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Gynecomastia – Symptoms, Causes, And Treatments

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Gynecomastia is a common ailment caused due to an irregularity of testosterone and estrogen hormones in males.  Gynecomastia can take place in either one or both breasts. Changes in hormone levels of newborn children, boys going through puberty and even older men can result in gynecomastia. There are other causes that can result in gynecomastia. Not a serious health issue, gynecomastia is a bigger problem psychologically. While some people may suffer pain in the breasts due to the enlargement, most suffer embarrassment due to their physical appearance. Medication and/or surgery might be required if it does not go away on its own. 

Signs and Symptoms of Gynecomastia
The signs of gynecomastia are swollen breast tissue and tenderness around the breast. The most important factor when checking for symptoms of gynecomastia is the duration of the enlargement. The other factors that a medical professional will check include problems of lowered libido or erectile dysfunction, signs of secondary sexual characteristics, pain around the area or discharge from the nipples and the medical history during puberty. 
However, other conditions could cause symptoms similar to gynecomastia. These could include fatty breast tissue, breast cancer, and breast abscess.
What are the Causes of Gynecomastia?
A decrease in the quantity of testosterone against estrogen is the prime trigger for developing gynecomastia. This could be due to an increase in the estrogen level, reduction in testosterone levels or conditions that block the effects of testosterone. Some of the various things that can upset the hormone balance are: 
Natural hormone changes – The sex characteristics of both men and women are controlled by estrogen and testosterone, hormones that are found in both the sexes. While estrogen controls the female traits, testosterone controls male traits. Gynecomastia can develop when the estrogen level in males is higher than the testosterone level. However, the majority of male children are born with enlarged breasts which subside within two to three weeks. This is due to the effect of the estrogen in the mother. Hormonal changes during puberty can also result in this issue. In the majority of cases, this subsides without treatment within six months to two years. Hormonal changes between the ages of 50 to 69 results in about twenty-five percent of men getting affected by gynecomastia.  
Medications – Some medications could result in gynecomastia and include anti-androgen drugs used for treating an enlarged prostate or prostate cancer, anabolic steroids that are used for muscle building or performance enhancement, medication for AIDS, anti-anxiety medications, some antibiotics, tricyclic antidepressants, certain heart medicines, calcium channel blockers, and medication for emptying the stomach. 
Gynecomastia can also be triggered by the use of marijuana, heroin, methadone, amphetamines, and alcohol. 
Health issues – Certain health conditions that affect hormonal balance can cause gynecomastia. These include hypogonadism – a condition that interferes with the production of testosterone; tumors affecting the pituitary or adrenal glands and testes; too high a production of thyroxine; kidney failure; liver cirrhosis and failure; starvation and malnutrition; and hormone changes due to aging. 
How can you Prevent Gynecomastia?
While there is not much that can be done to control the natural production of hormones, there are a few factors that are under your control. These include drinking alcohol in moderation or not at all; not taking drugs such as heroin, marijuana, amphetamines, androgens, and steroids; and consulting your doctor for alternatives if you are on any medication that can cause gynecomastia. 
How is Gynecomastia Diagnosed?
Physical examination of the breast tissue, genitals, and abdomen, along with questions relating to your medical history and family health conditions are the first step in diagnosing gynecomastia. Following this, the doctor may recommend a blood test and/or a mammogram. Depending on the results of the initial tests, you may need to undergo further testing that could include MRI, CT scan, testicular ultrasound, and tissue biopsy. 
How is Gynecomastia Treated?
Unless gynecomastia is caused by an underlying condition such as malnutrition, cirrhosis or hypogonadism; in most cases, it is resolved without treatment. Medications that may cause gynecomastia can be changed or stopped by your doctor. Treatment becomes necessary if the condition does not improve over time or if there is acute pain or tenderness in the area. 
Medications – Certain medications that are used for the treatment of breast cancer may be used for the treatment of gynecomastia. However, it is important to note that these medicines have not been approved specifically for this purpose. 
Surgery – Your doctor may advise you to undergo surgery for treating the problem. Generally, this is recommended only if there is no change over time, after the initial treatment or if the enlargement is significantly large. You can find out more details about gynecomastia surgery from Thomson Medical, regarding this type of surgery. There are two options for gynecomastia surgery:
  1. Undergoing liposuction, where the breast fat is removed and not the breast gland tissue. 
  2.  Undergoing mastectomy, where the breast gland tissue is removed. Involving small incisions, mastectomy is less invasive than liposuction and has a faster recovery period.
Gynecomastia Surgery Risk Factors
Gynecomastia surgery qualifies as plastic surgery. The decision to undergo this is purely personal and the patient has to evaluate if the risks and probable complications are acceptable. The risks include anesthesia complications; adverse reaction to injected agents or topical preparations; blood clots or hematoma; asymmetrical breasts; thrombosis; pulmonary and cardiac complications; seroma; secondary infections; pain; fat necrosis; scarring and a possibility of revision surgery. 
The Bottom Line
Most men will find enlarged breasts embarrassing and traumatic. While it is normal to feel so, certain things can be done to cope with this. Communicating with your partner, family members or a counselor will help cope with what you are going through. Speaking to other men who have gone through this experience will help you cope with your situation. If the problem persists, get yourself examined by a specialist and follow the advice and treatment protocol.   

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