The cause of “physiologic” adult gynecomastia is not known, and it is likely to be multifactorial. One of the possible factors is the age-related declines in serum testosterone after 30 years of age in males.

The answer to the common question of “Can gynecomastia cause low testosterone?” is that gynecomastia does not cause it, but conversely, it may possibly increase the risk of developing gynecomastia in males.

Does gynecomastia reduce libido?

Low testosterone level reduces libido, not gynecomastia.

Does gynecomastia contribute to low sperm count?

Low testosterone, not gynecomastia is one of the many possible causes of low sperm count.

Does gynecomastia result in erectile dysfunction?

Gynecomastia does not result in erectile dysfunction directly. It is not uncommon for patients who suffer from gynecomastia to have low self-esteem, social phobia, anxiety and even depression. Those psychological issues, if persistent and severe, may cause patients to suffer from erectile dysfunction.

The relationship between low testosterone and gynecomastia

Gynecomastia is a complex process resulting from many hormonal changes in the body. Estrogens strongly stimulate, and androgens, weakly inhibit breast gland growth. The imbalance between estrogen actions relative to androgen action at the level of breast tissue is believed to be the main etiology. Various hypotheses have been put forth to explain the etiology of gynecomastia, including: elevated estrogen levels; lowered free testosterone; abnormal testosterone-to-estrogen ratio; increased peripheral conversion of testosterone to estrogens . However, for most patients, the etiology still remains unclear.

In addition to treating gynecomastia, you may want to treat it

Testosterone levels in men tend to decline with age. Patients with testosterone levels require a thorough medical evaluation. Clinical assessment and lab investigations are required to identify possible underlying causes such as medical illness, lifestyle or ageing factors. If there are underlying causes for this, the patient will be referred for individualized treatment for these causes.

The testosterone levels can be supplemented by hormones prescribed by a doctor. Regular follow up will be required for the patients.

Dr. Delgado Bio


Dr. Delgado, MD is a world-recognized plastic surgeon and specialist in the treatment of male breast enlargement, also called gynecomastia. He has developed new techniques and owns and operates, which has become the largest gynecomastia forum in the world. Dr. Delgado holds the two most coveted credentials; the certification by the American Board of Plastic Surgery and membership in the American Society of Plastic Surgery.