Gynaecomastia

Gynecomastia is a problem that could occur at any age, from a newborn baby to a teenager or even an older man. The problem highly affects the self-confidence of many men who might for example stop going swimming because of their negative body image. Gynecomastia however, doesn’t affect the self-confidence only. It has other related issues that I would like to bring your attention to.

Breast enlargement could happen due to a pathological reason, which means that it could be a sign of a serious disease, especially if it appears acutely. In other words, if the patient has had no history with a bigger size of his breast and then it became suddenly enlarged. So always bear in mind that the sudden enlargement of a man’s breast could be a warning sign. And that is why I’d like to bring your attention to this aspect of your health.

In order to better understand Gynecomastia we need to first get to know the anatomy of the mammary gland, which is the gland of the breast. As you can see here on the board, this is a female breast and a male breast. In both cases they have the same components. They do? Yes! They have the same components. The only difference is the size. So let’s see: Both male and female breasts have skin, fat (colored in green here, under the skin), and then milk ducts and milk glands, or mammary glands. This is a side view of the breast and these yellow circles seen here are the rips. The pink is the muscle behind the breast. Here are the milk ducts and the mammary glands – so yes, even males have them too, but they’re atrophied because men don’t need to use them. And of course they can be seen larger in the female body.

In this case we can say that the Gynecomastia appears in one of two ways, either in the fat that is in the breast, or in the mammary (or milk) glands. This is why it’s very important to know the cause of the enlargement of the breast. Is the increase in the breast size due to the fat or is it because of the mammary glands? The only person who could specify the reason is your doctor, via medical checkup.

The first reason, enlargement due to fat deposition, is mostly a result of extra-weight. So when a male is overweight and has a bigger than normal breast size and this increase of the size of the breast is homogenously or evenly distributed, which means that it can be observed in the breast as a whole, we say it’s a breast enlargement due to fat deposits, and we would initially recommend that the patient reduces his weight.

So let’s have a look at this. As you can see here, one breast is enlarged while the other one is only enlarged in the area around the nipple, called the areola. Hence, we suspect that this enlargement is due to a problem in the mammary glands shown here. This is a result of the second reason why the male breast could be enlarged, which is hormones. This appearance means that there is some imbalance in the patient’s hormones, which causes the male hormones to become less effective or the female hormones to become more effective. And this has caused enlargement of the breast. This is why when your doctor first examines you he/she will manually check the breast and then will ask for a blood test to check for any hormonal imbalance. They also may ask for an ultra sound and might need to examine the testicles because they produce the sex hormones that might be of effect on the breast size. After that we need to know if the hormones are coming from a tumor in your body or an organ malfunction, especially the liver or the kidney.

Breast enlargement could also be due to a medication that you’re currently taking, or even something that you’re eating. Some weight loss drugs, anti-depressants, anti-acidity medications, supplements taken by bodybuilders, which could have hormonal content, or drugs like weed or heroin. All of the above can cause hormonal imbalance, and that might lead to breast enlargement.

Unfortunately you could be having these hormones from the food you’re eating. For example some kinds of meat contain hormones. Those hormones were given to the animals for profitability purposes. Chicken or red meat might contain the female hormones and can affect your male functions. That’s why I’d recommend that you pay a lot of attention while buying your food. A safer option is to buy biological products, and if they are too expensive try to minimize the consumption of meats in general. In some places the locally bread animals might be better fed and more natural than those coming from big companies.

After hormonal analysis we would like to make sure that the patient doesn’t have any other health problems in the liver, the kidneys, the testicles or the breast itself, as it might have a tumor. You might also need to recall if you’d ever had, in some point in your life, received a physical trauma on the testicles, because this could affect the function of the testes and therefore the hormones in your body.

So, how is gynecomastia treated?

First of all we need to find out the cause, in the light of a physical examination, the blood test results and perhaps other clinical tests. Then we make sure that the patient reaches a healthy weight by following a diet and a sports program when necessary, so as to reach a lower percentage of body fat. If it has been detected that the breast enlargement in your case is a result of hormonal imbalance due to the gland functions your doctor might prescribe medications. And if the enlargement is cosmetically embarrassing, the patient can opt for surgery and with the modern technology, there is laser surgery for fat removal that obtains very good results. Now, if the size of the glands is the cause of the enlargement, those glands can also be surgically removed. Surgeries to improve the breast appearance must be done by a plastic surgeon or a skilled general surgeon. Don’t be embarrassed to discuss the problem of breast enlargement with your doctor if it’s annoying you or affecting your self-confidence. Because it not only could affect the quality of your life, but also can be a sign of a serious underlying condition. It is very important to seek immediate medical advice if the breast enlargement happens suddenly over the period of days or weeks.

I wish you the best of health!

Alyaa Gad