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Gynaecomastia A

What is Gynaecomastia?

Gynaecomastia is a medical condition in which boys' and men's breasts expand and become abnormally large in size. It can affect one or both breasts and is commonly noted in teenage boys and older men. It occurs as a result of an imbalance in the hormones, such as testosterone and estrogen, causing an increase in the volume of breast glandular tissue or by an underlying medical condition.

Causes of Gynaecomastia

All men and women produce both testosterone (male hormone) and estrogen (female hormone) which control sex characteristics in the body. Normally, testosterone is produced in higher volume in men and similarly, estrogen in women. In gynaecomastia, a higher proportion of estrogen is produced in males causing the male breast tissue to swell. Some of the factors that may cause gynaecomastia include:

  • Puberty
  • Age
  • Thyroid problems
  • Side effects of medications
  • Illegal drugs
  • Excessive alcohol
  • Liver disorder
  • Kidney failure
  • Obesity
  • Tumours or cancers
  • Herbal products
Gynaecomastia B

Signs and Symptoms of Gynaecomastia

Some of the common signs and symptoms of gynaecomastia include:

  • Enlargement of the breasts
  • Tenderness and sensitivity in the breasts
  • A small amount of additional tissue around the nipples

Diagnosis of Gynaecomastia

In order to diagnose gynaecomastia, your doctor will conduct a review of your medical history to look for any history of medications and health conditions that run in your family. A thorough physical examination is also performed for careful evaluation of your breast tissue to look for signs of unusual growths, lumps, or other skin issues. To further confirm the diagnosis, your doctor may order tests and imaging procedures, such as:

  • Blood tests - To look for signs of abnormal hormone levels
  • Mammogram – an X-ray examination of the breasts to check for subtle changes not detected during a physical exam
  • Tissue biopsy – surgical removal of a sample of breast tissue for microscopic analysis
  • Ultrasound scan – use of high-frequency sound waves to create pictures of breast tissue to differentiate between a fluid-filled cyst and a solid mass
  • Magnetic resonance imaging (MRI) – use of radio waves and a strong magnetic field to produce detailed images of the breast tissue to detect cancerous lesions

These diagnostic steps help in confirming the root cause of gynaecomastia and determine the best course of therapy.

Treatment for Gynaecomastia

In most cases, gynaecomastia resolves on its own over time without treatment. However, if the condition does not resolve, the following treatment methods may be employed:

Nonsurgical Methods

  • In cases of drug-induced gynaecomastia, replacement of the offending drug with an alternative and safer medication is recommended
  • Medical treatment of the underlying disease conditions causing gynaecomastia
  • If the gynaecomastia is due to hormonal imbalance or hormone therapy, your doctor may recommend a drug such as tamoxifen to treat large or painful breasts
  • For gynaecomastia due to testosterone deficiency, testosterone replacement therapy is recommended to treat low levels of testosterone
  • For gynaecomastia due to increased levels of estrogen, a medication called Danazol is suggested to reduce the level of estrogen synthesis by the testes

Surgical Methods

In patients not responding to nonsurgical methods, surgery is considered as the last option. The surgical methods for management of gynaecomastia include:

  • Liposuction – a procedure for removal of breast fat
  • Mastectomy – a procedure for excision (removal) of breast gland tissue
  • Reduction mammoplasty or breast reduction – a procedure for removal of excess breast fat, glandular tissue, and skin
  • A combination of the surgical techniques mentioned above