What is Gynecomastia?
The term Gynecomastia comes from the Greek words gyne meaning "woman" and mastos meaning "breast." In practical terms, this means abnormally large breasts on men.
Types of Gynecomastia
How is it diagnosed?
The current standard definition uses the pinch test: if you pinch the areola area with your thumb and index finger and the thickness between them is more than 2 cm, gynecomastia may be present.
Prevalence
The condition is relatively common in adolescent boys — 60 to 70% experience some degree. In elementary school, boys' testicles gradually enlarge and the fatty tissue around them synthesises female hormones, stimulating breast tissue development. This often causes breast tenderness, which typically resolves with age.
Adults also experience gynecomastia. As men age, male hormones in the blood gradually decrease while the relative proportion of female hormones rises. Therefore, up to 72% of men aged 50 to 70 have gynecomastia. After age 70, however, the incidence drops to around 47%, possibly because fatty tissue atrophies along with all other organs.
Idiopathic (Unknown Cause)
The cause is unknown, yet this accounts for up to one quarter of patients.
Most gynecomastia cases have no identifiable cause. If the condition is mild and female hormone levels are not elevated, observation may be the best approach.
Adolescent gynecomastia is usually observed for two to three years. However, if obesity is present, weight loss may be needed for noticeable improvement.
Secondary (Disease-Related)
Usually associated with underlying medical conditions:
- Metabolic diseases (alcoholic cirrhosis / adrenal tumours)
- Endocrine disorders (hyperthyroidism or hypothyroidism / adrenal hyperplasia)
- Acquired hypogonadism (orchitis / testicular trauma / kidney failure / alcohol dependence)
- Congenital hypogonadism and elevated oestrogen (bronchial carcinoma / testicular cancer)
Drug-Induced
Certain heart medications, ulcer treatments, anti-cancer drugs, anti-anxiety medications, and asthma drugs can have gynecomastia as a side effect.
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