Gynecomastia, in very simple terms, is the enlargement of male chest caused by excessive growth of breast tissue inside breast glands. The name comes from the Greek words gynaik meaning “female” and mastós meaning breast. So the two words gynaik and mastós joined together forms the word gynecomastia meaning female breasts.
According to official statistics, 36% of adult young men and 57% of older adult men in the United States have this medical condition in one of the four grades and the numbers are only rising year after year . The Food and Drug Administration (FDA) reports that approximately 200,000 to 3 million cases are reported each year.
How Many Men Have Gynecomastia ?
Young Adult Men In United States
Older Adult Men In United States
Is Gynecomastia Life Threatening ?
No for 99.9% of the cases. The medical community considers gynecomastia as benign or not harmful to the body and gynecomastia generally does not pose an immediate health risk. Most cases of gynecomastia diagnosed in men happens NOT as a result of any serious underlying medical condition. Now this being said, a very very small percentage of instances of gynecomastia is caused by other underlying conditions such as a tumour.
However, the real risk is in terms of you losing self-confidence to form relationships, missed social exposure, feelings of inferiority as well as the chances of being ridiculed and bullied among peers due to this condition. In one study by Concordia University and University of Manitoba called “Men and Masculinities”, researchers found that young men do face body image anxieties and fears as those experienced by girls and women. Being afflicted with Gynecomastia hinders young men from developing a positive body image.
What Lies Beneath
The enlargement is actually caused by the presence of excess breast tissue under and around your nipple (areola is the medical term). You can see an illustration of the difference between gynecomastia and a normal male chest below.
Anatomy Of A Male Chest With Gynecomastia
The Hidden Dangers & Social Cost Of Gynecomastia
Boys and adult men who have gynecomastia are often hesitant to share their plight with family members due to a number of reasons. Sometimes they are ashamed thinking they are going to be laughed at. If your loved one has this medical condition, please understand the enormous pressures they are facing and afford them with all the empathy you could. This is especially, all the more important for teenagers with gynecomastia.
Whatever the severity (grades of gynecomastia) of this condition is, having larger chests than men of their age or peers poses a negative psychological for men. According to the April, 2013 issue of Plastic and Reconstructive Surgery, “Merely having gynecomastia was sufficient to cause significant deficits in general health, social functioning, mental health, self-esteem, and eating behaviours and attitudes compared with controls,” American Society of Plastic Surgeons (ASPS) Member Surgeon Dr. Brian I. Labow and his colleagues at Boston Children’s Hospital wrote.
Not All Breast Enlargement In Men Are Gynecomastia
Before we dive deep into other aspects of gynecomastia, let’s get some more clarity on breast enlargement. One of the common misconceptions is that all breast enlargement in men are as a result of gynecomastia or breast tissue growth. This is simply not true. In the case of gynecomastia, it is excess breast tissue under the nipples that gives the outer appearance of breast enlargement but NOT all breast enlargement need not necessarily be caused due to excessive breast tissue growth.
Another common cause of breast enlargement in men is due to fatty deposit or fat accumulation in the chest. Pectoral (chest) fat can also mimic the visual appearance of gynecomastia and this is called fake or pseudogynecomastia and is a very different scenario. There are definite ways you can find out if your breast enlargement is caused by excessive breast tissue growth or pectoral fat and that must be your next logical step if you think you have breast enlargement.
Difference Between Gynecomastia And Pseudogynecomastia
Difference Between Pseudogynecomastia And Normal Chest Anatomy
Grades Of Gynecomastia
Gynecomastia is classified into 4 grades by the American Society of Plastic Surgeons based on factors like size of breast enlargement and feminization of the breast. Grade 1 is considered mild and the highest grade of 4 is considered severe with noticeable feminization of the male chest. The table below shows each grade and its description.
Grade or Type
A localized button of tissue that is concentrated around the areola
Moderate breast enlargement exceeding areola boundaries
with edges that are indistinct from the chest
Mild to high
Moderate breast enlargement exceeding areola boundaries
with edges that are distinct from the chest with skin redundancy present
High and visible
Marked breast enlargement with skin redundancy and feminization
of the breast
Severe and visibly feminine
Causes Of Gynecomastia
Before mentioning the main causes or causes, it must be noted that studies into what causes breast tissue development are still in their infancy and in some cases, the cause of gynecomastia is an enigma for the medical field. In such cases, it is referred to as “idiopathic” meaning, the cause is unknown or cannot be found out. There are also only a limited number of studies that have been conducted around what causes gynecomastia. One reason for the low number of studies around this medical condition is that it is not a life threatening condition. Another reason for the lack of interest from a commercial point of view is that treatment of this medical condition is not covered by insurance unless accompanied by a life-threatening condition like a tumour.
Gynecomastia can be caused due to a number of reasons but usually, the main culprit is an excess presence of estrogen or female hormones in men. All males do have some amount of estrogen naturally present in their body but in the case of men with gynecomastia, estrogen becomes dominant and as a result, they develop feminine features like breast enlargement. Now there are other causes as well and they are wide and varied. Gynecomastia is also increasingly seen as a result of drug abuse, radiation from cancer treatments as well from use of medications like risperidone. For some, breast enlargement due to excessive breast tissue growth comes out of the blue for no apparent reason which is referred to as idiopathic in medical terms.
Prevalence of the female hormone estrogen in higher than usual proportion in the male body is one of the identified fundamental underlying causes of gynecomastia. For some individuals, there is naturally a higher amount of estrogen present in their body and this high presence of estrogen leads to the development of feminine characteristics and increased breast tissue growth.
Local tissue factors like increased presence of estrogen in the breast area, increased aromatase activity, (conversion of male hormones into female hormones) also contributes to causes of gynecomastia. There have been a number of studies and there is some agreement in the scientific world that a number of the food items that we in North America consumes on a daily basis are high in estrogen or facilitates the production of estrogen.
One of the major causes of gynecomastia among body-builders is the use of steroids. Steroids can influence the estrogen levels in the body and gynecomastia among body building professionals is a very common after-effect of not properly planned steroid use. When steroids are used, it changes the testosterone and estrogen balance in the body and as a result, the balance tilts towards estrogens and gynecomastia develops as a result.
One of the recurring questions about the causes of gynecomastia comes from body-builders who have developed gynecomastia as a result of unsystematic steroid use. There are products in the market specifically for bodybuilders or those taking steroids to address the threat of developing gynecomastia. If you are taking steroids, you will get gynecomastia unless you flush the excess estrogen. The process of flushing out excess estrogen and reversing its effects to prevent gynecomastia is called post cycle therapy.
Another cause of gynecomastia is Klinefelter syndrome and is a chromosomal abnormality. Individuals with this condition will have an extra “X” chromosome and to put things in perspective for you, X and Y chromosomes in our body determines our gender and men usually have “XY” combination whereas women have “XX” combination. However, in the case of men with Klinefelter syndrome, they will have an additional “X” chromosome leading to an abnormal “XXY” combination. According to studies on this medical condition, men with Klinefelter syndrome has a 20 fold chance of breast cancer than others and gynecomastia is a common symptom among men with medical condition.
The thyroid gland is one of the hormone producing glands in our body and controls a number of crucial functions like heartbeat rate and how fast we burn calories. When the thyroid gland become over-active, it produces more thyroid hormones than required and this leads to a medical condition known as hyperthyroidism. Hyperthyroidism is predominantly found in women but men can also have this medical condition and this is considered one of the causes of gynecomastia.
When men get older, the testosterone levels either become dormant or retards from their earlier levels and this can lead to a dominance of the female hormone estrogen that is already present in relatively few numbers. As mentioned above breast development occurs during three phases of life and the last one is during older adult age.
According to some studies, up to 25% of all cases of gynecomastia have no apparent cause. This in itself does not mean that there is no underlying reason but could be because of the lack of studies or research on this medical condition. The medical community for lack of a better word, simply does not know what is causing gynecomastia for a subset of the gynecomastia patient population.
In almost 20-25 % off all cases, the causes of gynecomastia can be traced back to the use and sometimes abuse of drugs. A number of drugs can directly or indirectly increase the amount of estrogen or catalyze its production. Estrogen is a female hormone that gives women their bodily features and when this hormone is produced more and more, it leads to breast tissue growth. Take a look at this list of drugs that may cause gynecomastia for more information.
One of the recent findings about the causes of gynecomastia is the “estrogen diet” or a diet that predominantly includes food habits and food items that speed up the production of estrogen. This is a topic that is beyond the cope of a breif mention here and for detailed information, take a look at our causes of gynecomastia page.
For in-depth information about the causes of gynecomastia, we have a dedicated page about the factors, medical conditions, medications as well as food items that can cause breast tissue growth. Read the causes of gynecomastia page for more information.
How To Know If You Have Gynecomastia
The diagnosis of gynecomastia can be done by your family doctor but it is best left to a doctor who specialises in the diagnosis and treatment of this medical condition. Below is one of the classic approaches that doctors use to make sure that the underlying mass is breast tissue. There are also advanced diagnostic tests like scanning if gynecomastia cannot be confirmed by physical examination alone.
Diagnosis Of Gynecomastia
The patient lies flat on his back with his hands clasped beneath his head. Using the separated thumb and forefinger, the examiner slowly brings the fingers together from either side of the breast. In patients with true gynecomastia, a rubbery or firm mound of tissue that is concentric with the nipple–areolar complex is felt. In patients with pectoral or chest fat, no such disk or tissue is found.
A mass under the nipple area of the breast with or without pain when touched or squeezed.
Breast enlargement involves the both breasts equally and evenly, without pain during palpation.
Gynecomastia Treatment Options
Once you have made a proper diagnosis of this medical condition, the next logical step is to look at all available options to get rid of it. I am using the word “treatment” in a very broad sense and is including temporary and permanent solutions. Effectiveness, affordability and convenience are the main factors you need to look at when selecting a treatment option.
Gynecomastia shirts are the cheapest treatment option you can start with. Their affordability and convenience are their advantages but keep in mind that they are only a temporary option. Once you take them off, the effect is gone. You are also limited to activities with your shirt on. Recommended if you are looking for a quick fix.
There are a number of orally administered products for gynecomastia including those with natural ingredients as well pure pharmacological agents. Their unique selling point is that they do not require surgery or cuts or staying at the hospital and only cost a fraction of surgery.
Gynecomastia surgery is a high-end but expensive option to get rid of breast enlargement. It is the most personalised and tailored treatment option to get rid of gynecomastia. A gynecomastia surgeon will get rid of unwanted breast tissue and will shape your chest in the best way possible.
Post Cycle Therapy
Post Cycle Therapy or PCT is a process used by steroid users to prevent and reverse gynecomastia. It involves SERM (Selective Estrogen Receptor Modulator), AI (Aromatise Inhibitor) and a Testosterone Booster (T-Booster).
Can I Get Rid Of Gynecomastia Naturally
One of the most frequently asked questions when it comes to gynecomastia is whether it can be get rid of naturally without using any supplements or surgery and just through diet or exercise. The answer is NO because you cannot reverse the already existing breast tissue with just a change in your diet. You can prevent further exposure to excess estrogen that goes through food items buy avoiding them but this will not reverse the breast tissue that is already there.
Naturally addressing gynecomastia comes down to controlling or limiting the intake of estrogen rich foods and increasing food items that contain testosterone or promotes testosterone production. Below is a very limited list of some common food items that is rich in estrogen. You can also do your own research and find out what other food items contain estrogen to avoid them.
Balance Estrogen – Testosterone Levels Through Diet
The best way to achieve estrogen-testosterone balance is to focus on eating foods that both regulate estrogen and promote healthy testosterone production in combination with a healthy lifestyle. The way the estrogen-testosterone ratio is regulated in the body is a bit complex and we will briefly go through what the process is and how we can use it to our advantage.
So how exactly does men produce unwanted estrogen and what constitutes a healthy level of estrogen for men? It may seem counterintuitive, but the majority of circulating estrogen in men is actually derived from the male sex hormone we call testosterone. The mechanism from which this occurs centers around an enzyme known as aromatase. The primary form of circulating estrogen is known as estradiol. Men lack the female reproductive organs necessary to produce this hormone so its main source is from the conversion of free testosterone to estradiol through this enzyme known as aromatase. This enzyme is expressed in various tissues throughout the body naturally but this can result in fluctuations in hormone levels throughout the body. Increased activity of this aromatase enzyme in fat cells surrounding the breast tissue is an underlying contributor to gynecomastia in males.
How To Naturally Raise Testosterone Levels ?
There are two aspects two naturally raising your testosterone levels. The first is to decrease your estrogen levels by avoiding estrogen rich foods and the second is to increase food items that are rich in testosterone and polyphenols which act to lower estrogen. Polyphenols compounds are surprisingly common and may already be a part of your diet. Common beverages that are high in polyphenols include:
Black or fermented teas (jasmine, oolong, etc.)
Pure lemon juice
Black and green olives
Red and yellow onions
Whole grain rye
A full list of the top 100 foods high in polyphenols is available in a database published by Nature. Incorporating a variety of these foods into a healthy diet is a great way to begin to shift the ratio between testosterone and estrogen in the right direction. In addition to polyphenol-rich foods, another set of related compounds that are known to be effective aromatase inhibitors are chrysin and propolis. Interestingly, these compounds are synthesized by honey bees, making honey another good addition (in moderation) to a diet focused on hormone balance for men.
Food Items Rich In Testosterone
Organic Beef and pork cuts with moderate amounts of fat
Organic Chicken (skin on is preferable)
Organic salmon and tuna
Nuts: pistachios, almonds, cashews, pecans, brazil nuts, walnuts.
Other factors including body fat percentage and inflammation are known to have an effect on aromatase activity and consequently balanced hormone levels in men. White fat cells (the majority of the fat cells in humans) are known to be a major source for the production of aromatase, so maintaining a healthy diet is highly important. Inflammation from dietary sources such as excess alcohol consumption and certain fats (those with a low omega-3 to omega-6 ratio) are also known to be contributing factors to increasing aromatase activity in the body.
Vitamin D also likely plays an important role in testosterone production. Results from contemporary studies are mixed, but there is likely a beneficial link between higher vitamin D levels and hormonal balance between testosterone and estrogen levels in men. It is important to have vitamin D levels checked by a medical professional in combination with testosterone in order to determine if supplementation may be needed. It is also important to consume foods high in Vitamin D if you have lower than normal levels. Vitamin D rich foods also happen to overlap with foods known to help improve testosterone levels, including fatty fish, dairy products, egg yolks, and beef liver.
Lastly, the easiest way to maintain a hormonal balance for men is to combine the listed dietary recommendations with adequate sleep, a low stress lifestyle, and a healthy body weight. Above all, studies have shown that maintaining a healthy body mass composition and getting plenty of sleep may be the be most important factors for boosting levels of testosterone and reducing unwanted estrogen production.
Not A Full Fledged Approach
Going on an anti-estrogen diet is definitely a right step but do not count on it to help you get dramatic results. It is more of a supportive practice that aids other treatment options like gynecomastia supplements and gynecomastia surgery. It has been proved beyond doubt that a number of foods that we consume on a daily basis are ticking estrogen bombs and by following a natural anti-estrogen diet, you are effectively cutting one source of excess estrogen.
100% natural way to control estrogen consumption.
Is not a major treatment option in itself to get rid of gynecomastia.
Compression shirts are cheap and affordable costing anywhere from $10-30 making it affordable for most individuals.
The effect of compression shirt is instant. You wear a compression shirt and your gynecomastia is no more visible or felt to the outside world.
They are only a temporary option and once you take off the compression shirt, the effect is reversed and can bring back that feeling of shame and desperation.
Compression shirts only work in formal settings. If you want to take your shirts off at the beach or by the pool, wearing a compression shirt will only attract eye balls.
There is a bit of uneasiness in the first few days of wearing it and can feel like being choked. This will go away as you start to get used with wearing them on a daily basis.
Affordable Temporary Solution
Compression shirts are a fast and affordable option to get hide a saggy chest and even though the effect is only temporary, I highly recommend that you get one just to see the effect of not having breast enlargement. You get to see the results of not having it and that will motivate you to do whatever it takes to get rid of this medical condition. Zappos.com have one of the best selection of compression shirts in the United States.
Gynecomastia pills are exclusively developed to reduce breast enlargement in males.
They are also the less expensive option currently available to get rid of excessive breast tissue.
They cost less when compared to the cost of gynecomastia surgery.
One month’s supply of over the counter supplements costs $60 – $70.
Over the counter gynecomastia supplements not covered by insurance.
Prescription drugs that targets breast tissue growth has been found to have a number of side effects.
Gynecomastia pills are the least expensive treatment currently available. There are over the counter supplements with natural ingredients and there are prescription drugs that you can use if you do not prefer surgery.
Breast tissue formation is also one of the most surprising and worst nightmares of those in the fitness and body-building community. This is due to not knowing how to use steroids and other performance enhancing supplements properly. Again, I want to emphasize that you can use steroids without side-effects as long as you take the necessary precautions. Breast tissue growth among steroid users is caused by excess estrogen formation that was not flushed out using post cycle therapy.
This process of flushing out excess estrogen from the body in simple terms is called Post Cycle Therapy or PCT. Failing to flush excess estrogen through PCT will lead to growth of excess breast tissue, a body builder’s worst nightmare. A proper post cycle therapy (PCT) must include a selective estrogen receptor modulator (SERM), an aromatise inhibitor (AI) as well as a testosterone booster. This is the combination that gives you the 360 degree protection and effectiveness. This also prevents all possible side effects and helps you preserve and sustain the results you so painstakingly achieved. To know more about quality and prescription grade PCT products, take a look at the post cycle therapy for gynecomastia page.
Prevents the effects of estrogen dominance and development of gynecomastia
Regulates estrogen/testosterone balance in the body
Helps sustain the muscle growth, performance and above all prevents muscle loss
Some users may experience side effects like mild nausea and vomiting.
Only Applicable For Steroid Users
PCT is to be done after you are done cycling and hence the name post cycle (meaning after the cycle in this context). The dosage of the PCT will depend on the strength of the steroids you had been taking. If you are currently taking steroids, you should be looking at PCT’s to preserve the muscle growth, prevent water retention and gynecomastia.
You are guaranteed that your breast enlargement is permanently gone for good when you wake up from sedation after surgery. Gynecomastia surgery has a 100% success rate.
The whole process from admission to discharge will only take 3-4 and you will leave the hospital as a completely different man with a whole new level of confidence.
You are also in the safe in hands of a surgeon who has at least 6-8 years of training and many more years of experience. You will also be given customised and personalised treatment and will be consulted in all aspects of surgery.
Costs between $5000-8000.
May not be covered by medical insurance in all instances.
Expensive But Guaranteed Option
Surgery is the expensive yet guaranteed option to get rid of gynecomastia. Surgery for gynecomastia is called reduction mammoplasty. The price you pay is definitely worth as your surgeon will perform the surgery based on your body contour and it will look natural. Surgery is also the fastest treatment option to permanently get rid of that excess unwanted breast enlargement.
If you still have a question, take a look at the world’s largest database/knowledge-base of question and answers about gynecomastia and you will most likely find the answer there. You can also send us your query through the contact form but please make sure that it is not already addressed in the knowledge base.