Dr. Ertan Beyatlı

Is gynecomastia dangerous?

(Update: ) - Skin and soft tissue diseases

Gynecomastia?

Gynecomastia means breast enlargement in men. The word is formed from the Greek words gyne (woman) and mastos (breast).

Although the cause is not known exactly, it is thought that there may be more than one reason. It is generally thought to be caused by an imbalance in sex hormones. Gynecomastia, which is common in adolescent men, disappears within a few years in the vast majority of cases.

Although it does not pose any health hazard, it may be an indicator of a different ailment that may threaten health in rare cases. It often causes social and psychological problems. Cause of gynecomastia If it can be determined, treatment can be applied accordingly. However, in many cases, the treatment is surgical.

Types of Gynecomastia

There are three main types of gynecomastia:

  • Glandular type Growth in real breast tissue
  • Lipomatous type - Increase in adipose tissue
  • Mixed type (mixed) - Increase in both breast and adipose tissue. It is the most common type.

Causes of Gynecomastia

There are many causes of gynecomastia; physiological, age-related, and drug-induced gynecomastia are just a few.

Men have both male (androgen) and female (estrogen) hormones. Male hormones determine masculine characteristics such as facial hair, baldness, male gonad development, and male muscle and bone development.

Normally, men have very low amounts of estrogen (female hormone). When there is an imbalance between the male and female hormones in men, they can develop feminine (feminizing) traits. The most important one gynecomastia.

Is gynecomastia normal?

Gynecomastia can be physiological in three stages of life: newborn period, in adolescence ve aging in men. It is due to relatively high estrogen levels in all three cases.

Milk secretion may accompany breast development in newborns. This happens because of the high levels of female hormones in the mother during pregnancy, which continue to stimulate breast tissue in the newborn. This usually resolves within a week or two and the breast tissue becomes normal.

Adolescent children develop breast buds that usually go down to normal size within a year or two. This is also due to changes in male and female hormone levels during puberty.

Estrogens actually correct bone elongation and it is necessary for its growth. In adolescence, these hormones it is normal to rise and may accompany breast bud development in adolescent males in up to 60% of cases.

Older men develop gynecomastia due to age-related decreases in testosterone levels, leading to a comparative increase in estrogenic activity in breast tissue.

Drug-induced gynecomastia

Some drugs are known to be associated with gynecomastia, their estrogenic properties, stimulation of estrogen production in the body, or a variety of mechanisms that provide molecules that are easily converted into estrogen. These include: -

  • Estrogen vaginal creams, topical estrogen spray, and herbs containing phytoestrogens
  • Some antifungals
  • Some diuretics
  • Some cardiac glycosides
  • Some antibiotics
  • Some antacids
  • Certain anti-androgens used to treat prostate cancer or enlargement
  • Some drugs used in the treatment of AIDS
  • Some anxiolytics

What are the other causes of gynecomastia?

Gynecomastia can also be seen in the following situations:

  1. Chronic liver disease can increase hormone production and cause gynecomastia in women.
  2. End-stage renal disease with testosterone deficiency
  3. Insufficient levels of testosterone or male hormones
  4. Exposure to female hormones
  5. Anabolic steroids
  6. Some illegal drugs and alcohol
  7. Radiation therapy and cancer chemotherapy, especially for testicular and prostate cancer
  8. Male hypogonadism, which may have several causes; Genetic disorders associated with low testosterone levels in men such as Klinefelter syndrome (causing malformation and underdevelopment of the testicles accompanied by gynecomastia) have caused testicular diseases or enzyme deficiencies that cause primary hypogonadism.
  9. Thyroid diseasesespecially associated with hyperthyroidism
  10. Tumors that secrete estrogen, including the testicles, adrenal glands, or pituitary glands, can alter the balance of estrogen and androgens in men.
  11. Malnutrition or vigorous diet is associated with lowering testosterone levels without a corresponding decrease to estrogens, causing gynecomastia in some cases, but refeeding after malnutrition is more common.
  12. Some herbs such as tea tree or lavender have been associated with gynecomastia, which is allegedly due to their weak estrogenic effects.

In most cases, the cause is unknown.

Does gynecomastia mean breast cancer?

Sometimes breast enlargement may be caused by an underlying tumor or cancer in men, but this accounts for only 0.2% of all male cancers. Breast cancer in men is rare but should be ruled out when gynecomastia is detected.

Breast cancer can most often occur with a painful or painless firm mass and discharge from the nipples. Tumors and cancers cause enlargement of a single breast, while gynecomastia is typically bilateral.

Treatment options for gynecomastia

  • Gynecomastia is the growth of the male breast more than normal. Although rarely before puberty, growth of breast tissue is most common. occurs after puberty.
  • Examination and, if necessary, in patients presenting with breast enlargement radiological examination is applied.
  • The causes of gynecomastia are different. Hormone imbalances are the most common cause. Taking hormone drugs, endocrine origin tumors, testicular development disorders are other causes of gynecomastia.
  • During puberty, 60-70% mammary gland enlargement occurs in boys, but this is not very noticeable. It disappears within 6 to 18 months and the breast returns to its normal size.
  • Gynecomastia changes are present in 40% of adult men, this growth may be unilateral or bilateral.
  • Surgical treatment method liposuction and mammary gland removal techniques are the most appropriate techniques. These treatment methods vary according to the examination findings of the breast.
  • Good results are obtained with liposuction method in patients with large amounts of adipose tissue in the breast tissue. In patients with excess adipose tissue and excess mammary gland, the breast tissue should be removed with liposuction.
  • If there is excess skin in addition to excess fat and breast tissue, the fat and breast tissue are removed together with the skin. Bandaging is applied for 3 weeks postoperatively and the patient is called for monthly control.
  • Breast growth in boys is not always a bad condition.

Why do men have breasts and nipples?

Put simply, because men start life as women. In other words, men have breasts and nipples because they already have them before they became a man.

The explanation for this is as follows:

Humans are mammals. Between the 4th week of embryonic development and the emergence of the genes on the Y-chromosome, male and female embryos are in the same development process.

Humans have 23 pairs (46 in total) of chromosomes. One pair of these is the sex chromosomes and is XX in females and XY in males. The 22 pairs outside of the sex chromosomes are called autosome chromosomes and are the same in all humans.

In the 8th week, the germ cells begin to determine the gender. Thus, males secrete factors that inhibit the development of female structures. As soon as the male embryo begins to secrete the male hormone testosterone, it affects the sex characteristics that distinguish men from women in the body.

Germ cells (Germ Cells in English) are the reproductive cells of a living thing. The sex cells are called "Sperm" in men and "Egg" in women. Germ cells are formed by meiosis.

The sexual glands that determine the gender in the embryo begin to appear as of the 4th week of development. Prior to this week, sex does not play a role in development and until six weeks of age, the embryo follows the female pattern.

As a result, we can say that all human embryos begin to develop with nipples. For this reason, men have nipples just like women.

On the other hand, men can also get breast cancer, despite having undeveloped breast tissue. Although rare, risk factors depend on estrogen levels, obesity, alcohol consumption, and liver disease.

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