About Gynecomastia

Underlying Medical Causes of Gynecomastia

Breast enlargement in men, known as gynecomastia, is often idiopathic type with unknown cause called “idiopathic gynecomastia”. However, there may be diseases that cause gynecomastia or some tumoral masses that can be mistakenly diagnosed as gynecomastia. Therefore, you shouldn’t attempt to diagnose and treat yourself based on information obtained from the Internet.

First and foremost, you should seek the advice of an Endocrinology and Metabolic Diseases specialist. The cause of the breast enlargement will be revealed more precisely following the examination, blood and radiological imaging procedures.

Male breast tissue, like female breast tissue, is made up of mammary glands and adipose tissue located between and around the mammary glands. Adult men normally have higher levels of male hormones and lower levels of female hormones in their blood.

Some diseases and substances that disrupt the blood’s hormone balance, lowering male sex hormone levels while increasing female sex hormone levels, may cause an increase in the volume of the mammary glands and the appearance of gynecomastia.

Before mentioning about the diseases that can cause gynecomastia, I’d like to point out that gynecomastia can occur as a result of natural hormonal changes during certain periods of life, and that this is a physiological process, not a disease. This condition may be caused by the estrogen hormone passed from the mother, particularly in newborns, but it can also be seen in adolescence and at advanced ages, such as over 50.

Underlying Medical Causes of Gynecomastia

The imbalance between male and female sex hormones in the blood is the underlying cause of diseases that cause gynecomastia or diseases in which gynecomastia is considered a symptom.

  • Hypogonadism: Hormone levels in the blood change as a result of inadequate sex hormone secretion due to a variety of factors.
    • Klinefelter Syndrome: The level of male sex hormone in the blood is low.
    • Pituitary insufficiency: The levels of hormones secreted by the pituitary gland are low.
  • Tumors: Testicular tumors, suprarenal gland tumors, and pituitary gland tumors.
  • Hyperthyroidism: Excessive hormone secretion by the thyroid gland.
  • Renal failure.
  • Chronic liver diseases such as cirrhosis, liver failure.
  • Malnutrition and Starvation.
  • Trauma or serious injury.

The appearance of gynecomastia will regress if the underlying diseases are treated and the hormone levels in the blood return to normal. It is recommended to wait at least a year before considering surgical treatment for gynecomastia.

Medications That Cause Gynecomastia

Besides diseases, there are also some drugs that may cause gynecomastia (overdevelopment of the male breasts). Some of these include;

  • Anabolic steroids and androgenic drugs used to increase protein synthesis and muscle mass.
  • Anti-androgens used to treat prostate enlargement or prostate cancer, which lower the levels of male sex hormone in the blood.
  • Sedatives used to treat anxiety such as diazepam.
  • Tricyclic antidepressants used to treat depression.
  • Fungicides and antibiotics such as ketoconazole, metronidazole, and isoniazid.
  • Drugs used to treat gastrointestinal ulcers such as cimetidine, ranitidine and omeprazole.
  • Chemotherapeutic drugs used in the treatment of cancer, such as methotrexate, alkylating agents, vinca alkaloids, and imatinib.
  • Heart medications such as ACE inhibitors, spironolactone, digoxin, amiodarone, verapamil, diltiazem, calcium channel blockers and nifedipine.
  • Drugs used to regulate bowel movements, such as metoclopramide.
  • Some drugs used to treat AIDS.

Gynecomastia can be observed in consequence of the use of these drugs for a long time. When the drug is no longer used, the breast size will gradually decrease over time. It is useful to wait at least 1 year to evaluate how much breast growth regressed after the treatment of the underlying diseases of gynecomastia and the discontinuation of the drugs.

Substances That Cause Gynecomastia

In addition to diseases that cause gynecomastia, long-term intensive use of certain substances can cause breast enlargement. The main ones are;

  • Excessive and prolonged alcohol consumption.
  • Marijuana
  • Cocaine, Heroin addiction.
  • Drugs such as amphetamine.
  • Foods That Cause Gynecomastia
  • Chickpea
  • Flaxseed
  • Parsley
  • Sesame
  • Green pea
  • Soybeans, soy milk, soy yogurt
  • Date
  • Dried apricot, prune
  • Sage

When these foods are consumed excessively on a regular basis for a long time, they are likely to disrupt the balance of male and female hormone levels in the blood, resulting in gynecomastia.

Creams That Cause Gynecomastia

  • Lavender oil
  • It has been reported that regular application of plant-based essential oils such as tea tree oil to the skin may increase the amount of estrogen in men, causing gynecomastia.

In fact, no specific condition that may cause gynecomastia can be identified during a gynecomastia investigation, but early diagnosis of the aforementioned diseases and other causes, as well as taking the necessary precautions, will both stop the development of gynecomastia and reduce breast size.

Pseudogynecomastia (False Gynecomastia)

It is a condition in which male breasts grow larger than normal due to regional fat accumulation in the breasts. Such a condition is not a real gynecomastia. It is usually bilateral and is more common in overweight men. The most effective treatment for pseudogynecomastia is to lose weight and then, if necessary, to perform surgical treatment procedures such as liposuction.

Finally, I’d like to emphasize again that benign or malignant tumoral masses that can cause breast enlargement can be misdiagnosed as gynecomastia and may remain untreated. Therefore do not attempt to diagnose or treat gynecomastia on your own; instead, consult a healthcare provider.


  1. Gynecomastia: Etiology, Diagnosis and Treatment

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