Why is your chest swollen?
You’re in the locker room after gym class and look in the mirror while getting dressed. You realize that your breast area looks like it is swollen and when you touch it, it’s tender. Some of the other guys notice too and start making fun of you. What’s going on? Should you see a doctor?
Gynecomastia is when a boy or man has an increase in breast tissue. It can affect one or both breasts and can affect them unevenly. Typically, it’s caused by an imbalance of the hormones estrogen and testosterone. Usually, estrogen controls female sex traits and testosterone controls male sex traits. It’s important to note that both are present in men and women. In gynecomastia, men have estrogen levels that are too high, resulting in the enlargement of their breasts. At certain points in life, this imbalance isn’t uncommon. For male infants, being born with gynecomastia is fairly typical due to the effects of their mother’s estrogen. Within two to three weeks after birth, the swelling should go away. When going through puberty, hormonal changes can cause gynecomastia. As the teen’s hormones regulate, the swelling will disappear within six months to two years without any treatment required. Adult men between 50 and 69 also have a high incidence of the condition, with 1 in 4 being affected. Once again, this is thought to be related to hormonal changes that occur during this time.
Besides hormonal changes, several other things can result in gynecomastia. Certain health conditions can cause it, including hypogonadism, tumors, hyperthyroidism, kidney failure, liver failure, cirrhosis, and malnutrition/starvation. Many different types of medication can precipitate the development of the condition, such as anti-anxiety medications, tricyclic antidepressants, antibiotics, ulcer medications, cancer treatments, heart medications, stomach-emptying medications, AIDS medications, anabolic steroids, androgens, and anti-androgens. Several substances, like alcohol, marijuana, heroin, methadone, and amphetamines, can also result in the disorder. Some plant oils used in shampoos, soaps, or lotions have been found to cause it.
Regardless of the cause, symptoms are the same and are swollen breast tissue and breast tenderness. If you have either of these and nipple discharge in one or both breasts, you should see a doctor. The most common complication from gynecomastia is the emotional and psychological effects the condition has on those who have it.
Since most gynecomastia cases are instigated by hormone imbalances and resolve on their own, the usual course of action is to wait it out. If you have another medical condition that has triggered the disorder, your doctor can help you control it and this should reduce the swelling in the breast tissue. If you’re taking medications that cause gynecomastia, your doctor will adjust these accordingly to reduce it. When it comes to illegal substances, your doctor can assist you in getting off of them.
If your gynecomastia doesn’t go away on its own or is causing significant pain or embarrassment, your doctor can prescribe tamoxifen or aromatase inhibitors to help. If the breast enlargement is substantial, you can have surgery to reduce it. The two options are liposuction or a mastectomy. At the beginning of the treatment process, your doctor will recommend that you receive counseling to help deal with the psychological stress that is usually seen. It’s also a good idea to stay connected with family and friends and if you feel comfortable with the idea, join a support group.
When it comes to preventing gynecomastia, there are a few things that you can do. The first is to manage any medical conditions that can cause it. Next, it’s vital to know if any of the medications you take result in the disorder and monitor for any changes. Also, only drink alcohol in moderation and avoid using illegal drugs and steroids.
Gynecomastia can be embarrassing, but it does get better. If you have any questions or concerns about gynecomastia, please speak with your doctor. If you would like more information, please visit the Hormone Health Network’s Gynecomastia page at https://www.hormone.org/diseases-and-conditions/gynecomastia