Anatomy
Causes of Gynecomastia
Diagnosis of Gynecomastia
History of gynecomastia treatment
Treatment of gynecomastia

Three stories out of millions...

"Gynecomastia" is a term derived from the Greek words, "gyne" (for "woman"), and "mastos" (for "breast"). It is used to describe the development of abnormally large breasts in men, leading to feminization of chest contour. Gynecomastia is a very common condition that has a multiplicity of causes, but the three typical stories shared below, along with the "Summary," will serve as a useful introduction to the topic.

Ben remembers first noticing he had "too much chest" when he was about 12 years old. His mother had told him he was "perfect," and not to worry, and the pediatrician had said that it would "go away" as he grew. It did not. Ben learned to always wear loose fitting shirts and never took his shirt off when playing ball with his friends. He got kind of heavy during his teen years, but noticed that maybe his chest didn't look as bad when he was heavy, so he didn't really care about the weight.

As a young man in his twenties, however, Ben became more interested in being and looking fit. He came to enjoy his workouts and took on a fitter, thinner appearance. Despite all his efforts with diet and exercise, though, his chest was still a source of chagrin to him, and he continued to design his wardrobe and activities in a way that would allow him to hide it from view.

Now in his thirties, Ben had become a successful banker with a lovely fiance. She was the only person with whom Ben had shared his feelings about his "problem" since his question to the pediatrician, those many years ago. It was she who now took Ben to see the doctor once again for advice.

Levon was not really athletic as a teenager, but he liked going to the gym, and was always drawn to weight-lifting. And if numbers were any indicator, he was good at it! After just a few years of training, he could out-lift most everyone at the gym, including much larger men. He started a small business for himself as a personal trainer, and worked very hard to make it grow.

Wanting to "look the part" as much as he could, Levon took the advice of some guys he knew and began "cycling" on anabolic steroids. At first, this seemed a dream come true, helping him to put on even greater mass through his work outs, and providing extra energy for the long days he devoted to both workouts and sessions with his clients. However, after several cycles, Levon began to notice something that he didn't like so much.

"Oh yeah," one friend said, "you've got 'man boobs'... a lot of the guys get them." Levon's beautifully muscled chest was now adorned by two, small breasts... and this was definitely not going to help business!

The diagnosis came as a shocker to Harry, but he was determined to beat it. Harry had been told after a blood test with his doctor that he would need a biopsy of his prostate, and unfortunately, the biopsy showed cancer. Other tests proved that the cancer had gone beyond his prostate, which meant that treatment would include the use of hormone-like medicines to discourage tumor growth.

This fifty-eight year old plumber and retired police officer charged into treatment with complete determination. "Whatever you gotta do doc, go ahead, " he would say as he went for his various treatments. "One thing though, is you gotta have me ship-shape for my little girl's wedding next summer."

Harry put up with it all... and did it with a grin. But as Winter turned to Spring and the date of the big party grew close, Harry found that his chest had been changed dramatically by his medicines. "Doc, we're having my little girl's wedding on a beach in the Caribbean. How can I give her away with a chest like a girl?"

normal male chest

Boys and men normally have breast tissue, but it is usually so scant in amount as to produce no visible alteration of the chest wall contour. Hormonal changes, and changes in body weight (and fat) can lead to disturbances in the outline that are both noticeable and distressing.

Although there are many potential reasons for the development of gynecomastia, (see "Causes"), in the majority of cases, breast development can be traced to some form of hormone imbalance, or possibly to alterations in the sensitivity of tissue hormone receptors.

Gynecomastia

So-called "physiological" gynecomastia may appear in some individuals and run a self-limiting course. In these types of cases, the expectation of spontaneous regression makes early treatment improper. For most other forms of the disturbance, however, regression does not occur, and the individual sufferer must then decide if he wishes to pursue treatment. The form that treatment takes may differ depending upon the cause and anatomical presentation. Importantly, the effectiveness of treatment and its longevity may also be related to the underlying cause. Naturally, where gynecomastia is but one expression of an underlying systemic pathology, that illness must be properly addressed along with any concerns about chest appearance.

There is no unanimity of opinion with regard to the prevalence of gynecomastia, since studies have reported wide ranges, (4%-70%). It is likely that those reporting small numbers are using definitional criteria that are much more strict, and may be limiting their counts to individuals who develop gynecomastia that does not regress. When one defines gynecomastia as any degree of breast growth in boys or men, whether permanent or not, one finds that the percentage of males affected is, in fact, quite large.