What is Gynecomastia and how to cure it?

Gynecomastia is an enlarged breast condition found in teenage boys and older men, due to excess fat tissue in the region. Gynecomastia may be characterised by an amount of fat tissue around the breast, causing them to look prominent. Sometimes, it may cause tenderness and pain in the swollen area. Gynecomastia may vanish on its own, but if the problem persists, then surgery is the best way to get rid of it.

Causes of Gynecomastia-

There may be different causes of Gynecomastia-

1)       Hormonal Imbalance-

Gynecomastia may be caused due to imbalance of male and female hormones, testosterone and oestrogen. Men usually produce large amount of testosterone, which stops the oestrogen hormones to develop breasts. If the secretion of oestrogen increases, then the breast tissue develops.

2)       Obesity-

Sometimes obesity can also increase the oestrogen levels, so the breast tissue develops.

3)       New Born Babies-

Gynecomastia may also develop in new-born baby boys, because sometimes, oestrogen passes through the placenta of the mother to the baby.

4)       Puberty-

During puberty, the hormonal levels in boys may vary and sometimes the oestrogen levels may increase, causing enlarged breast tissue.

5)       Old Age-

As men get older they produce less testosterone. They accumulate excess body fat and hence develop manboobs.

6)       Other causes of Gynecomastia-

a) Medicine side effects

b) Alcohol and illegal drugs like marijuana, amphetamine, heroin, methadone.

c) Chronic disorders like kidney failure or liver damage.

d) Malnutrition and starvation. 

e) Hypogonadism

f) Tumors

g) Antidepressants

h) Antibiotics

i) Ulcer medication like cimetidine.

When should you see the doctor for Gynecomastia?

Whenever you can see symptoms such as pain, swelling and tenderness along with some discharge, you should consider consulting a doctor. Your doctor will ask you questions about your medical and drug history and the health conditions running in your family. The doctor will also do a physical examination that may include careful evaluation of your breast tissue, abdomen and genitals.

Initial tests to determine the cause of your gynecomastia may include:

·         Blood tests

·         Mammograms

You may need further testing depending on your initial test results, including:

·         Computerized tomography (CT) scans

·         Magnetic resonance imaging (MRI) scans

·         Testicular ultrasounds

·         Tissue biopsies

Treatment for Gynecomastia-

In most cases, gynecomastia may vanish with time without any formal treatment. However, if gynecomastia is caused by an underlying condition, such as hypogonadism, malnutrition or cirrhosis, that condition may need treatment. If you're taking medications that can cause gynecomastia, your doctor may recommend stopping them or substituting them with other medications. In adolescents with no apparent cause of gynecomastia, the doctor may recommend periodic check-ups every three to six months, to see if the condition improves on its own. Gynecomastia often goes away without treatment in less than two years. However, treatment may be necessary if gynecomastia doesn't improve with time.

Surgery to remove excess breast tissue-

If you still have significant breast enlargement despite initial treatment or observation, your doctor may advise surgery. Two gynecomastia surgery options are:

·         Liposuction. This surgery removes breast fat, but not the breast gland tissue itself.

·         Mastectomy. This type of surgery removes the breast gland tissue. If the gynecomastia is caused due to excess breast tissue, then it needs to be removed with a scalpel. The surgery is often done endoscopically, meaning only small incisions are used. This less invasive type of surgery involves less recovery time.

Normally there are no complications post-surgery and the patient may return to normal activities, besides reduced sensation around the nipples and uneven contour of the chest. The patient can get back to normal life, six weeks after surgery.

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