What is gynecomastia?

Gynecomastia is a common condition where the tissue under a young man’s nipples starts to grow and can look and feel like small breasts. It can occur in one or both breasts. Pubertal gynecomastia happens during the early years of puberty and usually goes away within 12 to 18 months.

 What causes gynecomastia?

The causes of pubertal gynecomastia are not entirely understood.  However, it is thought that hormone changes in puberty lead to these physical breast changes in adolescent males.  It can affect 40-60% of adolescent males.  Pubertal gynecomastia accounts for over 90% of gynecomastia in adolescent males.

Gynecomastia can also be caused by different medications and substances.  Some medicines that can be associated with gynecomastia including medicines used to treat heart problems, stomach problems, and mental health problems.  It can be caused by anabolic steroid use.  Marijuana and alcohol use can also be associated with breast development in men.

Less commonly, gynecomastia can be caused by a hormone problem (not normal puberty), a liver problem, or a kidney problem.  Very, very rarely gynecomastia can be associated with cancer.

How do you know if you have gynecomastia?

Gynecomastia feels like a small, rubbery lump under the nipple(s). It can happen on one or both sides and the lump may feel sore.

Some people can confuse gynecomastia with fat tissue, especially if a young man is living in a larger body.

Should I talk to my health care provider if I think I have gynecomastia?

Yes. If you are concerned you might have gynecomastia, it’s important to talk to your health care provider.

Your health care provider will start by asking you questions to help decide whether this is pubertal gynecomastia or something else. Your health care provider will also perform a breast exam where they will look at your chest and feel for any lumps or bumps, as well as check for any nipple discharge and skin changes.  They may also check your thyroid, feel for your liver, and do a testicular exam to check for other causes of gynecomastia.  Depending on what they find they may order an ultrasound and blood tests.

Can pubertal gynecomastia be treated?

Pubertal gynecomastia is normally not treated with medications or surgery because it goes away on its own, but it may take some time. Occasionally, if gynecomastia does not improve after 18 months and/or after a young man has finished puberty, then surgery may be an option to consider.

Understandably having gynecomastia may be a source of stress and may affect your mood. If you notice this, talk to someone — your health care provider, a parent/guardian, or another trusted adult. Some people find talking to a therapist is helpful. You do not have to deal with this alone.

What do I do if I have gynecomastia?

You should talk to your health care provider. Other things you can try at home that may help:

• Wear layers or a thick t-shirt under your normal clothes. Sweatshirts are a good option. This may help decrease pain from when something rubs against your chest accidentally.
• Maintain a healthy lifestyle. Eat 3 meals a day consisting of a varied diet, including fruits and vegetables. Exercise for at 30-60 minutes a day, 5 days per week.
• You can try weightlifting exercises to develop the muscles in your arms, back, and chest, including your pectoral muscles. This may help balance the shape of your upper body. It is important to have someone show you how to use the right technique for weightlifting.
• Avoid the use of alcohol and/or marijuana.