Cancer Breast Cancer Benign Breast Conditions An Overview of Gynecomastia Enlarged male breasts are usually the result of a hormonal imbalance By Julie Scott, MSN, ANP-BC, AOCNP Julie Scott, MSN, ANP-BC, AOCNP LinkedIn Oncology Certified Nurse Practitioner and freelance healthcare writer with over a decade of medical oncology and hematology experience. Learn about our editorial process Updated on April 12, 2023 Medically reviewed by Doru Paul, MD Medically reviewed by Doru Paul, MD Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Coping Frequently Asked Questions Gynecomastia is the enlargement of the glandular tissue in one or both of a boy or older male's breasts. The condition is benign (noncancerous) and very common: Anywhere from 30% to 65% of males, depending on age, have experienced this. Though it is not life-threatening, it can be uncomfortable and may impact someone's self-esteem. This article will review the causes of gynecomastia, the symptoms someone may experience, and how it is treated. Inti St Clair / Getty Images The first recorded breast surgery was done on a man with gynecomastia in A.D. 625, according to breast surgeon Susan Love. Breast surgery was not performed on a woman until over 1,000 years later, in 1897. Symptoms The main symptom of gynecomastia is enlarged breasts. It often begins as a slight bump or lump behind the nipple. This enlargement is usually painless, but some men experience tenderness. While it usually occurs in both breasts, it can occur in only one. Causes There are many reasons why gynecomastia develops, but the most common cause is a hormonal imbalance. In breast tissue, there are receptors that can cause breast tissue to grow (estrogen receptors) or to not grow (androgen receptors). If a male has higher levels of estrogen than normal in their body, their breast tissue grows. There are some periods in a male's life when they do have higher estrogen levels, including: Birth: Many newborn boys have enlarged breasts as a result of the estrogen that's transferred from their mother in the womb. Newborn gynecomastia usually resolves spontaneously after about a month.Puberty: Half of adolescent boys will experience gynecomastia, usually at around age 13 or 14. It often goes away on its own within six months to two years, but the condition can persist into adulthood.Older adults: Decreasing levels of the hormone testosterone may contribute to the peak in gynecomastia incidence in men older than 50. Other Causes Gynecomastia may be caused by chronic conditions such as: Cirrhosis of the liver (chronic liver damage causing scarring and liver failure) Hypogonadism (sex glands produce little if any hormones) Hyperthyroidism (overactive thyroid) Poor kidney function Testicular or adrenal tumors (rare) Klinefelter's syndrome (genetic condition resulting from an extra copy of the X chromosome) Understanding Klinefelter Syndrome Use of certain drugs may also lead to enlarged breasts in men. For example: CaroSpir (spironolactone), a heart medication Nizoral (ketoconazole), an antifungal medication Heartburn and ulcer medications Certain supplements Recreational drug use, including of cannabis, heroin, and amphetamines Anabolic steroid use often causes irreversible gynecomastia as well. The injection of external testosterone inhibits the natural production of testosterone, which cannot recover quickly enough between steroid-injecting cycles to prevent estrogen predominance. Gynecomastia can also result from treatments of prostate cancer, as the typical treatment given blocks the production of testosterone. Lifestyle and environmental factors of gynecomastia can include: ObesityHeavy alcohol useExposure to estrogens Diagnosis To diagnose gynecomastia, a healthcare provider will perform a physical exam of the breasts as well as the entire body to assess for any areas of concern. It's important to be sure that a male's large breasts are due to excess growth of glandular tissue, which has a network of ducts that can be felt, and not excess fat tissue. Known as pseudo gynecomastia, this occurs when the breasts of overweight boys and men enlarge due to increased fat and not true breast tissue. Blood tests to check hormone levels may also be performed. Sometimes imaging tests like a mammogram or ultrasound may also be needed to confirm the diagnosis. Although breast cancer is rare in men, representing less than 1% of all cases of the disease, those with gynecomastia often become anxious and seek medical attention, according to a Mayo Clinic report on a five-year review of findings. Only 1% of mammograms in men reveal breast cancer. Treatment If pseudo gynecomastia is determined to be the cause, your breast size will not decrease on its own. A combination of diet and exercise can help reduce total body fat percentage and, likely, the breast size. In contrast, there are several possible treatment options for gynecomastia, and what is best for you depends on a few factors. Waiting and Watching No treatment may be needed at all. In a wait-and-watch approach, no specific treatment will be prescribed. If the breast tissue continues to enlarge or if other symptoms develop, further treatment may be recommended at a later date. Disease Management When gynecomastia is the result of an underlying health problem or use of a medication that may cause breast growth, treating that problem or discontinuing the medication usually improves the condition. Of course, this should be done under the advice of your healthcare provider. In Pain? Pain is more common in patients with gynecomastia that recently developed or has progressed rapidly. If breasts are tender, cold compresses may be applied. Over-the-counter (OTC) analgesics (pain relievers) may also be used. Medication In cases in which the condition is persistent or causing discomfort, a healthcare provider may prescribe a brief (three-to-six-month) course of an estrogen-blocking drug called tamoxifen or Evista (raloxifene). This is most often tried in puberty. Adult men may also be prescribed a short course of one of these drugs. However, this treatment is only effective in men whose breast tissue is tender and who have had the condition for less than a year. Tamoxifen Drug Interactions Breast-Reduction Surgery Surgery is a common treatment for gynecomastia. Surgery is generally not recommended for adolescents until puberty is completed to be sure the breast tissue has stopped growing. There are a number of surgical techniques used to reduce breast tissue, including removal of the glandular tissue and excess skin. The areola may also be reduced or repositioned. Liposuction (a surgical technique using suction) can remove excess fat. Coping With Gynecomastia Having gynecomastia can be difficult for some males to deal with. Theymay be embarrassed or insecure about their bodies. Younger males going through puberty have an especially hard time. If experiencing any symptoms of depression, embarrassment, or any other negative feelings, it is important to remember that you're not alone. Gynecomastia is fairly common, and it can get better over time. Talking about your feelings with supportive family members or friends can be very helpful. If needed, talking with a counselor or therapist may be needed to learn body acceptance and how to deal with these feelings. Summary Although gynecomastia, the enlargement of breast tissue in males, is not life-threatening, it can potentially cause discomfort or insecurity to the male who has it. There are many possible causes of gynecomastia, and it is important to seek medical attention to determine the cause and the best course of treatment, if any. A Word From Verywell Gynecomastia is a common problem among boys and men, and it's important to see your healthcare provider to rule out any medical cause for the condition. Though it may resolve on its own without treatment, gynecomastia can lead to feelings of anxiety, embarrassment, and even depression. If your condition persists and causes you discomfort, there are treatments—lifestyle changes, medication, and surgical procedures—that can help reduce the size of your breasts. Frequently Asked Questions How can you get rid of gynecomastia? The cause of gynecomastia needs to be found before determining the best treatment for it. For example, if it is caused by a medication, stopping that medication can resolve it. Can gynecomastia go away on its own? Gynecomastia can go away on its own, especially if it develops in a time of a male's life, such as at birth or at puberty, when hormonal imbalances are temporary. What happens if gynecomastia is not treated? There is no danger to gynecomastia not being treated. In some instances, the treatment recommended is to wait and watch to see if it progresses or causes symptoms. Can exercise reduce gynecomastia? No. Only if large breasts are caused by obesity (called pseudo gynecomastia) can exercise and decreasing body fat possibly improve breast size. 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Kanakis GA, Nordkap L, Bang AK, et al. EAA clinical practice guidelines—gynecomastia evaluation and management. Andrology. 2019;7(6):778-793. Lemaine V, Cayci C, Simmons PS, Petty P. Gynecomastia in adolescent males. Semin Plast Surg. 2013;27(1):56-61. doi:10.1055/s-0033-1347166 Niewoehner CB, Schorer AE. Gynaecomastia and breast cancer in men. BMJ. 2008;336(7646):709-13. doi:10.1136/bmj.39511.493391.BE Dickson G. Gynecomastia. American Family Physician. Apr 1, 2012. Taheri AR, Farahvash MR, Fathi HR, Ghanbarzadeh K, Faridniya B. The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction. World J Plast Surg. 2016;5(3):287-292. Mayo Clinic. Enlarged breasts in men (gynecomastia). Additional Reading Cuhaci, Neslihan. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab. 2014 Mar-Apr 18(2): 150-158. https://dx.doi.org/10.4103/2230-8210.129104 Henley DV, et al. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. 2007 Feb 1;356(5):479-85. doi:10.1056/NEJMoa064725 Johnson Ruth E and Murad M Hassan. Gynecomastia: Pathophysiology, Evaluation, and Management. Mayo Clin Proc. 2009 Nov; 84(11): 1010–1015. doi:10.1016/S0025-6196%2811%2960671-X Love Susan. "Dr. Susan Love's Breast Book." Sixth edition. Hachette Book Group; 2015. Niewoehner CB, Nuttal FQ. Gynecomastia in a hospitalized male population. Am J Med. 1984 Oct; 77(4):633-8. doi:10.1016/0002-9343(84)90353-x Taheri Ahmad Reza. The Satisfaction Rate among Patients and Surgeons after Periareolar Surgical Approach to Gynecomastia along with Liposuction. World J Plast Surg. 2016 Sep; 5(3): 287–292. Toorians AW, et al. Gynaecomastia linked to the intake of a herbal supplement fortified with diethylstilbestrol. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2010 Jul;27(7):917-25. doi:10.1080/19440041003660869 By Julie Scott, MSN, ANP-BC, AOCNP Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community. Originally written by Pam Stephan Pam Stephan Pam Stephan is a breast cancer survivor. Learn about our editorial process See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit