Gynecomastia is a male condition signified by increased breast tissue, including overdevelopment and swelling. Enlarged breast tissue causes male breasts to increase in size, often growing unevenly.

The most common times for this are at birth, during puberty, and with age-related hormonal decline, such as low testosterone.  can you buy testosterone

Although distressing for young males, gynecomastia is often a temporary problem, while pubertal hormone changes influence sexual development. Most boys naturally see an end to breast enlargement once their hormone levels balance.

Gynecomastia is a benign condition that rarely signifies cancer. The cause may not always be identified, but hormones are frequently involved. We examine the many causes of gynecomastia below:

  • Estrogen from the mother in newborns

Newborns enter the world with hormones (estrogen and progesterone) from the mother still in their bodies. Babies may be born with or develop breast buds soon after birth. Most baby boys lose their breast buds by six months, although it could last longer. 

  • Puberty

Enlarged breast buds are common as hormonal changes during puberty flood the body. Gynecomastia can occur during the preteen or teenage years. During early puberty, increased gonadotropins during sleep stimulate early morning testosterone production. Estradiol levels stay high all day, causing a higher estrogen-to-testosterone ratio than is usual in males. While the condition often improves within six months, it can last up to two or three years.

Another issue in young males could be an estrogen-producing tumor, which is less likely than pubertal hormone changes. 

  • Hormonal changes 

Hormonal imbalance is among the most common reasons for gynecomastia, especially in older men. Find out what gynecomastia is and how to prevent or treat it from hormone specialists. 

  • Tumors

Hormone-altering tumors can cause an increase in estrogen, especially testicular tumors. Other estrogen-secreting tumors include:

  • Adrenal tumors
  • Germ cell tumors
  • Granulosa cell tumors
  • Leydig cell tumors
  • Sertoli cell tumors
  • Other health conditions

Underlying health conditions can lead to gynecomastia, including the following:

  • Liver or lung cancer
  • Cancer of the adrenal glands, pituitary glands, or testicles 
  • Cirrhosis of the liver
  • Kidney disease
  • Spinal cord disorders
  • Overactive thyroid 
  • Injury or trauma
  • Congenital disorders in infants 
  • HIV patients 
  • Alcohol and drugs

Substance abuse, including excessive alcohol consumption, heroin, methamphetamine, or marijuana use, can increase male breast tissue. 

  • Obesity

Increased weight causes more aromatase production by belly fat. The enzyme aromatase converts excess free testosterone in the bloodstream to estradiol (estrogen). As estradiol levels increase, testosterone levels decline. That can lead to a hormonal imbalance called “estrogen dominance,” which increases the body’s fat storage. Thus begins a vicious cycle of weight gain and higher estrogen levels which lead to gynecomastia. 

  • Medications

Numerous medications can cause gynecomastia, including:

  • Steroids
  • Epilepsy drugs
  • Heart medicines, including digitalis
  • Chemotherapy drugs
  • Ulcer medications 
  • Antidepressant and psychoactive medications
  • Antiandrogen drugs, including cyproterone, flutamide, and spironolactone 
  • Certain infectious disease medications, including for HIV/AIDS

Gynecomastia Symptoms You Should Know

Although gynecomastia is identifiable as enlarged male breasts, there are some symptoms to know that are associated with this condition. If gynecomastia is associated with puberty or age-related hormone decline, the solution may be as simple as waiting it out during puberty or speaking with a pediatric endocrinologist about possibly getting hormone therapy when necessary. Resolving pubertal breast enlargement can take from six months to three years.

If you have any concerns about gynecomastia, it is best to contact your doctor to ensure that no underlying issues are causing your problems. 

The most common symptoms associated with gynecomastia are:

  • Pain in one or both breasts
  • A lump or increased fatty tissue under the nipple
  • Swollen breast tissue – breast enlargement
  • Breast tenderness or soreness
  • Nipple sensitivity 
  • Uneven breast growth

Diagnosing Gynecomastia

Contacting your healthcare provider is the best step when symptoms of gynecomastia are present. The pediatrician can run blood tests to check hormone levels in young males, referring the child to a pediatric endocrinologist if necessary. Because gynecomastia can be embarrassing as boys undergo puberty, treatment by an endocrinologist may help alleviate these concerns. 

Men will undergo a physical examination to determine if there is any concern, especially when a lump is present. Urinalysis, blood tests (including hormone and liver function tests), and possibly a low-dose breast X-ray (mammogram) may be necessary. If any concerns about cancerous tissue are present, the doctor may recommend that a small breast tissue sample (biopsy) be sent to a lab for checking.

Blood tests for gynecomastia patients should include the following:

  • Testosterone
  • Estradiol
  • HCG
  • Luteinizing hormone (LH)

The hormone specialist will likely include the following tests:

  • Thyroid levels
  • Complete metabolic profile (CMP)
  • Complete blood count (CBC)
  • Lipid profile 
  • Possible other hormones

Because gynecomastia in older males is often caused by a hormonal imbalance between testosterone and estrogen, getting help restoring balance to your hormone levels may be the best option for reducing breast enlargement. Testosterone replacement therapy (TRT), often with an estrogen blocker to prevent the conversion of testosterone into estradiol by the enzyme aromatase, is often the recommended treatment. A hormone specialist is the best person to prescribe this treatment and monitor your progress and results. 

If medication is the cause of enlarged breast tissue, your doctor might be able to prescribe a different treatment. If not, a hormone specialist may be able to help you find an alternative option. Although rare, surgical options to remove extra breast tissue are available. 


Gynecomastia can happen to males of any age, with puberty and advanced age being the most common. Enlarged breast tissue often grows unevenly and, when due to hormonal changes, naturally rectifies itself upon hormone rebalancing. 

If pain or tenderness in the breasts is present, it is best to seek medical care to ensure nothing more serious is involved. Treatment for gynecomastia depends on age, health status, medications used, and whether the condition may be rectified on its own (such as with puberty). 


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