Gynaecomastia may be seen in three phases of the life span of an individual and is basically associated with hormonal changes in the body.
- The first phase is during neonatal period (birth to 3 months) when 60-90% of babies both male and female, develop breast tissue. But this is asymptomatic gynaecomastia.
- The second phase being in teenagers or between 10-18 years or more, when 48% to 64% of all teenagers have some form of breast tissue growth.
- Gynaecomastia is believed to be a mid-puberty event as it is more frequent in boys. There have been a number of conflicting study reports in the literature regarding the association of BMI with gynaecomastia. While several investigators demonstrated that boys with gynaecomastia are heavier, others have found that boys with pubertal gynaecomastia are shorter, leaner and have a lower BMI.
- The third phase being in old age or between 50-80 years. The reported prevalence is up to 70%.
- Neonatal Gynaecomastia – Usually self-limiting and treatment not necessary
The neonatal gynaecomastia is asymptomatic which occurs as a residual effect of androgen to oestrogen conversion by the placenta. This temporary gynaecomastia usually subsides within four to three weeks.
2. Pubertal Gynaecomastia – Permanent solution is surgery
Gynaecomastia in teenagers is one of the most embarrassing situations and is very common for them. It is generally referred to as pubertal gynaecomastia. When boys go through puberty, their body produces slightly higher amounts of oestrogen (female hormones). Some boys will have a higher than usual level of oestrogens and this naturally results in growth of their breast tissue.
But pubertal gynaecomastia mat settle as teenagers enter adulthood. The excessive breast tissue that is the cause of concern will even out as the chest expands when you finish your teenage years. However, if this breast development carries over to adulthood, then you need to be concerned as this may be genuine case of gynaecomastia.
Post 20, if gynaecomastia symptoms persist then you should consult with a doctor so that a proper diagnosis can be performed.
If you are over-weight and have pseudo-gynaecomastia, then you can avoid surgery as you can probably reduce it with proper diet and exercise. You should go for a low fat diet in order to allow the body to burn off excess calories.
If you are suffering from pure glandular gynaecomastia or Mixed gynaecomastia then you should consider surgical options. However, if you don’t want to get surgery done, then you can also use gynaecomastia shirts or gynaecomastia pills. But the success rate of these non-invasive treatment depends on the severity of the problem and all these are temporary solutions. If you are looking for a permanent solution for gynaecomastia, then the only option is surgery.
3. Senescent Gynaecomastia – If severe, seek surgery
When males get older, the testosterone levels either become dormant or decreases from their earlier levels and there may be a relative increase in the fatty tissue which can lead to a dominance of the female hormone oestrogen over male hormone androgen and it may cause senescent (age related) gynaecomastia. In older men, the use of numerous drugs may also cause gynaecomastia. If medication or chemical use is the cause of gynaecomastia, then there is a chance that if you stop using these medications, then your gynaecomastia may also go away on it’s own but it depends on the severity.
If you think that you may have gynaecomastia, you should see a doctor so that it can be investigated and diagnosed. You should not try to guess whether you have just chest fat or true gynaecomastia, because the success of the cure depends on the reliability of the diagnosis.
If gynaecomastia is a new symptom, one should always consult with their doctor first and especially if it is unilateral to rule out any sinister causes.
Dr Ash Dutta has been performing surgery to correct gynaecomastia since 2000.
-Dr Ash Dutta