Physiologically, most males assigned at birth (MAAB) do not develop breasts. However, there is still a population of men who could suffer from enlarged breasts due to a condition called gynaecomastia. According to the Indian Journal of Endocrinology and Metabolism (IJEM), gynecomastia is the most common breast condition in males. We spoke to Dr Sitaram Prasad, Consultant-Plastic, Cosmetic and Reconstructive Surgery, Fortis Hospital, Mulund, to understand its causes and health consequences.
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What Is Gynaecomastia?
Gynaecomastia, commonly referred to as ‘man boobs’, is a physically harmless condition that associates with the enlargement of male breast glandular tissue. Dr Prasad said, “The reason gynaecomastia develops in men is because of an imbalance in the male hormone testosterone, and the female hormone oestrogen.”
According to the doctor, it occurs naturally at three points in the male life namely at birth, during puberty and during old age. “Most of the time, gynaecomastia is caused during birth or at puberty, but tends to recede over time. It may be classified in grades from 1 to 4, depending on the size and the amount of skin stretching. If during investigations an underlying cause is found, then that should be treated. Medical management of gynaecomastia may be attempted and might be effective if started early during the onset of gynaecomastia,” he added.
According to IJEM, at least 30% of males are affected during their lifetime, and since it causes anxiety, psychosocial discomfort and fear of breast cancer, early diagnostic evaluation is important and patients tend to seek medical attention.
Obesity And Gynaecomastia
Gynaecomastia can also be caused due to obesity, said Dr Prasad. This condition is called ‘pseudogynecomastia’, wherein the primary cause of enlarged male breasts is a buildup of fat that not only surrounds the nipples, but also manifests behind, or underneath the nipples. According to the doctor, the enlargement may persist even after fat reduction programmes are initiated.
Other Causes Of Gynaecomastia
Apart from hormone imbalance and obesity, there are other causes of gynaecomastia. These include:
- Alcoholism
- Liver disease and its failure
- Kidney failure
- Thyroid dysfunction
- Hypogonadism: When the testes have been either removed or destroyed or due to chromosomal abnormalities
- Tumours
Gynaecomastia And Mental Health
Dr Prasad said, “Gynaecomastia can cause some degree of mental distress and peer pressure. It is one of the most common causes for seeking treatment.”
According to a study published in Breast Care, a peer-reviewed journal, men with enlarged breasts reported feelings of anxiety, embarrassment, emasculation and even depression. The study authors concluded that men suffering from gynaecomastia were distressed by gynaecomastia and needed psychological support for any breast-related presentation.
Surgical treatment will always involve the removal of excessive fat using one of the modalities of liposuction, and removal of the gland through a small incision, said Dr Prasad.
Conclusion
Gynaecomastia is not life threatening, but can cause emotional and psychological distress. While it can resolve on its own, seeking professional help can fasten the process and improve your quality of life.
