Gynecomastia is the benign growth of male breast tissue resulting in the appearance of enlarged breasts.
Pseudogynecomastia refers to enlarged breasts due to excess fatty tissues as opposed to true glandular excess.
Having enlarged breasts or “man boobs” can be very concerning for men. Gynecomastia can affect one or both breasts. Enlarged breasts in men can cause discomfort, both physically and socially. While it is normal for men to have circulating levels of both testosterone and estrogen, a disturbance in this balance can lead to the development of more prominent breast tissue.
Gynecomastia is very commonly seen in infants, pubertal boys and older men, but medications can also be the cause of gynecomastia. Medications that have been associated with gynecomastia include: anabolic steroids, androgens, prostate medications, antiretrovirals, antidepressants, anti-anxiety medications, certain antibiotics, heart medications and ulcer medications. Recreational drugs, like alcohol, amphetamines, marijuana, and heroin, have also been associated with gynecomastia.
Most cases of gynecomastia resolve on their own. If the gynecomastia is secondary to an underlying health problem, this will need treatment. Examination will typically involve a breast and axillary (arm pit) exam, an overall assessment and a testicular exam (if one has not been performed recently). With the presence of any hard or non-mobile lumps, significant size or progression, additional work-ups will likely be warranted. A work-up often involves blood tests (hormone levels, et cetera) and imaging studies (testicular ultrasound and/or mammogram). Fortunately, as most cases of gynecomastia do not fall into a concerning category, further work-ups are not common.