Gynecomastia, otherwise known by its lay term of “man breasts” or “man boobs”, is a condition that will affect as many as 50% of all men at some point in their lives and is most commonly seen in the adolescent and the elderly and in both cases is a result of a hormonal imbalance or metabolic disorder of some sort, and is always considered abnormal.
Now, it should be pointed out that there’s also a condition known as “pseudogynecomastia” that’s not considered “real” gynecomastia but is often called “gynecomastia” because it’s visually indistinguishable from it. Real gynecomastia is when there is excess growth of the mammary tissue in the male breasts that’s caused by a hormone imbalance of some type usually, whereas what’s known as “pseudogynecomastia” is caused by excess fatty tissue in the male breasts that’s almost always a result of simply being overweight and can be addressed through simple weight loss via diet and exercise, whereas “real” gynecomastia cannot be dealt with so easily.
What Causes It
Gynecomastia is generally attributed to either an imbalance of sex hormones or the sensitivity of the breast tissue to those hormones (that is, you have a normal hormone level but your breast tissue is over-sensitive to those hormones), though a specific cause is rarely determinable in each individual case.
The exception to the above is if you’re taking either the drug Digoxin or Furosemide or both, as approximately 4-10% of all gynecomastia cases are due to these drugs (the chances are higher if both drugs are administer simultaneously).
Lastly, it could be due to excess fat, aka obesity. In this case the problem isn’t really gynecomastia, but that’s something specifically caused by excess mammary tissue, whereas in this case your “man boobs” are caused by excess fat, not mammary tissue.
Current Treatment Options
The first thing that should be checked is whether or not the patient in question is taking any drugs that are known to cause or aggravate gynecomastia, primarily Digoxin or Furosemide or both (they are sometimes taken simultaneously, which is more likely to cause gynecomastia than either one taken individually), which are known to be responsible for approximately 4-10% of all gynecomastia cases out there. Other drugs can almost always be substituted that will not cause or in any way aggravate gynecomastia.
After that, basic endocrinological treatments should be considered, which means oral prescription drugs that will adjust the body’s hormone levels. This needs to be done within the first 2-3 years because after that the mammary tissue will harden and require surgery to remove. The kinds of prescription drugs that would be considered would include drugs known as “selective estrogen receptor modulators” like clomiphene and tamoxifen, aromatase inhibitors such as Letrozole, and certain androgen drugs (basically, testosterone or some other steroid that simulates it).
Beyond that, surgery options will vary greatly depending on the type and severity of your gynecomastia and will up to your doctor, but they could include things like skin sculpture, liposuction, gland excision, reduction mammoplasty, or a combination of those techniques.