We all think that when it comes to breasts, they’re a concern pertaining only to the fairer gender. However, men do have breasts – even milk ducts.
With high testosterone levels produced puberty, for the vast majority of men, the breast tissue does not develop like it does for their female counterpart.
There are 2 types of conditions that affect men in Singapore.
The first is gynecomastia, which is a medical condition – men with such condition have more prominent glandular tissue present, often as a result of hormonal imbalance. When it comes to man boobs for the majority of men, they are usually a mixture of both fat and breast tissue enlargement.
The second condition is pseudogynecomastia, which is the accumulation of excess fat tissues on the chests.
Gynecomastia: Enlarged Male Breasts
For gynecomastia, the cause of the condition is an excess of glandular male breast tissue due to hormone imbalance.
Unlike fat tissue, glandular tissue is firmer and more fibrous, and it also does not respond to diet changes nor exercise.
Gynecomastia Symptoms: Soft Lumps & Tenderness
Feel for soft lumps in your breasts. In true gynecomastia, glandular breast tissue may develop in one or both breasts.
This tissue may be located directly behind the nipple. To check for the symptom, gently feel your breast with your fingertips.
Should you suffer from gynecomastia, you should feel a soft, rubbery lump in one or both breasts.
Gynecomastia may occur in just one breast or both breasts at a go. And with the size of the lump varying, it may not be the same in both breasts.
Breast buds which signal the start of puberty, are typically the size of a nickel or quarter in puberty-aged boys.
Take note of tenderness. Gynecomastia may cause your breasts to be tender and sore, especially when you touch or press on them.
If your breasts are causing you a significant amount of pain or discomfort, it is advisable to make an appointment with your doctor right away.
Causes of Gynecomastia: Natural Hormone Changes, Puberty & Health Conditions
An imbalance of hormones triggers gynecomastia. A decrease in the amount of the testosterone level compared with estrogen leads to the condition.
The decline in testosterone levels can be caused by conditions that block the effects of or reduce testosterone.
It may also be a condition that increases your estrogen level. Several factors can upset the hormone balance, and these include the following:
Natural hormone changes
The hormones testosterone and estrogen not only control the development but it is a maintenance of sex characteristics in both men and women.
Testosterone takes control of male traits, such as muscle mass and body hair, while Estrogen takes control of female traits, including the growth of breasts.
Most people associate estrogen as an exclusively female hormone, but the truth is, men also produce it — though generally in small quantities.
However, when male estrogen levels are too high or are out of balance with testosterone levels, this can cause the condition, gynecomastia.
Gynecomastia during puberty
Enlarged male breasts are caused by hormone changes during puberty is relatively common.
In most cases in Singapore, the swollen breast tissue will go away without treatment within six months to two years.
As for Gynecomastia in men, the prevalence of this condition peaks again between the ages of 50 and 69 with at least 1 in 4 men in this age group being affected.
Several health conditions can cause gynecomastia by tilting the normal balance of hormones. These include:
Any of the conditions that interfere with normal testosterone production, such as Klinefelter’s syndrome or pituitary insufficiency, can be associated with gynecomastia.
Hormone changes that occur during the normal course of ageing can cause gynecomastia, especially in overweight men.
Some tumours, such as those involving the testes, adrenal glands or pituitary gland, can produce hormones that alter the male-female hormone balance.
In this condition, the thyroid gland produces too much of the hormone thyroxine.
Kidney Failure. About half the people being treated with regular hemodialysis experience gynecomastia due to hormonal changes.
Liver Failure And Cirrhosis. Hormonal fluctuations related to liver problems as well as medications taken for cirrhosis are associated with gynecomastia.
Malnutrition And Starvation. When your body is deprived of adequate nutrition, testosterone levels drop, but estrogen levels remain constant. As such, this causes a hormonal imbalance. Unfortunately, Gynecomastia may persist despite resuming normal nutrition.
Common Gynecomastia Questions
Here are some common questions on gynecomastia:
1. Can Beer, Chicken, Eggs And Soya Beans Cause Gynecomastia?
Hoppy beers like IPA (Indian Pale Ale) contain phytoestrogen, a plant-based estrogen hormone. The common myth is that drinking too much of them will cause estrogen levels to skyrocket.
The truth is, the phytoestrogen levels are too low to create any hormone imbalance. The consumption of beers or any alcohol in excess can be detrimental to your overall health and thus, should be avoided.
Soy contains isoflavones, a class of phytoestrogens which may mildly mimic the hormone estrogen. The effects of soy isoflavones on estrogen levels are complex, but in general, soy is safe to be consumed in moderation.
As such, eggs, milk and other food products that contain hormones are safe for consumption when taken in moderation.
2. Can Steroid Eliminate Enlarged Male Breasts?
Anabolic steroids contain a lot of testosterone, which many may consider a solution since the key cause of enlarged male breasts is hormone imbalance where estrogen levels are higher.
Sounds like a solution right? Wrong.
Apart from other potential health issues, steroid use is the primary trigger for gynecomastia.
When you’re on steroids and then go off them, this results in testosterone levels fluctuating, causing an increase in your estrogen level.
This often leads to fat development in the chest area. As such, never self-medicate as this can cause your hormones to go out of whack.
Should you notice signs of gynecomastia, always seek appropriate and qualified doctor advice.
3. Does Andropause/Male Menopause Cause Gynecomastia?
Studies have shown that male menopause or andropause happens in men aged 50 or older when testosterone production drops.
Testosterone fuels changes during puberty and affects a man’s mental and physical energy as well as regulates other key evolutionary features.
As the levels of testosterone drops, it causes a hormonal imbalance and these may eventually lead to the development of enlarged male breasts.
4. Is Gynecomastia An Early Sign Of Breast Cancer?
Breast cancer is not only a concern for women since men can contract it too, albeit rarer in men. Gynecomastia, however, is not a sign of breast cancer.
Furthermore, excessive breast development and breast cancer are not found to be correlated.
When a person slims down, he will tend to see an overall reduction in size.
However, should you be suffering from true gynecomastia, your chest fullness will only look more prominent after other parts of your body have shrunk.
The only way to treat this part of your body is through a surgical intervention with gynecomastia surgery.
5. How To Get Rid Of Gynecomastia
Gynecomastia is a dual component problem as these excessive breasts glands and fat tissues, unfortunately, cannot be eradicated through diet and exercise alone, but with gynecomastia surgery.
6. Gynecomastia Grades On Excess Male Breasts
Enlarged male breasts tissue is divided into four different “grades”, based on the severity of the problem.
Gynecomastia Grade 1: The initial stage is characterised by minor breast enlargement without the development of excess skin. The excess skin, at this stage is found around the areola which is the coloured tissue that is surrounding the nipple.
Gynecomastia Grade 2: As the gynecomastia condition enters into the next stage, there will be a development of moderate breast enlargement without the development of excess skin. However, with enlarged male breast tissue, it now extends beyond the areola, with a minor degree of enlargement. Despite the enlargement, it is still imperceptible when a loose shirt is worn.
Gynecomastia Grade 3: Without treatment, the gynecomastia exacerbates and enters the 3rd stage. At this stage, there will be moderate breast enlargement with the development of excess skin. As the enlarged male breast tissue extends further into the breast zone, the male chest starts to look slightly like the feminine breasts and at this stage, the condition becomes clearly noticeable by others.
Gynecomastia Grade 4: As the gynecomastia enters the final stage, the condition is further aggravated with breast enlargement and excess skin. At this stage of the gynecomastia condition, patients will find that their chest appears similar to that of woman’s breasts. By now, the enlarged male breast tissue has become very noticeable and would be impossible to hide.
7. Will the skin sag after gynecomastia?
Most of the patients have degrees of gynecomastia that are not excessively saggy, as such, in these instances, the skin elasticity will ensure that the skin snaps appropriately into a more aesthetically pleasing position.
It is also important to wear the compression garment as it will help in guiding the skin back to the desired position.
8. Is recurrent of gynecomastia common after gynecomastia surgery?
When a gland is removed through the procedure, it is permanently removed and does not recur. The maintenance of post-surgery is also crucial in maintaining post-surgery results, and this includes adopting a healthy lifestyle that includes diet and exercise.
Does Cannabis cause gynecomastia? The simple answer is not 100% conclusively, but there is a very strong connection.
A man holding a cannabis joint in San Francisco
In simple terms, gynecomastia is the enlargement of male breast tissue and often referred to as man boobs or moobs for short. Male breast enlargement occurs due to an imbalance in the hormone levels of testosterone and estrogen. When the male hormone testosterone ratio decreases compared to that of the predominantly female hormone estrogen, then the body signals for creating excessive breast tissue in males.
What is the Active Ingredient in Cannabis?
The active ingredient in cannabis, tetrahydrocannabinol (THC), has been shown to reduce the level of testosterone in animal studies. The fall in testosterone is due to the effect of this THC in lowering the serum testosterone levels. THC can alter neural transmitters of the hypothalamus or that of CNS neural transmitters. Therefore, there is a reduction in testosterone produced by the testis’ Leydig cells (Harclerode, 1984).
Scientific Articles Investigating, Does Cannabis cause Gynecomastia?
Although animal studies have shown an association, studies in humans have not conclusively demonstrated that Pot causes gynecomastia. A clinical study conducted on U.S. army soldiers found no significant difference between cannabis users and controls (Cates & Pope, 1977).
In another human study, 1215 healthy men Dutchmen between the ages of 18 and 28 were evaluated for Pot induced gynecomastia between 2008 to 2012. The study showed that regular marijuana users had a reduced sperm concentration by 52%, and total sperm count by 55% (Gundersen, et al, 2015).
Cuhaci et al. (2014) has shown that cannabis use can lead to the development of male breast tissue or gynecomastia; however, the mechanism by which it happens is not very clear. Nordt & DiVasta (2008) have shown that it is essential to inquire if they have a history of illegal drug usage when examining adolescents with gynecomastia.
Clinical Observation by Gynecomastia Specialist
Dr. Steven Goldman, a plastic surgeon, has claimed that boys who are regular users of cannabis in their formative years, had a higher probability of developing man boobs later in life (Huffpost, Jan 2014). The transient effect of breast enlargement, which is seen in some boys reaching puberty, can become permanent due to pot use as their testosterone levels are altered by marijuana. Cannabis interferes with the healthy development in teen males, and it can lead to excessive breast tissue even after puberty than others who do not use it. Yet another plastic surgeon from Pennsylvania, Dr. Adrian Lo, who specializes in reducing male breast size, has stated that one-third of his male patients are frequent pot users (Huffpost, Jan 2014). Another gynecomastia specialist, Miguel Delgado, MD, has treated several thousand men with gynecomastia. He has observed a clear connection between Pot usage and gynecomastia. He states that it doesn’t affect all men, in the same way, and that the effect is dose-related or how much cannabis a person smokes. Also, when they start to smoke, rather it is during puberty or later in life.
With the state of Colorado legalized cannabis in 2012, there has been a boom in recreational marijuana. Legalization of Pot has led to an increase in the cases of male enlargement of breasts among 18-year-olds to 35 years olds. The number of plastic surgery cases has seen a jump by 8% in this state due to man boobs (Grosman Capraro, 2019).
Which States that have Legalized Pot?
The recreational use of Pot or cannabis is legal in 11 states in the United States. The States include Alaska, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, and Washington. So, over time we will see what legalization of Pot has on the increase in gynecomastia cases.
Even though there is not 100% conclusive evidence, it is clear that there is a connection between Pot and gynecomastia. We have present scientific articles and clinical observation by gynecomastia experts. We have also presented the spike is gynecomastia cases since Colorado legalized marijuana. More studies are needed, and with 11 States in the U.S. having legalized Pot, we will have more valuable information in the future.
Cates Jr, W., & Pope, J. N. (1977). Gynecomastia and cannabis smoking: a nonassociation among U.S. Army soldiers. The American Journal of Surgery, 134(5), 613-615.
Cuhaci, N., Polat, S. B., Evranos, B., Ersoy, R., & Cakir, B. (2014). Gynecomastia: clinical evaluation and management. Indian journal of endocrinology and metabolism, 18(2), 150.
Gundersen, T. D., Jørgensen, N., Andersson, A. M., Bang, A. K., Nordkap, L., Skakkebæk, N. E., … & Jensen, T. K. (2015). Association between use of marijuana and male reproductive hormones and semen quality: a study among 1,215 healthy young men. American journal of epidemiology, 182(6), 473-481.
It’s natural for men to worry if their breasts start to enlarge or swell. They’ll turn to the Internet, but land on articles on pseudogynecomastia instead.
What is Gynecomastia?
For enlarged male breast or gynecomastia, the nipples on a normal male chest are small and flat, and you can see the pectoralis muscle move whenever you flex the area. However, men with gynecomastia will have more rounded breasts, and the nipples seem swollen or puffy. Your breast will also feel tender and may feel more uncomfortable with each passing day.
Gynecomastia is caused by hormonal imbalance. All men produce some amount of estrogen, but when you produce more than the “normal” amount, that may lead to the development of excess breast tissues. This affects 1 out of 2 teen boys, and 2 out of 3 men above 50 years old, when hormone levels are affected by sexual development, thyroid problems, or as a side effect of some medications.
There are 4 grades in gynecomastia classification, with the mildest being just a local swelling around the nipple area, and the most severe showing a pronounced rounded appearance similar to a female breast.
What is Pseudogynecomastia?
Genetically, men tend to accumulate fat in the chest and abdomen area – your arms and legs may look slim, but you bulk up in your torso. When fat builds up behind and around the breast area, the chest appears puffy and swollen. This is clinically known as lipomastia, adipomastia, or pseudogynecomastia.
The more estrogen you have, the more your body tends to store fat. Interestingly, fat also causes your body to produce the aromatase enzyme, which can convert testosterone into estrogen and slow down your metabolism.
Unfortunately, a lower metabolism will also mean you burn less fat, and this triggers a vicious cycle where you store more and more fat on your chest area and worsen your hormonal imbalance.
Gynecomastia vs Pseudogynecomastia
Both conditions display similar physical traits an enlarged, chubby chest. The difference lies in what’s underneath. Gynecomastia is caused by overdevelopment of glandular tissues that comprise of fat tissues and glands, mostly as a result of hormonal imbalance and pseudo-gynecomastia is caused by excess fat accumulation. Only your doctor can confirm what you really have through a clinical assessment.
However, one clear sign that you have real true gynecomastia is you can feel a firm mound of glandular tissue around your areola area and painful to touch. For some, the nipple may even feel sensitive. But if it’s pseudogynecomastia, the entire breast is evenly enlarged.
Gynecomastia Surgery And Treatment
Both gynecomastia and pseudogynecomastia won’t hurt your health, but it can affect your self-confidence and damage your pride. Men can become very self-conscious about their chest, and in severe cases, may be bullied or ridiculed by other people for having “man boobs.”
You may try to get rid of it through chest exercises or a low-estrogen diet, but that rarely works. If you have gynecomastia, no amount of exercising will get rid of that you could even be perfectly fit, and still have a pronounced chest.
The only clinically proven treatment to date for gynecomastia is gynecomastia surgery that involves the permanent removal of excess glandular and fatty tissues. What is important also when considering gynecomastia surgery, is the surgical experience and results achieved by the doctor. A well-trained and experienced doctor will be able to not only help you to get rid of unwanted tissues permanently but also to contour your chest, making it look defined and sculpted but also improve the appearance of the nipples.
If you have pseudogynecomastia, it may take months or even years of dedicated workouts to see results. The alternative option for some is to surgically remove the excess fat via means of VASER LIPO as the fatty tissues can sometimes be too stubborn and hard to be eradicated by chest presses, gym works and endless dieting.
Can only overweight men get man boobs? Is it a sign of breast cancer? I set the record straight on common gynecomastia myth, and separate fact from fiction.
Man boobs, or gynecomastia, can be a confidence killer. But it’s not the end of the world.
Gynecomastia, or the development of man boobs and excess glandular tissues, can occur when there is a hormonal imbalance or low testosterone levels in men. Being a naturally occurring hormone, testosterone is not only directly responsible for a man’s physical features but also his sex drive and mood.
To help you learn more about gynecomastia – and finally say goodbye to your man boobs – here are some answers you need.
Gynecomastia Myth #1: Only Overweight Men Can Get Gynecomastia
Fact: When there is hormonal imbalance, gynecomastia can strike males of all ages – from infants, adolescents and teens to those aged 50 and older. However, the tenderness and swelling usually recede in a few months to two years, so it’s still possible for some – such as babies and younger males – to forego treatment.
These symptoms are not uncommon during puberty. However, should they persist upon reaching adulthood, gynecomastia surgery is the answer.
Other factors that can increase your chances of experiencing a hormonal change or imbalance, and thus gynecomastia, include medications or drugs, alcohol, ageing and other health conditions.
Gynecomastia Myth #2: Gynecomastia Is A Sign Of Breast Cancer
Fact: There is a risk, but it is rare. If you do feel any lumps or abnormalities, it’s good to go for a check-up. In most cases, gynecomastia will not pose long-term problems or complications. The effects are found to be more psychological due to the change in a man’s appearance.
Gynecomastia Myth #3: I Just Need To Exercise More To Get Rid Of My Man Boobs
Fact: If you’re only dealing with pseudogynecomastia or fat build-up on the chest, there are workouts designed to build muscle and promote loss of fat. A healthy diet and a regular exercise programme that includes cardio and interval training, bench presses and weightlifting may help.
But if you have gynecomastia or excess glandular tissues, these lifestyle changes will not guarantee you losing the man boobs.
Gynecomastia Myth #4: It’s Hard To Treat Gynecomastia
Fact: Gynecomastia is often treatable. Not only does gynecomastia surgery work towards the permanent removal of excess glandular tissues, it also sculpts and defines the chest area with the promise of a short recovery time.
While it may be every woman’s dream to inherit a set of well-sculpted breast, it is however, every man’s nightmare to find a pair of ‘man boobs’ aka Gynecomastia, hanging from their chests.
For most men, Gynecomastia robs away their self-esteem and has become a stumbling block in achieving the masculine male body.
But it is more than just the embarrassment of having a flabby chest that should be a cause for concern.
Gynecomastia is essentially a medical condition that should be addressed immediately.
And while many men may seek the gym for the solution to their unsightly bulge, unfortunately, the growing discomfort and swelling that stem from Gynecomastia does not simply ebb away with time nor hours spent at the gym.
Conversely, the soreness and pain experienced on a daily basis will be exacerbated with each passing day should treatment not be administered.
The main symptoms of Gynecomastia include the enlargement of the glandular tissue in both breasts and tenderness experienced around the area and nipple.
But what exactly is the cause of this distressing condition?
The truth is, there are a variety of reasons that contribute to Gynecomastia. Amongst the many causes are side effects of medication and aging.
Hormonal imbalance, where there is a plunge in testosterone levels, is one of the main culprits that results in this condition.
While symptoms of Gynecomastia are not uncommon during puberty, however, should symptoms not be alleviated upon reaching adulthood, surgical intervention is the answer to counter Gynecomastia.
Common questions on Gynecomastia
But to combat Gynecomastia requires more than just the acknowledgement of the causes of the condition.
A holistic and thorough understanding of Gynecomastia is what we need to tackle the ‘man boobs’ situation.
So, just what can we do to potentially diminish the effects of this agonising condition? Or is there anything that can be done to avoid Gynecomastia all together?
Let’s delve into these common and pressing questions to help answer your urgent queries on Gynecomastia.
Can taking hormones cure Gynecomastia?
Being a naturally occurring hormone, testosterone is not only directly responsible for the male physical features, but it also affects a man’s sex drive and mood.
Gynecomastia, or the development of larger breasts, can develop when there is an imbalance of the body’s hormones in men, including testosterone. This is also the case, when there is a low testosterone levels in men.
Both issues of low testosterone levels and gynecomastia are often treatable. However, it is of utmost importance to first understand the underlying causes for each condition.
Can gynecomastia decrease libido?
As age catches up, low testosterone levels and gynecomastia are common conditions among aging men.
With a decrease in testosterone levels, this results in reduced libido, low sperm count, erectile dysfunction, and enlarged male breast tissues.
Are there any food to avoid that can cause gynecomastia?
Being overweight or obese can cause larger breasts in men. As such, avoid foods that are high in saturated fat as these contribute to undesirable weight gain.
Also, highly processed foods that are high in sugar and fats content can promote weight gain and should likewise be avoided.
Foods such as soy can cause hormone imbalances are to be avoided as they can lower the testosterone levels and raise the estrogen levels, thereby causing male breast tissue growth, even in the absence of obesity.
Can’t I just diet and workout to get rid of my “man boobs”?
Gynecomastia is not merely an aesthetic issue; it is a medical condition that should be tended to. The causes of the condition vary, including hormonal imbalance, side effects of certain medications and aging, as mentioned above.
Gynecomastia Surgery not only permanently removes excess glandular tissues, but it also sculpts the chest area, leaving a more defined and masculine appearance.
A gynecomastia surgery has a short recovery time, thereby causing little disruption to your daily routine.
It is essential to discuss your goals and raise any concerns you might have in regard to the procedure during the consultation with your doctor.
As individual’s clinical condition varies, the treatment strategy and outcome will be different. It is important to look for a doctor with an extensive experience, knowledge in gynecomastia surgery and that you get to see the before and after pictures of the doctor’s own patients.