What causes enlarged breasts in men?

Richard Mwanje, a first year student had enlarged breasts as a teenager. 

“At 14 years of age, I noticed swellings in both my nipples. At first, I feared telling my parents but with time, the swelling increased and I started feeling pain. Because I was a bit chubby, at first the breasts were not visible but after a few months, they could be noticed,” Mwanje says.

He recalls a time when he would feign sickness in order to dodge going to school since other students had started laughing and teasing him about the enlarged breasts. 

“One day I asked my parents why I had big breasts. They took me to hospital and after examination, the doctor said with time, the breasts would disappear since he was still a teenager,” he says.

A year later, Mwanje’s breasts disappeared as the doctor had predicted. However, there are several other men who suffer from gynecomastia; a condition that makes breast tissue swell in boys and men causing enlargement of breasts. The condition is caused by an imbalance of the two main body hormones; testosterone and oestrogen. 

Men’s bodies naturally produce more testosterone than the oestrogen, a female hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. 

For example, this hormone is responsible for the growth of breasts in women. Although breasts do not develop in men the way they do in women, all boys are born with a small amount of breast tissue according to Dr Vincent Karuhanga, a general physician.

Vulnerable groups

Male babies have female hormones at birth since the mother passes it on to the baby through the placenta. Babies usually outgrow this enlargement as they grow older.

“During puberty, hormones change and when there is an excess of the oestrogen (female hormone), a teenager will have enlarged breasts. Generally, about half of adolescent boys and as many as two-thirds of men older than 50 make less testosterone, which predisposes them to developing enlarged breasts,” Karuhanga says. 

In some men, the enlarged breasts are because of fat deposits that are instead changed into male hormones in a process known as aromatisation. 

Causes 

Sometimes the cause is not known but besides hormonal imbalances and being fat, there are several other causes of enlarged breasts in men, including: 

● Injury or diseases that affect the testicles, which make testosterone.

●Excessive consumption of alcohol.

●Thyroid problems, since hormones from that gland control growth and sexual development.

●Obesity, which can result in more estrogen.

●Illicit drugs, including anabolic steroids, marijuana, and heroin.

●Kidney failure (when they can no longer clean and filter your blood).

●Some medicines such as drugs that treat enlarged prostate or prostate cancer and ulcer drugs.

Symptoms

The very first sign of enlarged breasts is a lump of fatty tissue under the nipple in one or both breasts. 

The fatty tissue may be tender or sore and sometimes painful.

Swelling of the breasts may happen unevenly, with one becoming larger than the other. If you have such symptoms, it is important to see a doctor who will carry out a physical examination as well as an ultrasound scan.

In some teenage boys, the breasts may disappear on their own but Dr Karuhanga recommends that you see a doctor if you notice that your breasts are swollen, painful or tender, or there is a discharge from the nipples.

Complications

According to Dr Karuhanga, men with enlarged breasts are prone to getting breast cancer. 

“About one percent of the men with enlarged breasts develop cancer. This is the reason why one should seek medical attention as soon as possible. It is important to note however, that enlarged breasts are not necessarily a sign of cancer so one has to go for tests to rule out the disease,” says Dr Karuhanga.

Singer Beyoncé Knowles’ father Mathew Knowles opened up about his own battle with breast cancer, encouraging other men to get tested .

Men who develop enlarged breasts usually get psychological problems and esteem issues; feel embarrassed, or feel anxious or depressed. 

Treatment

Most cases of enlarged breasts during puberty slowly get better on their own without treatment but Dr Karuhanga recommends that such a teenager or man must go through counselling to boost their esteem. 

He suggests going to a mental health professional who can help one manage any mental health problems and offer emotional support.

“How your condition is treated may depend on your age, your health, how long you have had the condition and how well you respond to certain drugs. If the enlargement is due to a cause that is treatable, the breasts will reduce in size once the problem is treated,” he says.

If the problem is hormone-related, the doctor will recommend an endocrinologist; a specialist who deals in treating problems related to hormones and how they affect your body.

Enlarged breasts in men are treated using aromatase inhibitors, a type of medication that addresses the hormonal imbalance causing breast growth.

Exercises

When excess fat stores are the cause of male breast expansion, one of the best remedies is a combination of diet and exercise.

When exercising, people can focus on both cardiovascular workouts to reduce weight overall and chest exercises that focus on developing the pectoral and other chest muscles.

Before starting a new exercise routine, it is best to speak to a doctor to determine what is safe and appropriate for a person’s individual needs and abilities.

Some cardiovascular workouts and activities for weight loss include walking, running, team sports, high intensity, interval training, jogging, cycling and swimming.

According to the United States Department of Health and Human Services, an adult should perform 150-300 minutes of moderate intensity exercise or 75-150 minutes of high intensity exercise per week.

Although it is impossible for a person to lose weight in a specific place on the body, targeted chest exercises can help them gain more muscle in the chest, which may help reduce the appearance of breast tissue.

In addition, the more muscle a person has, the faster their metabolism works and the more calories they will burn.