Unwanted breast growth in men is surprisingly common condition, with the scientific literature reporting that up to 70% of men will experience a noticeable degree of breast enlargement at some point in their lives (1).
Gynecomastia, (gyno for short) is a lot more than a physical issue for some. Embarrassment, anxiety and depression are all too familiar to a proportion of men who suffer from this condition, with many choosing to hide their bodies behind baggy clothes and avoid situations like swimming and locker rooms where exposed upper bodies are the norm (2).
The good news is that there are ways to prevent, minimise and even treat gyno.
The classic and defining symptom of gyno is the development of breast tissue. This tissue can be felt as rubbery lump, initially forming behind the nipple. For some people, this may cause discomfort and pain. Other sympoms which may accompany gyno include enlargement, darkening, and discharge from the nipples. Gyno is most commonly bilateral, affecting both sides of the body, but it is not unusual for breast development to occur on one side only, or for it to occur at an uneven rate (2).
It is important to distinguish true gynecomastia, which is the development of breast tissue, from a condition called pseudogynecomastia, which is the appearance of breasts caused by fat deposits, commonly seen in the obese. Unlike true gynecomastia, this condition can be effectively treated by losing weight (3). It is quite easy to tell the difference - In pseudogynecomastia, the tissue feels uniform and soft, similar to the fat on the stomach, while in true gyno, the tissue is distinct and firm.
The general cause of gyno is an imbalance in the ratio of the male hormone testosterone to the female hormone, oestrogen. Just as women's bodies have a small amount of testosterone, men's bodies produce oestrogen. It is when these oestrogen levels increase, or testosterone levels drop, that the body produces breast tissue. There are a lot of reasons that this can occur.
Natural factors: Newborn babies, males going through puberty, and older men can develop gyno through natural hormonal fluctuations. In babies and children, this settles down as hormone levels stabilise, while in the elderly, it is a normal symptom of decreasing testosterone levels. Some people naturally have lower than average testosterone, or higher than average levels of aromatase, which is an enzyme that converts testosterone to oestrogen. These people are particularly prone to gyno (2).
Disease: There are a number of diseases that can alter the hormone balance and cause gyno. Some of the major ones include tumours of the endocrine system, which can directly increase or decrease hormone levels. Kidney and liver failure can prevent the body from producing testosterone or breaking down oestrogen. Malnutrition can prevent the body from producing testosterone, and ironically, obesity can also cause gyno, as body fat stores oestrogen, and having large amounts can can tip the balance (2).
Endogenous factors: There are a number of substances that can cause gyno when introduced into the body. Anyone who has seen Fight Club knows that some cancer treatments can cause gyno, but so can some antibiotics, HIV treatments, medication for hypertension and peptic ulcers, pain relievers, and even household products like lavender and tea tree oil. The phytoestrogens in hops combined with the potential to suppress liver function puts heavy beer drinkers at risk, and those people who avoid soy might be interested to know that they are also thought to be at risk from hormonal components in milk and meat (4).
Gynecomastia and Steroids
By far the biggest risk for the development of gyno, particularly within the bodybuilding community, is the use of anabolic steroids. Steroids exert their action by behaving like testosterone, but paradoxically, high levels of male hormone encourage gyno.
We touched upon aromatase before, and this enzyme plays a big role in the development of gyno in steroid users. Aromatase converts androgen hormones like testosterone to oestrogen, and can turn the artificially inflated levels of male hormones in steroid users into doses of female hormone that are high enough to stimulate the growth of breast tissue (4).
But that's not the end of it. The body regulates testosterone through a feedback system, so it is constantly measuring and adjusting levels in the bloodstream. Adding a massive dose of steroids into the mix overrides the body's need to produce any of its own testosterone, so the Leydig cells in the testes that normally make this hormone stop producing and lay dormant. With sustained steroid use, these cells atrophy and die – the death of these cells is the reason that long term steroid users experience testicular shrinkage. These cells don't regenerate, so this means that the steroid user's body now lacks the capacity to make its own testosterone, leaving the steroid user prone to the development of gyno (5).
Steroid use carries a large and significant risk of not only gynecomastia, but a whole host of serious, permanent and potentially fatal side effects.
No need to give up and buy a bra just yet, there are many things you can do to lower your risk of developing this condition. To get the obvious out of the way early, saying away from steroids is a great first move.
Anyone experiencing the symptoms of gyno should really be checked over by a doctor. Although the condition is usually benign, and is surprisingly common, there are a number of causes that are smart to rule out. Ths goes double if you've noticed any changes to your testicles, or if the lumps in your breast tissue are irregular and don't sit behind the nipple. A doctor can also check and make sure your testosterone levels are normal and prescribe hormone therapy if necessary.
If the doctor gives you the all clear, there are a number of things you can try.
- Cut back on the meat and booze, or try organic meat and switch the beer for another tipple if you're not going to be able to survive barbie season otherwise.
- Go over any medications you may be taking, and talk to a doctor about changing anything that may be contributing to your condition.
- Are you a teenager? Patience probably isn't your strong point, but now is the time to develop some. 95% of gyno in teens resolves by itself in three years (2).
- Losing weight is a great idea, and if you're not weight training already, start. Lifting can enhance your natural levels of testosterone.
- Throw out anything in your house that is lavender scented. This is good general advice.
There are a number of safe, all natural supplements that may be of assistance to people struggling with unwanted chest baggage.
Testosterone boosters: These non hormonal supplements contain ingredients that encourage the body to up its own production of testosterone. The test boosters we sell are safe, competition legal, and effective, particularly for older men with naturally decreasing testosterone levels. Try Elemental Nutrition Massive Muscle Fuel 2.0 and BSc Triandrobol.
Anti-Estrogen: These supplements block the action of aromatase, preventing the body from converting testosterone into oestrogen. Once again, these are all safe and legal. Try BPI's A-HD and Beast E-Liminate
Fat Burners: Sometimes dropping a bit of weight clears this condition up, and a fat burner can give your diet and exercise regime the extra kick it needs. EHP labs Oxyshred and MuscleTech Hydroxycut Hardcore Elite are two of the best on the market.
Gynecomastia - Surgery as a Cure
Some people are unable to get rid of their gyno through simple lifestyle changes and interventions. A consultation with a doctor can determine whether you may be a candidate for surgical correction of this condition.
(1) Narula HS, Carlson HE (August 2014). "Gynaecomastia-pathophysiology, diagnosis and treatment". Nat Rev Endocrinol 10 (11): 684–698.
(2) Neslihan Cuhaci, Sefika Burcak Polat, Berna Evranos, Reyhan Ersoy, and Bekir Cakir. Gynecomastia: Clinical evaluation and management. Indian J Endocrinol Metab. 2014 Mar-Apr; 18(2): 150–158.
(3) Ruth E Johnson, Cindy A Kermott, M Hassan Murad.Gynecomastia – evaluation and current treatment options. Ther Clin Risk Manag. 2011; 7: 145–148.
(4) Deepinder F, Braunstein GD. Drug-induced gynecomastia: an evidence-based review. Expert Opin Drug Saf. 2012 Sep;11(5):779-95.
(5) Orlandi MA, Venegoni E, Pagani C. Gynecomastia in two young men with histories of prolonged use of anabolic androgenic steroids. J Ultrasound. 2010 Jun;13(2):46-8.