The Impact of Gynecomastia on Self-Esteem and Confidence

The Impact of Gynecomastia on Self-Esteem and Confidence

Have you ever seen a male friend or family member with enlarged male breasts? If so, they may have gynecomastia. This condition can have negative psychological effects on those living with it. Read on to learn more about the toll gynecomastia can have on a male’s confidence and feelings of self-worth.

About Gynecomastia

Gynecomastia is a condition that affects males of all ages. It causes male breast enlargement due to glandular tissue in one or both breasts. It is usually caused by a hormonal imbalance, which can result in an increase in glandular breast tissue. The second most common cause is anabolic steroid use which is used to build muscles. For some adolescent boys, gynecomastia may resolve on its own. However, if gynecomastia persists past the teen years, it will most likely stick around.

Impact on Self-Esteem and Confidence

This increase in male breast tissue can take a negative toll on a male’s self-worth and confidence. This can result in a number of negative mental health effects, including the following:


Gynecomastia can have a psychological impact on those living with it. One of the first emotional responses is often anxiety, as patients are unsure regarding the outcome of diagnosis and a possible treatment plan. Gynecomastia can also cause anxiety around social interactions where a male should take their shirt off such as spending time at the pool or beach.

Low Self-Esteem

Men living with gynecomastia often experience a negative self-image due to their enlarged breasts. They may experience feelings of shame to expose their body or incompleteness due to social phobia.


The most severe psychological issue associated with gynecomastia is depression. Individuals may feel that they have a low quality of life due to their condition. While women generally reach out to friends and relatives when they are experiencing psychological issues, men with gynecomastia have shown that they tend to conceal their mental condition. This can lead to feelings of helplessness.

Social Isolation

Many gynecomastia patients feel as if they don’t “fit in” with peers, which can lead to loneliness. Many males with gynecomastia, especially teens, tend to withdraw from social functions, which can lead to continued isolation as they grow into adults. Individuals may also withdraw from family and friends to conceal their breast enlargement to avoid possible teasing or judgment.

Disordered Eating

Some patients with gynecomastia may believe that weight loss can help to reduce their excess breast tissue. While weight loss may be helpful in cases of pseudo gynecomastia, however, male breast reduction surgery is the best solution for true gynecomastia. Because of this, some patients may begin to control their eating habits in a disordered way, leading to dangerous conditions such as anorexia.

Schedule a Consultation

As you can see, gynecomastia can take an enormous toll on the mental health of those living with it. If you or a loved one are dealing with gynecomastia and are seeking treatment, Dr. Delgado can help. The most effective solution for treating gynecomastia is male breast reduction surgery. If you are interested in discussing your gynecomastia surgery options, please contact Dr. Delgado today to schedule a consultation appointment.

Steroids And Gynecomastia: Prevention And Treatment For Enlarged Male Breasts

Steroids And Gynecomastia: Prevention And Treatment For Enlarged Male Breasts

It’s not just pubescent teens or overweight adults who develop the often-embarrassing symptoms of gynecomastia, or male breast enlargement. Additionally, a surprising group of people who develop breast tissue are some of the fittest people alive, bodybuilders. This is because of male breast enlargement’s many possible causes, which includes the use of certain medications or supplements, including steroids.

What is Gynecomastia?

Gynecomastia is the medical term for an under-studied condition often referred to as “man boobs” or “puffy nipple.” It’s the abnormal development of breast tissue (not just fat) in the chest in biological males. There are several degrees, or grades, of gynecomastia, from localized fat tissue just beneath the nipple to pectoral-sized growth of glandular tissue and fat that causes the chest to droop.

Along with the look of the chest changing with gynecomastia, the sensation and texture of the chest can change as well. Glandular tissue is firmer than pure fat, and can result in tinges of pain when touched. Fatty deposits feel squishy or pliable as they contribute to a swollen or enlarged look.

Causes of Gynecomastia

Because there isn’t a wealth of research on gynecomastia, there are many possible contributing factors for gynecomastia. Most often, though, it’s due to hormone fluctuations common in younger men. It can also be influenced by:

  • Genetics
  • Weight gain
  • Substance use (or abuse)
  • Certain medications

While some remedies for gynecomastia make the condition reversible, such as growing out of puberty or losing weight, you can’t often change your genetics, and if you’ve tried and failed to reduce gynecomastia on your own, it might be a more permanent case.

Why do Steroids Cause Gynecomastia?

Steroids themselves may not be to blame for the growth of breast tissue in users of substances like Anadrol or Dianabol. Instead, they might influence the user’s hormones, causing them to be out of balance. These anabolic steroids are often converted to estrogen in the body, which signals a number of changes, including breast tissue growth.

These substances are often available without a prescription, but even doctor-monitored drugs can cause the condition as a side effect. This is why it’s important to fully understand the risk of side effects when starting any medication, no matter how accessible it might be.

Preventing Steroid Gynecomastia

As with many conditions, early diagnosis is vital for the best outcome. When it’s caused by a medication or steroids, the simple solution is to stop the medication if possible. There might be alternative drugs that provide the same boosts or necessary health benefits that don’t have the same side effects.

For bodybuilders, switching from anabolic steroids to more natural supplements that won’t be converted to estrogen once they’re in your body. Many supplements are available to help you gain muscle mass without the risk of gynecomastia.

Treating Gynecomastia

If you’ve had a case of gynecomastia for a long time, perhaps outlasting your use of steroids or other medication, the best solution is gynecomastia surgery. This is a highly customizable procedure that an expert like Dr. Miguel Delgado is well-versed in and who can get you the best results.

Schedule a Consultation About Gynecomastia

Gynecomastia is often “treated” by the person changing their behavior, wardrobe, or activities in order to hide the condition rather than seek help. At, that’s what we hope to change with the information we share. No matter who you are, gynecomastia can affect you, and there are treatment options available to help you feel like your masculine self again. To learn more about your options for treatment, don’t hesitate to contact us online today.

What Is Steroid Induced Gynecomastia?

What Is Steroid Induced Gynecomastia?

man weight lifting dumbbells

Steroid induced gynecomastia can be caused by drugs such as Anadrol and Dianabol (used for medical conditions) and anabolic steroids taken by bodybuilders. Men taking steroids for medical reasons should consult their prescribing physician if they notice any changes in nipple size and tenderness or swelling in the chest area. 

There are various ways to resolve man boobs caused by steroid induced gynecomastia. Here are the options available if you are concerned about steroid use and gynecomastia.

What Is Gynecomastia?

Gynecomastia is the medical term for the growth of breast glandular tissue in men’s chest area. Breast enlargement in men is often unknown, although steroid use is a known cause of bodybuilder gynecomastia. Gynecomastia symptoms can present as puffy nipples and a slight increase in chest size, through to full, feminine-looking breasts or man boobs. 

Do Steroids Cause Man Boobs?

The leading cause of gynecomastia is hormonal imbalance. Steroid use disrupts hormonal balance and may cause higher estrogen levels, which can lead to gynecomastia symptoms. Longer-term steroid use may worsen the symptoms, which is why many bodybuilders develop man boobs. 

When steroid use is stopped, gynecomastia will not simply go away. The breast glandular tissue growth is permanent. The only recognized way to resolve bodybuilder gynecomastia is with surgery.   

Can I Prevent Gynecomastia?

The only way to prevent steroid induced gynecomastia is to not use steroids. If you require steroids for medical conditions, speak to your physician about your concerns. 

Do Antiestrogens Prevent Man Boobs?

Bodybuilders often use antiestrogens to prevent man boobs, including Tamoxifen (Nolvadex® or Soltamox®) and Arimidex®. These drugs are not FDA-approved gynecomastia medications and although they do work for some men, when they don’t work, it’s too late to do anything as the  breast glandular tissue will have already started to grow. Bodybuilders who take steroids should also consider that antiestrogens have a range of side effects, including weight gain and erectile dysfunction, and some more severe side effects such as reduced bone density, leading to bone fractures and stroke.

Can Supplements Prevent Man Boobs?

Numerous companies advertise supplements as estrogen blockers. However, not only are they extremely unlikely to make any difference, supplements have been found to contain dangerous ingredients. Supplements are not regulated by the FDA and are usually produced in countries with little or no regulations.

Gynecomastia Surgery For Steroid Induced Gynecomastia

Gynecomastia surgery is a fast and safe way to eliminate man boobs caused by steroid use. Gynecomastia symptoms are divided into four grades that determine how severe the symptoms are. Grade 1 and some grade 2 gynecomastia can be treated with surgery requiring only a small incision at the edge of the periareolar, called the pull-through technique.

Grade 2 gynecomastia that can not be effectively treated with the “pull through” technique can be treated with standard gynecomastia surgery. This only requires a slightly larger incision at the edge of the areola. Both types of surgery leave small scars that are well hidden by the change in skin color from the areola to the surrounding skin. Once healed (within a few months), the scar will start to fade. After around six months, the scar will be difficult to detect.

Grade 3  gynecomastia can sometimes be resolved with a two-stage procedure which involves the pull-through technique, followed by standard gynecomastia surgery four to six months later. This is the preferred gynecomastia surgery option for men who are concerned about scars and all incisions are made at the outer edge of the periareolar. This means that once healed the scars will be well hidden and hard to see.

In the case of more severe grade 3 and 4 gynecomastia symptoms, a double incision mastectomy is usually recommended. This will create larger scars across the chest. Most men prefer scars that fade and become less evident over time than living with man boobs. The patient satisfaction rate is high for all types of gynecomastia surgery, and unlike medications, results are reliable and always permanent (as long as steroid use is avoided).

Why Choose a Board-Certified Plastic Surgeon for Gynecomastia Surgery?

Gynecomastia surgery can be performed by any physician with a medical license. Gynecomastia surgery cost may be a consideration. However, many plastic surgery companies offer reduced rates by employing surgeons without appropriate training or experience. Unfortunately, the revision rate for gynecomastia surgery is high, and poor results may not be reversible.

Not all board-certified plastic surgeons specialize in gynecomastia, and many will only perform a few gynecomastia procedures each year. Board-certified plastic surgeon and gynecomastia specialist Dr. Miguel Delgado has been providing gynecomastia surgery for all grades of gynecomastia for over 30 years. Over 40% of his patients come to him unhappy with the results of gynecomastia surgery performed elsewhere. Whether you are considering initial gynecomastia surgery or gynecomastia revision surgery following unsatisfactory results, Dr. Miguel Delgado always discusses your concerns and explains the surgical options available. All gynecomastia surgery is performed at the Gynecomastia Center of Excellence — Marin Cosmetic Surgical Center*, with the highest level of patient safety and care.

*Federal and state-accredited surgical facility.


For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form


Miguel Delgado, M.D, F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021.” 


Does Steroid Use Cause Man Boobs/Gynecomastia?

Does Steroid Use Cause Man Boobs/Gynecomastia?

man using steroids

Often referred to as man boobs, this medical condition is called gynecomastia by the medical community, and is usually caused by a hormonal imbalance. Research has shown that a high level of estrogen found in men is usually the cause of gynecomastia symptoms. Hormonal imbalance can happen for various reasons, including anabolic steroid use. The high associated risk that steroids cause gynecomastia is a huge concern in the bodybuilder community.

What Is Gynecomastia?

The medical term for man boobs is gynecomastia, which causes excess growth of breast glandular tissue in the male chest. Gynecomastia symptoms are often a combination of glandular tissue and fatty tissue. Another condition, pseudogynecomastia, is the growth of only fatty tissue in the chest area in overweight and older men. This is not true gynecomastia and is rarely experienced by men who are not overweight.

Women and men produce estrogen and testosterone. In women, the estrogen levels are higher than the testosterone levels, and in men, the testosterone levels are higher than the estrogen levels. This is why estrogen is often referred to as the female hormone and testosterone as the male hormone. 

Causes of Gynecomastia 

There are various known causes of gynecomastia symptoms, and it is crucial to have an accurate diagnosis. Dr. Miguel Delgado can diagnose gynecomastia with a physical examination and the gynecomastia pinch test. When there is no known cause of gynecomastia symptoms, blood tests may be requested, to check for any other underlying medical problems.  

The Male Menopause or Andropause

Men between 50 and 60 years old will typically experience the male menopause or andropause. When this occurs, testosterone levels naturally start to decrease, which may cause glandular tissue growth. During the menopause, the body ratio of muscle to fat will normally change. Both of these developments can cause gynecomastia symptoms and man boobs

Pubertal Gynecomastia

During puberty, estrogen levels are higher than testosterone levels, which often causes glandular tissue to grow and results in man boobs. This is likely to be more pronounced if an adolescent is overweight. Pubertal gynecomastia will usually resolve within two to three years, although occasionally, it will remain.  


Medical Conditions and Medications

Steroids and Gynecomastia 

Bodybuilders can rarely achieve significant size using exercise, diet and weightlifting, to produce the muscle mass needed to compete professionally. This has led to a high incidence of anabolic steroids use in the professional bodybuilder community. Steroids help men increase muscle mass faster and induce larger muscles when combined with weightlifting.   

Recognized by the world as one of the top professional bodybuilders, seven-time Mr. Olympia winner and four-time Mr. Universe winner Arnold Schwarzenegger admitted he used steroids when competing. Although at the time he was competing, steroids were legal, the lack of testing is still a controversial issue for many bodybuilders. The International Federation of Bodybuilding Professional League (IFBB) rules state that steroid use is not allowed, and all competitors are subject to IFBB random drug testing. Yet tests do not routinely take place. Even though steroids are now illegal in the US, it is generally accepted by the bodybuilding community that bodybuilders who want to compete in more challenging competitions, will take steroids

Anabolic steroids cause gynecomastia by disrupting the endocrine system that regulates hormones, increasing the enzyme responsible for converting testosterone into estrogen. In many men, this leads to the growth of breast glandular tissue and man boobs. One of the main issues caused by anabolic steroid use is gynecomastia. In the bodybuilding community, gynecomastia symptoms are often referred to as “bitch tits” and are a real problem for many men. Even when steroids are no longer used, gynecomastia will not go away.

Gynecomastia Symptoms

The most obvious gynecomastia symptoms are the appearance of man boobs or moobs, which vary in size. The difference is defined by gynecomastia grades, a system adopted by the American Society of Plastic Surgeons. 

grades 1 to 4 of gynecomastia

There are five gynecomastia grades:

  • Grade 1 gynecomastia symptoms refer to a slight increase of glandular tissue and often cause the appearance of puffy nipples. 
  • Grade 2 gynecomastia symptoms cause a more significant growth of glandular tissue, resulting in small man boobs and a more feminine appearance of the male chest.
  • Grade 3 gynecomastia symptoms will produce feminine-looking breasts with a slight mammary (breast) crease.
  • Grade 4 gynecomastia symptoms are the most severe and result in extremely feminine-looking breasts that are full and noticeable, with a significant drop and mammary crease. 

Treatment for Gynecomastia 

Treatments for gynecomastia fall into three types: natural supplements, medications, and gynecomastia surgery. Numerous companies sell a range of supplements they claim will inhibit estrogen production, which prevents and reduces gynecomastia. There is no scientific research to back up these claims, and supplements are not regulated by the Food and Drug Administration (FDA). 

Treatment for Gynecomastia With Tamoxifen (Nolvadex® or Soltamox®) 

Tamoxifen (Nolvadex® or Soltamox®) is widely used by bodybuilders to prevent and reverse gynecomastia. Research shows that men only experience a partial reduction of gynecomastia with tamoxifen, and the associated severe side effects of tamoxifen include stroke, vision impairment, and liver disease. To date, the FDA has not approved any medications for gynecomastia treatment. 

Gynecomastia Surgery for Steroid Induced Gynecomastia 

Gynecomastia surgery is the only guaranteed way to eliminate man boobs from steroid use. It is highly advisable that bodybuilders wait until they have stopped using steroids before having gynecomastia surgery. Otherwise, the symptoms are likely to return. Grade 1 and some grade 2 gynecomastia symptoms will usually require standard gynecomastia surgery, with gland excision to remove the excess breast tissue. This requires a small incison on the edge of the areola of around 2.5 to 3 cm. Once healed the scar will normally be well hidden by the change in skin color between the areola and chest skin. Another type of gynecomastai surgery that is often referred to as scarless gynecomastia surgery is the pull-through technique.

The pull-through technique is normally only suitable for grade 1 gynecomastia and only requires a small incision of around 5 to 10 mm cm in length, made at the edge of the periareolar, which means the scar  will be almost invisible when it has healed.  

Dr. Miguel Delgado performing the pull-through gynecomastia surgery technique

Grade 3 and grade 4 gynecomastia symptoms will generally require a double incision mastectomy or a two stage procedure. This is due to excess skin that needs to be removed for tight, masculine chest contours, as well as glandular and fatty tissue. Patient satisfaction for gynecomastia surgery is high, with research showing that 98% of bodybuilders receiving gynecomastia surgery are pleased with the results


For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form. 


Miguel Delgado, M.D, F.A.C.S is a world-renowned Board-Certified Plastic Surgeon granted by the American Board of Plastic and Reconstructive Surgery and a member of the American Society of Plastic Surgery and Aesthetic Society. Dr. Delgado has a surgical practice solely dedicated to cosmetic plastic surgery. He specializes in gynecomastia surgery and is the medical director of, the oldest and largest gynecomastia forum dedicated to supporting, educating, and providing solutions for men with breast enlargement. Dr. Delgado celebrates 30 years of practice in San Francisco, California. He was voted the “Best Plastic Surgeon of 2017-2021.” does not provide medical advice, treatment, or diagnosis. 


The Truth About Anabolic Steroids & Man Boobs (Gynecomastia)

The Truth About Anabolic Steroids & Man Boobs (Gynecomastia)

The Truth About Anabolic Steroids & Man Boobs

Many guys use non-prescription testosterone and other substances to build up their muscles.

The levels of testosterone that some people achieve by doing this can be as high as 10 times the normal level!

Cycling testosterone can turn into a bit of an obsession, and lead to the pursuit of higher and higher levels.

That’s right, too much testosterone leads to physical problems. At the end of the cycle, you can have a build-up of estrogen, leading to fluid retention in your face and neck and man boobs.

Some of the stronger horse testosterones on the market can cause serious aggression (so-called “roid rage”) and night sweats.

In the longer term, breast development is a big risk.

By the way, those small balls won’t be producing sperm anymore.

It may be difficult to reverse this effect, so if future fertility is important to you this is something to consider before starting out.

With long-term heavy use of high dose testosterone, your health can be seriously affected, including having a pair of enlarged male breasts.

This is the Truth About Anabolic Steroids & Man Boobs

Gynecomastia (Man Boobs) Amongst Bodybuilders

Gynecomastia (Man Boobs) Amongst Bodybuilders

The use of anabolic steroids in bodybuilding is notorious to the point of being synonymous. But the trend is not limited to the sport’s competing athletes or bodybuilders only; even the regular gym-going Joe and hobbyists are onboard the steroid train. What’s more alarming is the reports on the rising numbers of its use among teenagers.

What are anabolic steroids?

Anabolic steroids are essentially synthetic variations of the male sex hormone, testosterone and often used to build muscles. Healthcare professionals prescribe them to address hormonal issues such as delayed puberty and muscle loss caused by diseases.

But it is the misuse and abuse of these drugs that often form the headlines. For professional bodybuilders or even anyone who’s looking to put on some muscles, these drugs may seem to be the “miracle” supplement and dismally, even a staple diet.

Side effects

One of the most common side effects is roid rage. Although it is not classified as an official medical condition, the root of this issue can be linked to the misuse of anabolic steroids as they can cause extreme irritability. In women, common side effects include reduced breast size, deepening of the voice and the growth of facial and body hair, among others.

In men, they include shrunken testicles, decreased sperm count, baldness, acne and even gynecomastia.


Gynecomastia is the enlargement of the breast tissue in men. The cause of this condition is hormone imbalance, primarily the rise in estrogen levels. The abuse of anabolic steroids causes this increase and overtime, men will develop oversized breast tissues resulting in the, not only embarrassing but at times also painful, condition.

Although exercise won’t help, stopping the use of anabolic steroids is the first step in preventing the condition from evolving further. For those already affected, help comes in the form of Gynecomastia Surgery.

Gynecomastia Surgery

Gynecomastia surgery, usually done in the form of liposuction or mastectomy, involves the removal of excess fat and glandular tissue. This tightens the skin leaving a more contoured and flatter chest. The procedure usually takes around one to two hours and recovery typically varies with each patient.

Muscle up without steroids

Taking anabolic steroids to build muscles knowing that there is a high probability of getting Gynecomastia is certainly not an option. Instead, there are other ways to achieve your goals. These include:

  • Proper nutrition and dietary habits
  • Custom-tailored (gym) training programmes
  • Getting enough rest
  • Additional supplementation like whey proteins

and more.

Regardless of gender, a beautiful or more defined physique is arguably a common goal. If bodybuilding is your hobby, by all means, pile those muscles on. But do it the right and do it the safe way.