Understanding Endocrine and Metabolic Conditions

Learn about a wide range of hormonal, adrenal, thyroid, and metabolic conditions. Each article provides clear, concise information to help you better understand the causes, symptoms, and potential health impacts of these disorders.

Gynecomastia: Understanding Male Breast Enlargement

What Is Gynecomastia?

Gynecomastia is the benign enlargement of male breast tissue, typically caused by a hormonal imbalance between estrogen and testosterone. It can affect one or both breasts and may occur at any age — from newborns and adolescents to older men.


What Causes It?

Gynecomastia results when the ratio of estrogen to testosterone shifts, either due to increased estrogen levels, decreased testosterone, or both. Common causes include:

  • Puberty (transient hormone fluctuations)
  • Aging, particularly in men over 50
  • Certain medications (e.g., anti-androgens, steroids, antipsychotics, heart medications)
  • Underlying conditions such as liver or kidney disease, hyperthyroidism, tumors, or hypogonadism
  • Substance use such as alcohol, marijuana, anabolic steroids, and some herbal products (e.g., tea tree oil)


Symptoms

Gynecomastia typically presents as:

  • Swollen or tender breast tissue
  • A rubbery or firm mass beneath the nipple
  • Sensitivity or discomfort in the chest area

It is important to differentiate gynecomastia from pseudogynecomastia, which is fat accumulation without glandular growth, typically seen in overweight or obese individuals.


Diagnosis

Diagnosis may involve:

  • Physical examination
  • Hormonal blood tests (testosterone, estradiol, LH, FSH, prolactin)
  • Liver, kidney, and thyroid function tests
  • Imaging, such as breast ultrasound or mammography, if there is concern for breast cancer or a mass

Treatment

In many cases, no treatment is required, especially in adolescents, as the condition often resolves on its own. Treatment may include:

  • Observation for spontaneous resolution
  • Medication management if caused by a drug or underlying condition
  • Hormonal therapy (e.g., tamoxifen) in persistent or painful cases
  • Surgery (liposuction or mastectomy) for long-standing or severe gynecomastia, especially when psychologically or physically distressing


How Health Force One Helps

At Health Force One, we offer:

  • Comprehensive hormonal evaluations to identify underlying causes
  • Personalized treatment plans, including medication management and specialist referral
  • Education and lifestyle counseling to support recovery and confidence
  • Monitoring for hormonal balance and any recurrence of symptoms

 

References

  1. Niewoehner, C. B., & Schorer, A. E. (2021). Gynecomastia and Breast Cancer in Men. New England Journal of Medicine, 384(3), 138–147. https://doi.org/10.1056/NEJMcp2003877
  2. Dickson, G. (2020). Gynecomastia. American Family Physician, 101(4), 214–220.
  3. Rhie, J., et al. (2020). Current Approach to the Evaluation and Management of Gynecomastia. Translational Andrology and Urology, 9(Suppl 2), S76–S82. https://doi.org/10.21037/tau.2019.10.05
  4. Narula, H. S., & Carlson, H. E. (2022). Gynecomastia. Endocrinology and Metabolism Clinics, 51(2), 327–344. https://doi.org/10.1016/j.ecl.2022.01.001
  5. Shalhoub, J., et al. (2021). Surgical Management of Gynecomastia: A Review. Aesthetic Plastic Surgery, 45(2), 661–667. https://doi.org/10.1007/s00266-020-01950-1