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 exagerated “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
- Non-prescribed anabolic steroids and steroid boosters
- Congenital: eg Klinefelter’s syndrome
- Malnutrition, Liver cirrhosis, Adrenal & Testicular tumours
- Excess body fat
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. This is sometimes the best approach.
- Lose weight if over weight and get your body mass index into the normal range. Work to specifically reduce overall percentage of body fat.
- Avoid exposure to things linked to gyanecomastia development.
- Medical therapy- withdrawal of drugs that may be associated with it, or hormone treatment to block any estrogen drive to the tissue under specialist supervision.
- Surgery- there are different options here. Be aware that surgery tends to give a partial improvement in larger volume gynaecomastia, and the result can sometimes be unpredictable and there will be scars.