Some may think that gynecomastia is an unhealthy phenomenon or a disease, but it is not a disease in itself; rather, it is a sign from the body that there is a problem or a health condition that requires treatment. The causes of gynecomastia in men are numerous, and the treatment varies depending on the cause. Therefore, it is necessary to identify these causes to determine the appropriate treatment. Now, let us learn about the causes of gynecomastia in men.

 

Gynecomastia is the enlargement of breast tissues that is located behind the nipple in males, making the breast tissue elastic in texture and turning it into firm fibrous tissue in some cases. Gynecomastia can affect one or both breasts and can appear at any age, from childhood to old age.

Gynecomastia appears as a protrusion in the breast gland due to the expansion of the glandular tissue rather than fat. It is usually located directly behind the nipple and can be elastic or firm, occurring on both sides. In rare cases, gynecomastia occurs on one side only and may affect both breasts, where one breast is smaller than the other. It is usually not accompanied by pain, but some may feel pain when pressed.

 

The main cause of gynecomastia in men is an imbalance between the female estrogen hormone and the male testosterone hormone, which controls male characteristics. Testosterone levels should naturally exceed estrogen levels in men, and an imbalance between the two hormones can cause gynecomastia. This imbalance can occur at different stages of life:

• After birth: More than half of newborn males are born with breast enlargement due to the increase in estrogen in the baby's body while still in the fetal stage. During breastfeeding, estrogen is still high in breast milk. Then it disappears naturally within 3 weeks of the baby's birth.

• Puberty: Hormone levels change between 12 and 14 years, and gynecomastia disappears within 6 months to 2 years on its own.

• Midlife: The highest stages of gynecomastia occur at this age, especially from the 50s to the 80s, as one in four men suffer from gynecomastia in their fifties and beyond.

The causes of gynecomastia in men can be related to various health conditions, including:

• Kidney failure.

• Hyperthyroidism.

• Obesity.

• Malnutrition.

• Testicular tumors.

• Adrenal gland tumors.

• Androgen deficiency.

• Hypogonadism.

The following medications can also cause gynecomastia:

• Antibiotics.

• Anti-anxiety medications.

• Calcium channel blockers.

• Acid reflux medications.

• Heart medications such as digoxin and amiodarone.

• Antifungal medications.

• Fertility medications.

• Estrogen hormone.

• Amphetamines, heroin, methadone, and alcohol.

• Preparations containing estrogen, such as lavender oil.

 

Gynecomastia diagnosis depends on identifying physical symptoms, conducting a breast examination, reviewing medical history, reviewing medications, conducting blood tests, and assessing breast sensitivity. Gynecomastia is diagnosed when a solid, elastic mass is located directly under the nipple and can easily be moved within the breast during testing.

Dr. Wael Ghanem, a consultant in plastic surgery and repairing birth defects, will review herbal supplements and medications and may request breast imaging tests, such as X-rays or ultrasounds, which are usually requested to exclude breast cancer. Dr. Wael Ghanem may also request blood tests to check hormone levels.

 

Other conditions may resemble gynecomastia but are not gynecomastia, and Dr. Wael Ghanem can discover this during breast examination, including:

Breast cancer: Men rarely develop breast cancer, but it can be distinguished by affecting only one breast and causing breast hardening and a hard mass when touched, as well as enlargement of lymph nodes in the breast area. Also, the appearance of the skin changes, and there may be a fluid discharge from the nipple.

Fatty gynecomastia: obese men usually develop fatty gynecomastia, known as pseudo-gynecomastia, due to many fatty deposits in the breast. It can be eliminated through diets, exercise, or liposuction.

 

Gynecomastia treatment depends on the causes of gynecomastia in men. If the medication is the cause of gynecomastia, stopping or switching to an alternative medication is recommended. Surgery to treat gynecomastia is usually recommended if the gynecomastia is causing extreme pain or embarrassment.

 

Gynecomastia can cause anxiety, depression, and a loss of confidence for some. Therefore, it is recommended to go for gynecomastia surgery to get rid of the embarrassment, especially for people who feel embarrassed when changing clothes in public places, gyms, or swimming pools.

 

The VASER technique eliminates gynecomastia when there is fat in the breast tissue in addition to glandular tissue. The fat is removed first, then the breast tissue, using VASER by breaking it down. The procedure is performed under local anesthesia through small surgical incisions that are not easily visible. VASER also tightens the skin by stimulating collagen production through heat, and it can accurately sculpt the chest using precise tools. Strong chest muscle achieves better results.

 

The surgical procedure is performed under general anesthesia. Dr. Wael Ghanem, a consultant in plastic surgery and surgical correction of congenital deformities, makes surgical incisions in multiple locations, either under the armpit, below the breast, or around the areola. Then, surgical instruments are inserted, and the enlarged tissue is removed. Then the surgical incisions are closed. Male breast reduction surgery requires a longer recovery period and has more side effects.

 

If the cause of gynecomastia is hormonal fluctuations, whether associated with aging or with growth, it cannot be prevented. If the causes of gynecomastia are health conditions or types of medications, it can be prevented by replacing or stopping medications. You should also avoid eating products that cause gynecomastia, such as soy products because they contain natural estrogen and lotions that contain tea tree or lavender oil.

 

Dear reader, these are the causes of gynecomastia, how to identify the symptoms, and what is important to know about treatment methods. In the end, we hope we have provided sufficient answers to all your questions and inquiries. If you have more questions or need more information, please do not hesitate to contact Dr. Wael Ghanem, a consultant in plastic surgery and surgical correction of congenital deformities.