Gynecomastia – symptoms, causes and associated complications


Gynecomastia is a condition in which there is overdevelopment of the male breast. In response to too little testosterone (a male hormone) or too much estrogen (a female hormone), the glandular tissue of the breast swells and it forms a breast bud – enlarged breast. This condition is happening in babies, teen boys and older men. This condition can affect one or both breasts, sometimes unevenly. Older men, boys going through gynecomastia and newborns can develop this condition as a result of normal changes in their hormone levels, but also there can exists other causes. In the most this is not a serious condition but it can be tough to cope with it. Boys and men who have this condition can have pain in their breasts and in some cases they can be embarrassed [1]. This condition may go away on its own. If it persists, then surgery or medication can help.

Symptoms of gynecomastia

Men or boys who have gynecomastia can notice that their breast feels firm or rubbery. Boys can have a breast bud on one or both sides about the size of a quarter or a nickel. Breast buds are also common in adolescent boys during their puberty. They can last up to two years but also they tend to go away within the first year. Here are the signs and symptoms of gynecomastia:

  • Breast tenderness
  • Swollen breast gland tissue

You should see your doctor if you have tenderness, pain, swelling and nipple discharge in one or both breasts.


Causes of gynecomastia

This condition is triggered by a decrease in the amount of the hormone testosterone compared with estrogen. The cause of this decrease can be conditions that increases your estrogen level or conditions that block the effects of or reduce testosterone [2]. There are several things that can upset the hormone balance, including the following:

  • Herbal products: Plant oils such as lavender or tree, used in lotions, soaps or shampoos have been associated with gynecomastia. This is probably happening due to their weak estrogenic activity. [3]
  • Health conditions: We know that there are several health conditions which can cause gynecomastia by affecting the normal balance of hormones and they include:
  • Malnutrition and starvation: When the body is deprived of adequate nutrition, then the testosterone levels drop, but the estrogen levels remain constant, which is causing a hormonal imbalance. Also the gynecomastia can happen when the normal nutrition resumes. [2]
  • Cirrhosis and liver failure: There are hormonal fluctuations which are related to liver problems as well as medications for cirrhosis are also associated with gynecomastia. [4]
  • Kidney failure: It is known fact that about half the people who are treated with regular hemodialysis are experiencing gynecomastia due to their hormonal changes. [5]
  • Hyperthyroidism: When someone has this condition, then his or her thyroid gland is producing too much of the hormone thyroxine [6].
  • Tumors: There are some tumors, such as those involving the pituitary gland, adrenal glands or testes, can produce hormones which alter the male – female hormone balance. [7]
  • Aging: It is known fact that hormone changes are happing normally when people are aging and they can cause gynecomastia and this is especially happening in men who are overweight.
  • Hypogonadism: Any of these conditions can interfere with the normal testosterone production, such as pituitary insufficiency or Klinefelter’s syndrome and they can be associated with gynecomastia. [5]
  • Street drugs and alcohol: There are some substances which can cause gynecomastia such as [8]
  • Methadone
  • Heroin
  • Marijuana
  • Amphetamines
  • Alcohol
  • Medications: There are many medications which can cause gynecomastia [9] such as
  • Gastric motility medications, such as metoclopramide (Reglan)
  • Heart medications, such as digoxin (Lanoxin) and calcium channel blockers
  • Cancer treatment (chemotherapy)
  • Ulcer medications, such as cimetidine (Tagamet HB)
  • Antibiotics
  • Tricyclic antidepressants
  • Anti – anxiety medications, such as diazepam (Valium)
  • AIDS medications
  • Anabolic steroids and androgens
  • Anti – androgens, used to treat prostate enlargement, prostate cancer and some other conditions. Examples include spironolactone (Aldactone) and futamide, finasteride (Proscar, Propecia)


[1] Kipling M, Ralph JEM, Callanan K. Psychological impact of male breast disorders: Literature review and survey results. Breast Care. 2014;9(1):29–33.

[2] Cuhaci N, Polat SB, Evranos B, et al. Gynecomastia: Clinical evaluation and management. Indian Journal of Endocrinology and Metabolism. 2014;18(2):150–8.

[3] Toorians A, Bovee TFH, de Rooy J, et al. Gynaecomastia linked to the intake of a herbal supplement fortified with diethylstilbestrol. Food Additives and Contaminants. 2010.

[4] Cavanaugh J, Niewoehner CB, Nuttall FQ. Gynecomastia and cirrhosis of the liver. Archives of Internal Medicine. 1990;150(3):563-5.

[5] Iglesias P, Carrero JJ, Diez JJ. Gonadal dysfunction in men with chronic kidney disease: clinical features, prognostic implications and therapeutic options. Journal of Nephrology. 2012;25(1):31-42.

[6] Prabhakaran P, Miskiewicz S. Gynecomastia as the initial presentation of thyrotoxicosis – A case report. The Internet Journal of Endocrinology. 2010;6(2).

[7] Olsson H, Bladstrom A, Alm P. Male gynecomastia and risk for malignant tumours – a cohort study. BMC Cancer. 2002.

[8] Goldman RD. Drug-induced gynecomastia in children and adolescents. Canadian Family Physician. 2010;56(4):344–5.

[9] Nuttall FQ, Warrier RS, Gannon MC. Gynecomastia and drugs: a critical evaluation of the literature. European Journal of Clinical Pharmacology. 2015;71(5):569–78.


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