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Gynecomastia

Definition

Gynecomastia is an enlargement of breast tissue in men. It is not due to obesity.
Gynecomastia
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Causes

All men produce male and female hormones. Normally, men produce more male hormones than female hormones. Gynecomastia is caused by an imbalance in the female and male hormones. This may be caused by:
  • Changes during puberty
  • Aging, especially in men with low testosterone levels
  • Certain genetic problems that cause low levels of testosterone
  • Certain medicines, such as digoxin, spironolactone, cimetidine, and many others
  • Using anabolic steroids to boost athletic performance

Risk Factors

Gynecomastia is more common in teens and in men over age 50.
Other things that may raise the risk are:
  • Diseases that affect the whole body, such as hypogonadism, liver cirrhosis, and kidney failure
  • Treatment for prostate cancer
  • Tumors of the testicles, lung, stomach, liver, kidney, or pituitary gland
  • HIV infection
  • Abuse of substances such as marijuana or heroin
  • Family history

Symptoms

Problems may be:
  • Enlarged, firm breasts
  • Breast pain or tenderness

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. It will focus on your breasts. This is often enough to make the diagnosis.
Images may be taken to rule out cancer. This can be done with:
Other tests may be done to find the cause of the gynecomastia.

Treatment

Treatment is rarely needed. The problem often goes away on its own. Or, it does not cause symptoms.
Men who do have symptoms may need to have the underlying cause treated. Others may need to stop or change medicines. Surgery may also be done to remove breast tissue.

Prevention

There are no known guidelines to prevent this problem.

RESOURCES

Family Doctor—American Academy of Family Physicians
http://familydoctor.org
Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES

Health Canada
https://www.canada.ca
Men's Health Centre
http://www.menshealthcentre.net

References

Gynecomastia. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/gynecomastia.html. Accessed September 22, 2020.
Gynecomastia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gynecomastia . Accessed September 22, 2020.
Kanakis GA, Nordkap L, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019 Nov;7(6):778-793.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 03/2020
  • Update Date: 09/22/2020
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