What Is Gynecomastia?: Symptoms , Cause And Classification


The Term Gynecomastia Refers To The Abnormal Development Of The Size Of The Breasts In Men. The Resulting Bulge Of The Chest Gives The Chest A Typically Feminine Appearance.
This Similarity Creates In Most Cases Important Psychological Repercussions. Generally, The Difficult Coexistence With This Pathology Results In Social And Sexual Disorders. The Problem Is So Felt That The Number Of Males Who Have Undergone Surgery In Recent Years Has Increased Significantly.


Gynecomastia Can Be Unilateral Or Bilateral, Initially Manifested By An Increase In Sensitivity And The Appearance Of Painful Bumps Under The Nipple Area . In A Second Moment There Is A Further Swelling Associated With The Deposition Of Adipose Tissue And The Increase In Glandular Tissue.


The Causes That Lead To The Onset Of Gynecomastia Are Numerous, Among The Main Ones We Mention Those Of A Genetic, Hormonal, Pharmacological Nature And Those Dependent On Other Pathologies.
Drugs Such As Anabolic Steroids, Drugs Used In The Treatment Of Hiv , Anti-Androgen Drugs Or Antidepressant Drugs Are Just Some Examples Of Drugs That Can Favor The Onset Of The Disorder.
Likewise, Pathological Conditions Such As Hypogonadism Or Certain Types Of Cancer Can Cause Hormonal Imbalances Which Lead To The Development Of Gynecomastia.
In The Light Of What Has Been Said So Far, It Therefore Appears Clear That The Main Cause Of The Appearance Of This Condition Is To Be Found In The Alteration Of The Hormonal Balance. In Particular, An Imbalance Is Created In The Metabolism Of Testosterone And Estrogen In Favor Of The Latter. Increased Estrogen And/Or The Body’S Sensitivity To It Can Occur For

  • Excess Testosterone : Occurs Naturally In Puberty (Pubertal Gynaecomastia), Or “Artificially” Following The Intake Of Anabolic Steroids. The Body Tries To Protect Itself From An Excess Of Androgens By Converting A Portion Of It Into Estrogens, Typically Female Hormones Responsible, Among Other Things, For Breast Development.
  • Excess Estrogen : Occurs Naturally (Genetic Predisposition) Or Due To Promoting Substances, Such As Drugs, Pesticides And Other Pollutants.


Based On Its Origin, Gynecomastia Is Classified As:

  • Puberty Gynecomastia : It Is A Physiological Process That Occurs In Puberty (12-17 Years) When The Intense Hormonal Production Causes An Excessive Development Of The Mammary Glands. This Phenomenon Generally Regresses Within A Couple Of Years.
  • Congenital Gynecomastia : The Primary Cause Is Given By The Altered Hormonal Balance Which Can Have Familial Connotations (Heredity).
  • Induced Gynecomastia : In These Cases The Causes Must Be Sought In The Intake Of Certain Drugs Capable Of Compromising The Natural Hormonal Function.

Depending On The Distinctive Features, Gynecomastia Can Be Classified Into:

  • True Gynecomastia : The Increase In Volume Of The Breasts Is Caused By The Increase In The Glandular Component.
  • False Gynecomastia (Or Pseudo-Gynecomastia ): The Enlargement Of The Breasts Is Caused By The Increase Of Adipose Tissue In The Mammary Area.
  • Mixed Gynecomastia : The Enlargement Of The Breasts Is Caused By The Interaction Of The Two Factors Described Above.

Today, Gynecomastia Is A Rather Widespread Phenomenon, Especially If We Also Consider The So-Called “False Gynecomastia”. The Significant Increase In Cases Found In The Last Decade Assumes That In The Future There Will Be Further Diffusion Of The Problem (Especially In Industrialized Countries).


The Diagnosis Is Made Through Simple Palpation ; In Any Case, With An Ultrasound Of The Chest It Is Possible To Resolve Any Doubts About The False Origin Of The Breast Swelling (False Gynecomastia).


The Treatment Of Gynecomastia Can Vary According To Various Factors, Such As The Triggering Cause, The Type Of Gynecomastia That Has Affected The Patient (True, False, Mixed) And The Degree Of Severity With Which The Disorder Presents Itself.
Fortunately, In The Case Of Pubertal Gynecomastia, In Many Situations No Treatment Is Necessary, As The Disorder Tends To Regress Spontaneously.
In Other Cases Of Gynecomastia, However, It May Be Necessary To Intervene With Drug Therapies And/Or Surgery.
Naturally, In The Event That Gynecomastia Is Caused By Underlying Pathologies, The Primary Treatment Must Be Directed Towards The Underlying Disease.

Pharmacological Treatment

Unfortunately, The Drug Therapies Currently Available For The Treatment Of Gynecomastia Not Dependent On Other Pathologies Are Few.
The Main Pharmacological Treatment Of Gynecomastia, In Fact, Involves The Sole Administration Of Drugs With Anti-Estrogenic Activity, Such As Tamoxifen And Anastrozole.

Notes On Surgical Treatment

In Case Of “True Gynecomastia” The Regression Of The Disease Can Only Occur In Puberty, After This Period The Chances Of Spontaneous Regression Are Very Reduced. This Type Of Disease Requires Surgery.

Conversely, If The Gynecomastia Is Due Only To Localized Fat And Muscle Relaxation, The Chances Of Recovery Are Higher. Surgery Is Not Always Necessary, As The Disease Can Simply Be Treated With A Food Program Aimed At Reducing Body Fat And Toning Muscles.
Surgical Intervention Strategies Differ According To The Nature Of The Problem.
If For The Excess Of Adipose Tissue It Is Generally Sufficient To Perform A “Simple” Liposuction Under Local Anesthesia, For The Excess Of Glandular Tissue It Is Necessary To Perform The Surgical Removal Of The Mammary Gland.
In The Latter Case, The Operation Takes About An Hour And Is Carried Out In Day Hospital. A Small Incision Is Made In The Lower Half Of The Areola To Allow The Glandular Tissue To Be Removed. After A Few Days, The Patient Can Resume Normal Daily Activities.


Nutrition And Physical Activity

For Some Years Now There Has Been A Lot Of Talk About The So-Called ” Estrogen-Like Foods “. This Term Identifies Those Foods Contaminated By Substances That Have A Particular Affinity For Estrogen Receptors.
Currently, More Than One Hundred Chemical Components Are Known That Possess Such Harmful Characteristics, The Main Ones Being: Pesticides, Livestock Growth Promoters, Medicines For Human And Veterinary Use. Even Plastic Containers Can Contain Estrogenic Chemicals That Are Harmful To Your Health Prepubertal Children Are Particularly Sensitive To The Effects That These Substances Have On Growth And Sexual Development (Since Extremely Low Levels Of Endogenous Hormones Are Produced Before The Pubertal Spurt).

To Reassure Parents And Consumers There Are Numerous Laws Which Strictly Forbid The Use Of These Substances But Which Cannot Prevent The Natural Contamination Of Food.
The Contribution Of Diet In The Appearance Of Gynecomastia, Usually Marginal, Can Therefore Become Significant In The Case Of Particularly Unregulated Eating Habits Combined With Reduced Physical Activity.

Some Advices

To Prevent Gynecomastia It Is Good To Respect The Following Rules:

  • Do Not Exaggerate With The Consumption Of Meat And In Any Case Make Sure Of Its Origin (In Some Non-Eu Countries The Quality Controls May Be Lower).
  • Eliminate Visible Fat: As Toxic Substances Accumulate Mainly In The Animal’S Adipose Tissue .
  • Keep Your Fiber Intake High (Consume Plenty Of Fruit And Vegetables ), As Inedible Plant Residues Can Reduce Excess Estrogen In The Body.
  • Follow A Regular Program Of Physical Activity, In Many Cases (See False Gynecomastia) This Disorder Is Caused By The Simple Increase Of Fat Located In The Breast Area And The Simultaneous Relaxation Of The Pectoral Muscle.
  • Keep Body Weight Under Control : In Obese Subjects, Testosterone Levels Are Significantly Reduced, On The Contrary, Estrogen Levels Increase.

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