The Causes of Gynecomastia and the Treatment Options Available

Gynecomastia is the enlargement of a man’s breast tissue due to excess fat or excess breast tissue. It’s caused by various factors and can affect one or both breasts. Nearly 50% of boys in their adolescent age and two-thirds of men above the age of 50 experience gynecomastia.

Most of the boys who experience gynecomastia at a younger age don’t have to worry about it because it disappears in a few years. Some men who have gynecomastia also say that it disappeared after some time, especially if overweight issues caused it; when they lose the excess weight, the breasts tend to go back to normal. Gynecomastia isn’t a serious problem, but will often lead to low self-esteem and self-awareness.

What’s gynecomastia?

Gynecomastia, sometimes called “man boobs,” is a medical condition where localized fat and glandular tissue deposits develop in a man’s chest. This makes their breasts look larger than normal, causing them discomfort and sometimes pain.

Causes of gynecomastia

Hormonal imbalance

Gynecomastia can also be caused by an imbalance between the sex hormones in men: testosterone and estrogen. Men who lack or have decreased levels of testosterone are likely to develop this condition. With high estrogen levels in the body due to low testosterone, the glandular tissues will be triggered, causing male breast enlargement.

  1. Gynecomastia in babies or infants: More than half of male boys are born with enlarged breasts due to the effects of their mother’s estrogen. The swollen breasts usually disappear in two or three weeks after birth.
  2. Gynecomastia in puberty: Gynecomastia, which is caused by hormonal changes during puberty, is quite common. In most cases, the enlarged breast tissue will disappear on its own.
  3. In adults, gynecomastia is caused by decreased testosterone levels as men grow older, leading to breast tissue development. This happens around the age of 50 onwards. At least one in four men of this age group is usually affected.


Some medications can target the endocrine system, which usually controls the production of hormones. When the endocrine system is triggered to produce more hormones than necessary, it can enlarge male breasts. The medications that can cause gynecomastia may include:

  • Anabolic steroids and androgens, which are usually prescribed to treat certain conditions. Athletes also use them to build muscle and increase performance, though this is usually illegal.
  • Anti-androgens, which are usually used to treat prostate cancer, an enlarged prostate, and other conditions. Examples of such drugs are finasteride, flutamide, and spironolactone.
  • AIDS medications: Gynecomastia can develop in HIV-positive men receiving highly active antiretroviral therapy. Efavirenz used for HIV treatment is the one more commonly associated with gynecomastia than other HIV medications.
  • Antibiotics
  • Anti-anxiety medications, such as diazepam (valium)
  • Tricyclic antidepressants
  • Cancer treatments
  • Ulcer medications like over-the-counter drugs, such as cimetidine
  • Heart medications like digoxin and calcium channel blockers
  • Stomach-emptying medications, like metoclopramide

Drug and alcohol use

People who experiment with drugs like heroin, amphetamines, marijuana, and methadone create a risk of developing enlarged male breasts. On the other hand, alcohol affects how a man’s body metabolizes its hormones. This usually leads to an excess amount of estrogen, and this causes gynecomastia. Excessive drinking of alcohol may also cause liver cirrhosis, and this can also risk the development of large breasts in men.

Health conditions

Several conditions are known to cause gynecomastia because they affect the balance of hormones in the body. These health conditions include:

  • Tumors: Tumors found in the testes, pituitary glands, or adrenal glands produce hormones that alter the balance between estrogen and testosterone in the body.
  • Aging: Hormonal changes that occur as men grow older can cause gynecomastia, and the risk is higher in men who are overweight.
  • Hypogonadism: An example of a condition known to interfere with normal testosterone levels. Others are Klinefelter syndrome or pituitary insufficiency. 
  • Hyperthyroidism: With his condition, the thyroid gland produces too much of the hormone thyroxin.
  • Kidney failure: About half of people treated for kidney failure with dialysis experience man boobs due to hormonal changes.
  • Liver failure and cirrhosis: Cirrhosis medications and changes to the body’s hormonal changes because of liver problems can cause gynecomastia. 
  • Starvation or malnutrition: When you deprive the body of adequate nutrition, testosterone levels drop while the estrogen remains the same, causing hormonal imbalance in the body. This will trigger the formation of enlarged breast tissue.

Essential oils

Using plant oils such as lavender oils or tea tree oils that come in essential oils, shampoos, or lotions have also been associated with gynecomastia. This is due to their weak estrogenic activity in the body, causing hormonal imbalance.

How to treat gynecomastia

Treatment of gynecomastia aims to manage the underlying causes of the condition. Your doctor may recommend stopping specific medications, losing weight, or surgery if the condition requires it. Here are some treatment options for gynecomastia.

  1. Medications: Your doctor will prescribe medications that will help balance your hormones, such as selective estrogen inhibitors, which have been effectively used to reduce breast volume in patients with gynecomastia.
  2. Surgery is best if there’s a significant increase in breast tissue. Surgery is recommended to remove the excess breast tissues. There are two surgical options available: liposuction and mastectomy. Liposuction is the commonly used procedure where excess fat tissue is removed from the breasts. On the other hand, mastectomy is a surgical procedure where the excess breast gland tissues are removed. It’s a less invasive procedure that requires less time for recovery.

After the surgery, it’s good to purchase compression t-shirts, which you must wear 24/7 for the first two weeks after your surgery and 12 hours for the next two months after that. The compression shirts help with the healing process, reduce the swelling, and give you the desired effects of a well-contoured chest area.


Making healthy lifestyle choices help prevent the risk of getting the underlying conditions that may lead to gynecomastia. Eat a balanced diet, and avoid excessive intake of alcohol, self-medication, or taking illegal drugs.

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