
Gynaecomastia
- By Dr. Neha Agrawal
Breast tissue is simply a glandular tissue. The glandular tissue is well developed in women. Normally, men do have breasts but they are not like a woman’s. When a male complains of abnormally large breasts (like a female’s), it is called gynaecomastia.
Incidence is commonly noted in newborns, adolescents and elderly males. In 25%, no cause can be identified.
What is it?
Gynaecomastia may occur on one or both sides. It is an abnormal enlargement of male breasts. It could be either actual enlargement of the beast tissue or it could be muscular enlargement. The chest muscles are the pectoralis. Swelling up of the pectoralis or increase in the adipose (fat tissue) may appear like gynaecomastia, but it is not actual enlargement of breasts and is called as pseudogynaecomastia.
Gynaecomastia, in itself, is not harmful in any way. It is merely a cosmetic aberration. However, it may be a sign of some underlying conditions and hence a detailed examination becomes a must.
Causes
The causes are multifold.
Benign hormonal imbalance due to life stages: Imbalance between the hormones, estrogen and testosterone, can lead to over development of the breast tissue in males. In newborn babies, there may be increased levels of estrogen due to placental blood leading to gynaecomastia. It is temporary and resolves on its own. During puberty, there is a lot hormonal variation. Teenage boys may have enlarged breast tissue during this time. For most, it resolves with time. In old age, when the testosterone levels drop, again breast tissue may grow in an abnormal manner.
Hormonal causes: The basic cause lies in suppression of testosterone. Apart from the age related factors, there abnormal conditions which lead to low levels of testosterone in the body. These include testicular tumours, chromosomal abnormalities which affect gonad development (testes), increased thyroid activity, renal failure and liver cirrhosis. Also, inadequate nutrition and starvation (going for days without food) may lead to suppression of testosterone.
Surgeries to correct this condition have become increasingly popular across the world.
Treatment
The condition does not call for immediate treatment, if the cause is benign. Treating the underlying cause is far more important. When the underlying cause has been corrected, the testosterone levels return to normal and the condition is treated as a byproduct of the same.
However, gynaecomastia does affect a person’s self-image. Earlier, men would shy away from discussing the problem and struggle with low self-esteem or heightened consciousness about their physical image. With time, internet, support and surgical success, people are opening up and seeking help.
Treatment with hormonal medication is partially helpful. Surgery has become a popular solution to this problem. The excess tissue is removed by a simple surgical procedure. So, feel free to approach a surgeon if the condition really bothers you. However, keep in mind, the internal cause needs to be treated as well.
Cancer Risk
Gynaecomastia is not a risk for breast cancer in men. Yet, it is best to seek medical opinion if you notice a swelling, lump or pain in the breast area.
Counseling
Sometimes, all we need is someone to talk to. Before you consider an invasive procedure like surgery, please think if you really need it. If it is only for self-confidence, may be psychological counseling is a better option. There are all kinds of diseases in this big world. There are several conditions which may create men-like symptoms in women and women-like symptoms in men. It is not as bad as you think, probably!