Gynecomastia is a condition affecting adolescent boys, teens, and men. The condition refers to cases in which one or both breasts have excess glandular and fatty tissue, causing them to be enlarged. While this may be a perfectly normal temporary condition of childhood, prolonged gynecomastia can be embarrassing, particularly for adolescent boys who face taunts from their schoolmates.

What Causes Gynecomastia?

Most cases of gynecomastia are due to hormonal imbalances in which there is more estrogen than testosterone, which is why the condition is so common in adolescent males. In most cases, the condition will resolve on its own. However, there are certain illnesses that can also cause gynecomastia. These include:

  • Malnutrition and re-feeding (recovery from malnutrition)
  • Cirrhosis of the liver
  • Disorders of the male sex organs, including testicular cancer, injury, infection, or aging
  • Chronic renal failure
  • Hyperthyroidism

Certain drugs have also been linked to gynecomastia, including:

  • Calcium-channel blockers or ACE inhibitors for hypertension
  • Some antibiotics and anti-ulcer drugs
  • Anti-androgen or estrogen treatments for prostate cancer
  • Digitoxin
  • Valium
  • Alcohol, marijuana, and heroin
  • Lavender oil and tea tree oil in skin-care products

Standard Treatments for Gynecomastia

Standard treatment for gynecomastia that is not drug-induced is male breast reduction surgery to remove excess glandular and fatty tissue. Dr. Paul Pin often performs this procedure with a combination of mammary gland excision and liposuction (vacuum removal) of excess fatty tissue. However, surgery will not guarantee that the condition will not reappear later on. This is particularly true in adolescence, as the body is still going through a growth spurt.

There are some testosterone replacement medications (similar to testosterone replacement for patients with prostate or testicular cancer) that may reduce gynecomastia, but many patients may find that such medications have adverse side effects. Tamoxifen and raloxifene are drugs normally used to treat breast cancer that may also be used to treat gynecomastia. However, neither drug has been specifically approved by the U.S. Food and Drug Administration (FDA) to treat the condition.

Can Pectoral Exercises Help?

It is not unusual for patients to ask Dr. Pin this question, particularly if they are uncertain about medication or surgery, or if either is not a viable option. Because gynecomastia is often initially misdiagnosed as simply the result of being overweight, many patients may think that they can reduce the size of their breasts by strengthening their pectoral muscles through exercise and weight training.

The truth is that while exercise can help reduce the amount of male breast fatty tissue in overweight patients, it will have little effect upon true gynecomastia, which involves a combination of glandular and fatty tissue. Given that the root cause of gynecomastia is often related to hormone imbalances, it will generally not be affected by either weight loss or strengthened pectoral muscles. In fact, building up the pectoral muscles may actually make the appearance of gynecomastia even more pronounced, as the chest will then stick out even further due to the built up pectoral muscles.

Dr. Pin understands the frustration that patients may feel in attempting to find a simple solution to treating gynecomastia. Unfortunately, if it is true gynecomastia, the most effective treatment is surgery to remove the excess glandular and fatty tissue.