Men normally have very small amounts of breast tissue behind the nipple. Gynaecomastia is the medical term for the enlargement of the male breast as a result of an abnormal increase in the glandular tissue at this site. It is much more common than most people reaslise.

How many men are affected?

  • 40-60% of men are affected to varying degrees
  • The commonest age in which it develops is from early teens to early 20s, and after the age of 50 years

What are the causes?

  • Physiological: this means it forms for no reason other than an exageerated “normal” process in the body. eg Typically during teenage years when testoterone levels are high.
  • Excess regular alcohol consumption
  • Prescribed medication: There are many drugs that seem to be associated with the development of gynaecomastia in a small proprtion of those that are on them eg:
    • Cimetidine: a type of antacid
    • Zoladex: used to treat prostate cancer
    • Thioridazine: an antipstchotic
    • Digitalis: a cardiac drug
    • Captopril: used in heart failure
    • Diazepam: a sleeping pill
    • Heroin
    • Cannabis
  • Congenital: eg Klinefelter’s syndrome
  • Malnutrition, Liver cirrhosis, Adrenal & Testicular tumours

How is it classified?

  • Group 1 is minor but visible breast enlargement without skin redundancy
  • Group 2A is moderate breast enlargement without skin redundancy
  • Group 2B is moderate breast enlargement with minor skin redundancy
  • Group 3 is gross breast enlargement with skin redundancy that simulates a pendulous female breast

 

What can be done about it?

  • Do nothing- if minor or no symptoms and prepared to see if it will settle of own accord. Only adopt this approach after specialist review and advice.
  • Medical therapy- withdrawal of drugs that may be associated with it, or hormone treatment under specialist supervision.
  • Surgery

 

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