8 Causes of Gynecomastia

There are certain physical traits that are classically male: facial hair, a deep voice, and larger muscles to name a few. Large breasts, on the other hand, fall into the feminine category. So, when a man’s breasts become enlarged and take on the rounded, softer look of a woman’s — a condition called gynecomastia — it can lead to embarrassment and loss of self-esteem, not to mention isolation and depression.

Frederick H. Watkins, MD, in Rockville, Maryland, and McLean, Virginia, helps men address their chest issues with liposuction and plastic surgery. He specializes in restoring symmetry and balance by expertly recontouring body tissues through plastic surgery and other treatments. 

Primarily, gynecomastia stems from hormonal imbalances. If your estrogen-testosterone ratio is off, it can trigger several symptoms, including breast enlargement. But what’s throwing your hormones out of whack? Here, Dr. Watkins explains eight common reasons behind gynecomastia.

1. Low testosterone

Given the media attention it has received over the last decade or so, you may be familiar with the term “low testosterone” or “low T.” Technically, this condition is called hypogonadism, and it can occur for many reasons, but it’s a fairly predictable sign of advanced years. 

Because of this drop in testosterone, the differential decreases between it and the small amount of estrogen normally in a male’s body. This imbalance, in turn, can lead to swollen breast tissue. About one out of every four men past age 50 experiences gynecomastia to some degree. 

2. Medications

Any medications that affect your hormones can lead to symptoms of gynecomastia. The following medications have been linked to the development of gynecomastia:

• Anabolic steroids 
• AIDS and HIV medications, particularly efavirenz (Sustiva®)
• Tricyclic antidepressants
• Anti-anxiety medications
• Certain antibiotics
• Anti-androgens used for enlarged or cancerous prostate
• Some cancer treatments
• Calcium channel blockers used for heart conditions
• Medications that empty your stomach
• Ulcer medications

While these are all prescription drugs, some over-the-counter medications, such as Tagamet HB®, can also disrupt hormonal balances. Furthermore, even certain herbal supplements, such as ginseng, tea tree oil, lavender oil, saw palmetto, and grape seed oil, can produce enlarged breasts. 

3. Illegal drugs

In addition to putting your life in danger, habitually using drugs bought on the street — specifically methadone, heroine, amphetamines, and marijuana — can lead to gynecomastia.

4. Excess alcohol

Alcohol contains a lot of calories, so if you drink a lot, your gynecomastia may be a matter of fat tissue building up in your breast tissue. 

But alcohol and gynecomastia have another connection: your liver. If you have an alcohol-related liver disease, such as cirrhosis, it can disrupt the delicate balance of estrogen and testosterone in your body.

5. Liver disease

While we’re on the subject of liver disease, it’s important to note your liver’s role in your breast tissue. Your liver is tasked with breaking down and getting rid of excess estrogen. If your liver is inflamed, fatty, or diseased, it might struggle to do its job and allow estrogen to build up in your system. If you overdo it with carbs and alcohol — especially beer — you might upset your hormonal balance and end up with growing breasts.

6. Kidney failure

Kidney failure can lead to hormonal imbalances. Consequently, it’s common for men suffering from chronic kidney disease to also experience low testosterone. And nearly 50% of men undergoing dialysis treatments also show signs of gynecomastia.

7. Malnutrition

Proper nutrition is essential for all your body’s functions, including the production of hormones. If you eat a poor diet or are starving, your testosterone level can drop. Ironically, in some men recovering from malnutrition or starvation, the re-entry into a healthy diet can trigger gynecomastia as well. 

8. Tumors

Whether in your testes, adrenal glands, or pituitary gland, tumors can wreak havoc with your body and your hormones. Certain tumors can trigger your glands to produce more or less estrogen and testosterone, tipping the balance and leading to swollen breast tissue.

Getting rid of gynecomastia

Relieving the symptoms of gynecomastia is often as simple as resolving the underlying cause. Getting your hormones back in balance is the key to most cases. However, if Dr. Watkins determines that you’re a good candidate for liposuction or a male breast reduction procedure, he can discuss the benefits and risks with you.

If the problem is primarily excess fat, liposuction may be the best treatment. Here, Dr. Watkins suctions out the fat cells using a slender cannula inserted through very small incisions. 

If your enlarged breasts are due to excessive glandular tissue, you may need a surgical procedure to remove it. 

To find out how to resolve your male breast issues, book an appointment online or over the phone with the practice of Frederick H. Watkins, MD, today.