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Q: I’m a 45-year-old man, and I have overly large breasts. My wife tells me it’s because I need to lose weight. I’ve researched the problem online and read about something called gynecomastia. Is that the cause? What can I do about this? I’m starting to feel embarrassed.

A: Enlargement of one or both breasts in men is surprisingly common. So you’re not alone.

One condition that causes large breasts in men is, as you mention, gynecomastia. In this case, the glands of the breast become enlarged. Lipomastia, on the other hand, also causes breast enlargement but the underlying cause is an increase in fatty tissue around the breast—with no changes in the glands.

While it can be hard to tell the two apart, with gynecomastia the breast tissue feels firmer and more rubbery than with lipomastia. In addition, gynecomastia may cause breast soreness, something that is uncommon with lipomastia.

Hormones are usually the culprit behind gynecomastia in men. Although testosterone is the dominate sex hormone in men, males also have small amounts of estrogen on board. If estrogen levels increase relative to male hormones (or if a man becomes more sensitive to the effects of estrogen), breast tissue may enlarge.

Temporary gynecomastia is common in newborns due to exposure to the mother’s estrogen during pregnancy. This may occur in adolescence, too, because estrogen increases during puberty.

However, gynecomastia is also common in older men. As men get older, testosterone production falls. In addition, the testosterone that is produced is more likely to be converted to other hormones that act like estrogen. Certain health conditions such as liver or kidney disease, hormonal disorders, and heavy alcohol use can also cause gynecomastia.

Gynecomastia can be a side effect of some medications, such as:

* Spironolactone (used for heart failure and high blood pressure, among other conditions)
* Cimetidine (used for heartburn and acid reflux)
* Finasteride (used for an enlarged prostate and male pattern baldness)
* Performance-enhancing steroids

However, the cause of gynecomastia is often unknown.

So, as you can see, both you and your wife have good theories as to why your breasts are enlarged—but you’ll need your doctor’s help to figure out who is correct.

After reviewing your symptoms and performing a physical examination, your doctor may be able to distinguish between gynecomastia and lipomastia. Weight loss may indeed reduce breast enlargement due to lipomastia.

Additional evaluation is warranted for gynecomastia if the breast size is particularly large (more than 2 or 3 inches across), a lump is present, or there are findings that raise concerns about the possibility of breast cancer, such as enlargement of only one breast, or nearby lymph nodes that are swollen. (While it’s rare, men can get breast cancer.)

Blood tests for kidney and liver function, hormone levels, and a mammogram are commonly ordered, though frequently all of these tests are normal.

The treatment of gynecomastia depends on the cause. Options include the following:

* No treatment (especially if breast enlargement is longstanding and has not changed in more than a year or two)
* Treatment of the underlying cause. For example, when medication-induced gynecomastia is suspected, stopping or changing medications can return breast size to normal.
* Treatment with medicines that reduce or counteract estrogen, such as clomiphene, tamoxifen, or danazol
* Surgery to remove breast tissue

See your doctor for a proper diagnosis and to discuss your treatment options.

***This post was taken from a story on MSN. It is a nice summary of the condition***

Lee Corbett, MD

All posts on this blog are presented by Louisville, Kentucky plastic surgeon Dr. Lee Corbett.

Got man boobs? Search has information about your condition, what it is and what you can do about it.

What it is. Of course, there’s a technical name for it: gynecomastia.
What does it looks? Search here.

Not surprisingly, real gynecomastia (see more on pseudo gynecomastia below) is often caused by an imbalance between the hormones testosterone and estrogen, both of which are naturally occurring in men.

You knew about testosterone, but yes, guys need estrogen, too.

There are other causes as well, including the use of some recreational drugs. 

At least one hair-loss drug may also cause it. Can’t a guy get a break?

What to do. As many as half of all adolescent boys show signs of gynecomastia during puberty. It makes gym class tough, but it also usually disappears in a couple of years.

It’s a different story for adult men, for whom breast reduction surgery is a common form of treatment. Some dietary supplements purport to treat the condition. You’ll have to judge those for yourself.

When it’s not gynecomastia. Some man boobs, maybe even most, aren’t caused by hormone imbalances at all. This would, of course, be pseudo gynecomastia.

For those cases, the problem is being overweight, and all the usual solutions apply. Chief among them: Put the cookie jar back on the shelf, get off the couch, and get some exercise.

****I copied this from MSN. Couldn’t say it any better myself.****

Lee Corbett, MD

All posts on this blog,except this one, are authored by Louisville cosmetic plastic surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction,  and tummy tucks.