Gynaecomastia: Enlarged breast in men

One in six boys develops breasts during puberty
Doctors say that 50 per cent to 60 per cent of male adolescents have the condition, although for many, there are no symptoms. PHOTO: ISTOCKPHOTO

If you are in your early teens and start developing breasts or suffer from breast pain, do not worry. It is a normal part of puberty – yes, even for boys. Around 17 per cent of boys around the age of 13 develop “male boobs”, or gynaecomastia, according to Dr Chin Xinyi, a senior endocrinologist at KK Women’s and Children’s Hospital (KKH).

Doctors say that 50 per cent to 60 per cent of male adolescents – those aged between 10 and 19 – have the condition, although for many, there are no symptoms. This is caused by hormonal imbalance during puberty when a boy gains sexual maturity.

Gynaecomastia also occurs in an estimated 60 per cent to 90 per cent of newborns, caused by oestrogen, the female hormone that babies receive from their mothers. Seventy per cent of men develop the condition from around the age of 60, as they produce less testosterone, the male hormone. In most infants, the condition appears a few days after birth and disappears within weeks, said Dr Chin. When it manifests during puberty, the boy will feel an achy pain made worse when touched.

Doctors say more SG men are now seeking treatment for gynecomastia (man boobs)

Doctors have recently seen an uptick in men seeking treatment for gynaecomastia, as reported by TODAY. Gynaecomastia, as defined on the Singapore General Hospital’s (SGH) website, involves the enlargement of male breast tissue. It often presents as a rubbery or firm mass starting under the nipple and extending outward across the breast area.

This condition is also colloquially referred to as “man boobs.” According to doctors, men, usually in their 20s to 30s, have visited their clinics more frequently to seek help for this condition. However, Dr Samuel Ho, a cosmetic plastic surgeon from Allure Plastic Surgery, notes that this doesn’t necessarily indicate that gynecomastia is prevalent in Singapore. He suggests that the rise in cases over the past five years is likely due to increased awareness.

In his interview with TODAY, Dr. Ivan Puah, medical director of Amaris B Clinic, also mentioned that, based on international studies, approximately 50–60% of men worldwide experience this condition. He explained that this condition typically affects adolescents, overweight men, ageing men, and individuals with underlying medical conditions.

Gynaecomastia - What it is

Gynaecomastia is the enlargement of male breast tissue. It is common in newborns, at puberty, as well as in older men. There is growth of the male breast glands and not just the fat. It may occur in one or both breasts and it is a benign condition.

Symptoms - This may present as a rubbery or firm mass that starts from underneath the nipple and then spreads outwards over the breast area. There may be discomfort or tenderness. It may occur in one or both breasts.

Causes and Risk Factors - Gynaecomastia can be due to the imbalance of the sex hormones, testosterone and oestrogen. Oestrogen is a female hormone that causes the breast tissue to grow. Men do produce some oestrogen but they usually have more testosterone which prevents the effects of oestrogen.

Enlarged breasts in men (gynecomastia)

Gynecomastia (guy-nuh-koh-MAS-tee-uh) is an increase in the amount of breast gland tissue in boys or men. An imbalance of the hormones estrogen and testosterone causes it. Gynecomastia can affect one or both breasts, sometimes unevenly.

Pseudogynecomastia is an increase in fat but not gland tissue in male breasts. Newborns, boys going through puberty and older men may develop gynecomastia due to natural changes in hormone levels. There are other causes too.

Most often, gynecomastia isn't a serious problem. But it can be tough to cope with the condition. People with gynecomastia sometimes have pain in their breasts. And they may feel embarrassed. Gynecomastia may go away on its own. If it doesn't, medicine or surgery may help.

Adult male with significant gynecomastia

Gynecomastia (also spelled gynaecomastia) is the abnormal non-cancerous enlargement of one or both breasts in males due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Gynecomastia can cause significant psychological distress or unease.

Gynecomastia can be normal in: newborn male babies, due to exposure to estrogen from the mother; adolescent boys going through puberty; older men, over age 50; and obese men. Most occurrences of gynecomastia do not require diagnostic tests. Gynecomastia may be caused by abnormal hormone changes, any condition that leads to an increase in the ratio of estrogens/androgens such as liver disease, kidney failure, thyroid disease and some non-breast tumors. Alcohol and some drugs can also cause breast enlargement. Other causes may include Klinefelter syndrome, metabolic dysfunction, or a natural decline in testosterone production. This may occur even if the levels of estrogens and androgens are both appropriate, but the ratio is altered.

Gynecomastia is the most common benign disorder of the male breast tissue and affects 35% of men, being most prevalent between the ages of 50 and 69. It is normal for up to 70% of adolescent boys to develop gynecomastia to some degree. Of these, 75% resolve within two years of onset without treatment. If the condition does not resolve within 2 years, or if it causes embarrassment, pain or tenderness, treatment is warranted. Medical treatment of gynecomastia that has persisted beyond two years is often ineffective. Gynecomastia is different from "pseudogynecomastia", which is commonly present in men with obesity. Medications such as aromatase inhibitors have been found to be effective and even in rare cases of gynecomastia from disorders such as aromatase excess syndrome or Peutz–Jeghers syndrome, but surgical removal of the excess tissue can be needed to correct the condition. In 2019, 24,123 male patients underwent the procedure in the United States, accounting for a 19% increase since 2000.

What is gynecomastia?

Gynecomastia is a condition of overdevelopment or enlargement of the breast tissue in children and adults who have a penis. The breasts become larger. They may grow unevenly. Gynecomastia often happens when a preteen or teenage child is going through the hormonal changes of puberty. But it can also happen to newborn babies and to adults as they age.

What causes gynecomastia? Gynecomastia is usually a benign (noncancerous) condition. It may be linked to many different causes of hormone changes. In many cases, the cause isn’t known. Gynecomastia is often caused by changes in levels of the hormones estrogen and testosterone. But it can be caused by other things as well. Gynecomastia can be a side effect of certain medicines, such as antidepressants, antibiotics, chemotherapy, prostate cancer medicines, or ulcer or cardiovascular medicines. Illegal drugs, such as anabolic steroids, heroin, or marijuana can also cause gynecomastia.

Some diseases and health conditions may also cause gynecomastia. These include:
  • Liver diseases
  • Kidney disease
  • Lung cancer
  • Testicular cancer
  • Tumors of the adrenal glands or pituitary gland
  • Some conditions that a baby is born with (congenital disorders)
  • Thyroid disorders
  • Injury
  • Obesity