Gynecomastia is a condition that results from an imbalance in hormones in males. During puberty, hormonal imbalances can cause gynecomastia in boys, and the same can occur in older men due to imbalances in their hormones. This condition leads to swelling in the breast tissue around the nipple, resulting in breast tissue that resembles that of a female.
Breast tissue swelling is typically not painful, although it can sometimes cause discomfort. Gynecomastia is generally not a serious medical issue, and although research in the past has suggested a potential link between gynecomastia and male breast cancer, it has not been definitively proven. In some cases, hormonal imbalances can correct themselves or be treated with hormonal therapy.
However, treatment for gynecomastia is often necessary due to the social embarrassment and psychological distress it can cause. If the swelling does not resolve over time, surgical intervention may be required to correct the size and shape of the breast tissue. Gynecomastia surgery is a cosmetic procedure typically performed by a qualified plastic surgeon.
The root cause of gynecomastia lies in the difference in the effects of androgens and estrogens on mammary gland growth. While androgens do not inhibit mammary gland growth in men, estrogens strongly inhibit it in women. As a result, hormonal imbalances in males can lead to mammary gland growth and an enlargement of the male breast, affecting both breasts evenly or unevenly.
Several factors can contribute to hormonal imbalances, including an imbalance in Sex-Hormone-Binding-Globulin (SHBG), chronic liver diseases or hyperthyroidism, certain medications or drugs, anti-androgens, steroids and protein powders, and certain medical conditions such as Klinefelter’s syndrome or aging.
Some common drugs which causing gynecomastia condition are:
- Hormones: Aromatizable androgens, hCG, Estrogens, Human growth hormone, Anabolic steroids, GnRH agonists/antagonists
- Anti-androgens: Flutamide, bicalcutamide, Finasteride, dutasteride, Spironolactone
- Antibiotics: Isoniazid, Ketoconazole, Metronidazole
- Anti-ulcer medications: Cimetidine, rantidine, Proton pump inhibitors
- Chemotherapeutic medications: Alkylating agents, Methotrexate, Vinca alkaloids
- Cardiovascular medications: Digitoxin, Verapamil, diltiazem, nifedipine, Amiodarone, Captopril, enalapril
- Psychoactive medications: Diazepam, Antipsychotics, Antidepressants
- Drugs of abuse: Marijuana, Alcohol, Amphetamines, Heroin, methadone
- Others: Metoclopramide, Phenytoin, HIV medications (protease inhibitors), Statins, Theophylline
It is not necessary that only allopathic medicine is responsible for causing gynecomastia, In the evaluation phase, we have to rule out any use of homoeopathic or herbal medicine manipulating free estrogens and hence causing an imbalance in the hormonal levels.
Medication is not the only culprit for gynecomastia; Some medical conditions are also responsible for the gynecomastia condition. Some common medical conditions are stated below:
Klinefelter’s syndrome: One of the main reason behind the enlarged male breast is this syndrome, In K’s syndrome there is a combination of XXY chromosomes in males, which results in small testicles and infertility, low level of testosterone. It is always necessary to have a proper diagnosis done before the treatment of the syndrome.
Aging: Hormones level do changes with time and ageing is also one of the common factor leading to gynecomastia, In most of the cases, enlarged breast settles down, and hormonal level comes to level, However, if nothing happens with time, medical intervention is necessary either in the form of Gynecomastia Surgery or medicines.
Tumours, Hyperthyroidism, Kidney Failure, Liver Failure, Malnutrition are among the common causes of gynecomastia.
Alcohol and ill-Legal Street Drugs: Alcohol, Marijuana, Heroin, Methadone are some common drugs associated with an enlarged breast condition. It is better to avoid the consumption of street drugs and keep the intake of alcohol minimum.
It is not only allopathic medication that can cause gynecomastia. The use of homoeopathic or herbal medicine that manipulates free estrogens can also lead to hormonal imbalances. It is important to diagnose the root cause of gynecomastia before deciding on the appropriate treatment. The patient should be open about their medical history, lifestyle habits, and any medication or drug use to ensure proper diagnosis and treatment.