Gynecomastia

Gynecomastia causes breast tissue to grow in men and boys, most often because estrogen and testosterone have fallen out of balance. Sarah Waterman, MD, at Green Mountain Breast Care Center in Stowe, Vermont, diagnoses gynecomastia, identifies what is behind it, and treats it medically or surgically depending on the cause. Call the Stowe office or request an appointment online to have your symptoms evaluated.

What is gynecomastia?

Gynecomastia describes what happens when the glandular breast tissue in males enlarges beyond its usual flat state. Estrogen and testosterone fall out of balance, and estrogen stimulates tissue that normally stays quiet. 

You may notice a firm, rubbery disc directly beneath the nipple, tenderness when your shirt brushes against it, or a change in the shape of your chest.

Gynecomastia differs from fat accumulation in the chest, which stems from weight rather than hormones. Dr. Waterman can distinguish between the two during an exam.

Who develops gynecomastia?

Three age groups account for most cases. Newborn boys often have temporary swelling from their mother’s estrogen, which resolves within weeks. Adolescent boys frequently develop it during puberty, and it usually settles on its own within two years. 

Men over 50 make up the third group, since testosterone declines with age while body fat, which produces estrogen, tends to rise.

What causes gynecomastia?

Dr. Waterman evaluates for a range of contributing factors, including:

• Normal hormonal shifts during puberty and aging
• Prescription drugs, including some heart medications, antidepressants, and antiandrogens
• Anabolic steroids and testosterone supplements
• Alcohol, marijuana, and certain other substances
• Liver or kidney disease
• Thyroid dysfunction
• Testicular or adrenal tumors
• Obesity

Identifying the cause matters, because gynecomastia sometimes resolves once you stop a medication or treat an underlying condition.

How is gynecomastia treated?

Your visit begins with a physical exam and a full review of your medications, supplements, and health history. Dr. Waterman may order bloodwork to check your hormone, liver, kidney, and thyroid levels, along with imaging when she needs a clearer picture of the tissue.

Treatment starts with the cause. Stopping a contributing medication or treating a thyroid problem often reverses recent gynecomastia on its own. Cases that have persisted longer than a year typically involve scar tissue that will not resolve without surgery, and Dr. Waterman removes the excess glandular tissue through a small incision as an outpatient procedure.

Any new lump in male breast tissue also warrants evaluation, since men can develop breast cancer.

A change in how your breasts look deserves an answer rather than a wait-and-see approach. Call Green Mountain Breast Care Center today or request an appointment online if you experience enlarged breast tissue as a man.