What is gynecomastia?

Gynecomastia is the enlargement of the breasts in children or men due to a benign (non-cancerous) increase in the tissue of the breasts. This disorder is the result of an imbalance between testosterone (a male hormone) and estrogen (a female hormone). All men have a little estrogen. But an excess of estrogen can cause the breasts to grow.

What causes gynecomastia in adults?

Several factors can cause enlarged breasts in men:

• Hormonal changes with age (having less testosterone and more estrogen) for gynecomastia
• Greater fat in the body, which can increase the level of estrogen
• Medicines and other substances (see box)
• Certain health problems:
• Disorders that result in a low level of testosterone (called hypogonadism), such as Klinefelter syndrome or problems with the pituitary gland
• Too active thyroid gland (hyperthyroidism)
• Liver diseases
• Kidney diseases and kidney failure
• Tumors in the testicles, adrenal glands or pituitary gland

How is gynecomastia diagnosed?

Your doctor will ask you questions about the conditions you may have and medications you take regularly, including over-the-counter medications. On a physical exam, your doctor will check the breast tissue to see if the enlargement is due to gynecomastia or another disorder. Among other causes of enlarged breasts are fatty deposits, benign tumors and bags filled with fluid (cysts). Your doctor will look for signs of breast cancer, a rare disorder among men. Your doctor will also examine your testicles to see their size and if they have tumors.

Your doctor may recommend the following tests:

• Blood tests to detect the level of hormones
• Tests to determine if the liver, kidneys and thyroid are functioning properly
• Imaging tests, such as ultrasound or computed tomography or CT scan that detect tumors
• A mammogram to rule out breast cancer
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