primary testicular failure may then cause increased breast development.
Medications and Substances
- Anabolic Steroids, Often used to enhance athletic performance or muscle growth, can disrupt the body’s hormone balance.
- Drug-Induced Gynecomastia: Certain medications can cause breast swelling, like amphetamines, marijuana, and opioids. Calcium channel blockers and tricyclic antidepressants, can lead to gynecomastia as a side effect as well.
How Gynecomastia Is Diagnosed
Diagnosing gynecomastia involves a detailed clinical examination aimed at identifying the underlying cause in adult males who develop enlarged breasts. This condition can be confused with simple fat accumulation or more severe conditions like cancer.
Therefore, detailed physical and breast examinations are crucial for distinguishing gynecomastia from male breast cancer or other abnormalities.
Clinical and Physical Examination
- Physical Examination: A comprehensive evaluation to check for enlarged breasts, palpable breast tissue, and any signs of male gynecomastia, including nipple discharge or tender, swollen breast tissue.
- Breast Examination: Focuses on assessing the firm glandular tissue beneath the nipple to differentiate between gynecomastia and fatty breast tissue. The presence of unilateral or bilateral enlarged breasts can provide insights into the nature of the condition.
Diagnostic Tests
- Palpable Breast Tissue Assessment: Determines the extent of breast tissue growth and helps distinguish between gynecomastia and cancer.
- Breast Biopsy: In cases where a lump is palpable, the patient is experiencing excessive breast pain, or if there’s a significant risk of cancer, a biopsy of the enlarged breasts may be performed to rule out malignancy.
- Liver Function Tests: Important for detecting chronic liver disease that can lead to hormonal imbalances affecting breast tissue.
- Testicular Ultrasonography: Utilized to identify any testicular tumors or variances that could disrupt hormone levels, leading to gynecomastia.
- Hormone Level Assessments: Measurements of estradiol concentration, free testosterone, and thyroid-stimulating hormone are important for understanding the hormonal imbalances associated with gynecomastia. This includes evaluating levels of luteinizing hormone and human chorionic gonadotropin, which are indicative of the pituitary gland’s function or potential primary or secondary hypogonadism.
Gynecomastia Treatment Options
The positive news about gynecomastia is that it is absolutely treatable. Your clinician will employ several methods to treat it, and more often than not, a multifaceted approach will be taken.
Medical Treatments
A common methodology for treating gynecomastia is medical treatment. However, before that can be done, any underlying conditions must be ruled out (or treated, if present).
This includes managing endocrine disorders like primary hypogonadism, Klinefelter syndrome, or conditions affecting the pituitary gland that decrease testosterone production.
Another common medical treatment for the condition is estrogen receptor blockers. Drugs like tamoxifen target estrogen receptors directly, limiting the action of estrogen on both male or female breast tissue.
This can be particularly effective in treating gynecomastia characterized by tender or swollen breast tissue in one or both breasts, offering relief from breast pain.
Surgical Options
- Excision of Glandular Tissue: For cases of persistent pubertal gyno, unexplained gynecomastia, or when medical treatment is insufficient, surgery to remove excess glandular tissue may be indicated. This procedure addresses the firm tissue behind and around the nipple.
- Liposuction of Swollen Breast Tissue: Aimed at removing fatty tissue, this liposuction may be combined with glandular tissue excision to achieve optimal cosmetic results for patients with enlarged breasts.
- Mastectomy: In severe cases, particularly when there’s a significant risk of breast cancer or in the presence of a testicular tumor or adrenal glands’ tumors, more extensive removal of the male breast tissue might be necessary.
Questions and Answers
Does Gynecomastia Go Away In Adults?
Yes, gynecomastia can resolve in adults, especially if it is related to factors like minor hormonal fluctuations.
When the underlying cause, such as the use of anabolic steroids or calcium channel blockers, is addressed, gynecomastia may diminish without further treatment.
That being said, in cases where gynecomastia is due to persistent hormonal imbalances, medical intervention or gynecomastia surgery may be necessary to treat gynecomastia effectively.
How Long Does Gynecomastia Last In Adults?
The duration of adult gynecomastia varies depending on its cause. Gynecomastia during puberty often resolves within six months to two years without treatment.
For adults, the condition’s persistence largely depends on the underlying cause. If gynecomastia results from temporary factors, such as medication use or acute conditions, it may resolve upon addressing the cause.
The more urgently one is able to treat gynecomastia, the quicker it may be resolved.
How Long Is Recovery From Gynecomastia Surgery?
You can usually resume daily activities and light exercise within 1-2 weeks post-cosmetic procedure. Full gynecomastia recovery typically takes 6 weeks; avoid strenuous activities for optimal healing.
Is There A Link Between Gynecomastia And Prostate Cancer?
There is no direct link between gynecomastia and prostate cancer; however, some treatments for prostate cancer like androgen deprivation therapy can lead to gynecomastia.
Medications like anti-androgens used in prostate cancer treatment can also affect the balance of hormones testosterone and estrogen, potentially causing breast tissue growth.
Schedule Your Consultation Today
When you develop gynecomastia, it can sometimes feel as though you have nowhere to turn. Know that that is far from the truth when you chose the right gynecomastia surgeon.
Dr. Charles Galanis is here to address your breast growth and get you feeling confident again. Galanis Plastic Surgery, located in Beverly Hills, CA, prides itself on its professionalism, attentiveness, and ability to tackle anything thrown its way.
If you’re interested in a gynecomastia procedure, contact us today to get started on your road to the body you’ve dreamed of.
