There are few things that can be as discouraging as man boobs.
Gynecomastia—the disorder which causes boys and men to develop breast tissue similar to that of women—does not discriminate. It does not care whether you’re skinny or fat, good or bad, tall or short. If your hormones aren’t in order, you can potentially develop male boobs.
In fact, as many as 30% of boys and teenagers have this condition, developed to an extent. During the massive transformation processes with the boys’ hormones, it is not uncommon for boys anywhere between 8 and 18 years old to develop female-looking breasts.
Unfortunately, sometimes the condition persists even past the teenage years. That’s when things can start getting really awkward for men.
Despite some popular beliefs and high-school-locker-room jokes, gynecomastia is mainly caused by hormonal imbalances, and is rarely something men can control.
See, all men produce both estrogen (the “female hormone”) and testosterone (the “male hormone”) in their systems. During puberty, our bodies “specialize”: testosterone helps teenage boys develop into men (testicles, musculoskeletal structure and function), while rising levels of estrogen turn girls into women (menstrual activity, breasts.)
For some men (and women), these processes get mixed up, and the wrong type of hormone is produced within the body. In men—who normally only have a very thin, almost unnoticeable layer of breast tissue—this often means developing excess amounts of breast tissue.
Mild gynecomastia cases can and should be successfully treated with appropriate hormonal medicine. However, sometimes the pills don’t do the trick.
Luckily, there are several surgical breast reduction options available for men who feel embarrassed by their man boobs.
Do I Really Have Gynecomastia?
Before you dive into the world of surgical options, first you should make sure that it’s indeed gynecomastia you’re suffering from. While it’s quite distinctive in its looks and the overall feel, it can be confused simply with folds of fat.
As gynecomastia is mainly caused by excess amounts of estrogen in the male body—and/or low testosterone levels—you may be noticing several other symptoms that will reinforce the fact that you have gynecomastia:
- Low sex drive. Low testosterone and high estrogen levels in males usually result in lower libido and sex drive.
- Enlarged breasts. Duh.
- Lots of belly fat. An expanded waistline is a good indication of high estrogen levels.
- Feeling tired. Men with the highest testosterone levels feel most active and energetic throughout the day.
- Loss of muscle mass. Men with low testosterone and high estrogen levels usually have noticeably small and weak muscles.
- Emotional instability and depression. Men with deficient testosterone and high estrogen tend to display a range of anxiety and depression symptoms.
What Does Gynecomastia Look Like?
Often times, men who worry about gynecomastia simply have pronounced fat bulges in the chest area. Just so you know, there are surgical options for that, too.
Estrogen-induced male boobs look differently from just fat in the chest area:
- Man boobs will have a fairly pronounced shape, whilst fat folds will be distributed evenly across the chest cavity
- Man boobs tend to be distributed in one area (much like women’s breasts), whilst fat folds will have no particular shape
- Man boobs sometimes look like developed chest muscles (firm and forward pointing), while fat folds will be saggy and downwards-pointing
What Does Gynecomastia Feel Like?
If you’re still not sure whether it’s gynecomastia or simply fat that’s not giving you rest, a simple feel-up should dissolve any final doubts.
There are a couple of distinctive texture traits to gynecomastia-caused breasts:
- Lumps beneath the skin in the chest cavity. When you press onto the area around the nipple with your fingers, you should be able to detect small lumps. That is the overdeveloped breast fatty tissue. The important difference man boobs have from just fat is that you’ll be able to clearly feel the shape and the boundaries of the lump (or lumps.) This may be present in just one, or both breasts. If you cannot detect a specific lump in your chest cavity, and it simply feels like skin and fat, it most likely is.
- Tenderness and sensitivity in the chest area. Estrogen-induced breasts will feel more tender than other body parts. If you’ve noticed any unnatural irritation, skin softness and/or sensitivity, it’s a good sign you’re suffering from gynecomastia. Sometimes, estrogen-caused breasts in the male body may be accompanied by soreness. On the contrary, excess pockets of fat (a result of bad metabolism and other causes) will not feel sensitive and tender at all.
What Causes Gynecomastia?
Naturally, it may also help to know what exactly causes the male boobs to grow.
While we already know it’s the hormonal disbalance that ultimately does the trick, there are a lot of factors involved that could add onto the effect.
Due to its hormonal nature, gynecomastia is very directly correlated to men’s age.
During infancy, the development of disproportionately large breasts in baby boys is extremely common. In fact, more than half of all male babies develop abnormally large breasts. That is the direct result of all the estrogen coming from the mother’s body, even after childbirth.
Puberty is the most sensitive period in many people’s lives, and developing female-looking breasts definitely doesn’t help to win popularity. Unfortunately, around 30% of all teenage boys suffer from gynecomastia—to a degree—during their teenage years. Teenage male breasts appear as a direct result of the hormonal thunderstorms happening in their changing bodies, and usually go away within a few months, although they can persist for a few more years.
During adult years, gynecomastia is least prevalent. If you’re between 20 and 50 and match the symptoms, it’s probably due to hormonal disbalance, medications, or simply the gynecomastia carrying over from teenage years.
The last big threshold when men’s hormonal levels change significantly is around the 50-year mark. That’s when testosterone levels tend to drop significantly, causing male breasts to appear. According to a number of sources, around 1 in 4 men between ages 50 and 69 suffer from gynecomastia.
Testosterone deficiency is another major cause of gynecomastia. Since male breasts develop as a direct result of testosterone-estrogen imbalances, T-deficient men often find themselves with the condition.
Low testosterone levels are considered anything below 300 ng (nanograms) per deciliter of blood.
It is estimated that around 30% of overweight men are suffering from testosterone deficiency.
Also, multiple sources agree that around 1 in 4 men over 50 years old suffer from low testosterone levels.
The general consensus is that men start losing around 1% of body testosterone past the 40-year mark.
In addition to gynecomastia, testosterone deficiency can cause a number of other symptoms, including but not limited to:
- Low libido. Around 28% of men with testosterone deficiency report low sex drive, poor sex satisfaction and performance. Erectile dysfunction is also a primary symptom of testosterone deficiency.
- Physical changes. Besides developing male breasts, low T-levels also cause a myriad of physical transformations in the male body. To name a few, decreased muscle size and performance, reduced bone density and increase in body fat percentage are the most common ones.
- Mental changes. Both directly and indirectly, testosterone levels have a tremendous effect on men’s mental states. Men with TD often report increased anxiety levels, trouble concentration, poor memory, reduced motivation and drive, and a number of depression symptoms.
Medications and Supplements
It is important to note that not every case of gynecomastia is caused by natural changes and body developments. Up to 50% of gynecomastia cases are caused by certain medications and medical procedures, as outlined by the Mayo Clinic:
- Prostate enlargement or cancer medication. Many patients who receive nonsteroidal androgenial treatment for prostate cancer often find themselves developing symptoms of gynecomastia. In fact, male boobs appear in 80% of the treatment cases within 6 to 9 months after the start of the program.
- Anti-anxiety medications. Development of gynecomastia is tightly linked to a number of antidepressant medications. Always talk to the prescribing doctor about the potential adverse effects of the antidepressant treatment.
- Alcohol. While having 1-2 drinks after work won’t significantly affect your testosterone levels (and small doses of alcohol have been actually shown to slightly increase T-levels), consistent consumption of alcohol messes up our endocrine system, which ultimately affects our estrogen-testosterone ratio, causing gynecomastia symptoms. Excessive alcohol use can also lead to a number of health conditions that also affect our T-to-E ratios.
- Marijuana. While the relationship between recreational marijuana use and the development of man boobs isn’t fully researched (and provides ambiguous conclusions), there is some evidence that pot-smoking can lead to gynecomastia. While this is clearer in animal studies than human ones, gynecomastia appears as a result of lower testosterone, caused by marijuana use.
- Anabolic steroids. While not exactly the most “popular” cause of gynecomastia, multiple studies show that as many as 52% of men who use anabolic steroids for increased muscle size and exercise performance suffer from developing man boobs.
Up to this point, we’ve described the various factors that may become a causing factor for gynecomastia.To summarize, here is a rundown of health conditions that are directly linked to the development of man boobs:
- Testosterone deficiency. Otherwise known as hypogonadism, the condition can be caused by a number of factors—from injury to genetics. It is important to test your testosterone levels and make sure hypogonadism is indeed the cause of the problem. That way, Testosterone Replacement Therapy may be the better option to address man boobs.
- Forms of cancer. While definitely not the leading cause of gynecomastia, certain tumors can affect specific hormone-producing body parts, such as the testes, the adrenal gland and pituitary gland, which, in turn, affects your estrogen-to-testosterone ratios in favor of the former, causing man boobs to surface.
- Hyperthyroidism. A condition that forces our thyroid glands to produce too much thyroxine, which can lead to a condition called thyrotoxicosis. Thyroxine is a hormone that is responsible for our metabolism rate and body composition. In cases of thyrotoxicosis, male boobs are the first symptom doctors look for.
- Wrong nutrition. It is also not uncommon for patients to experience symptoms of gynecomastia that is caused by bad nutrition. There are a number of foods that are rich in nutrients responsible for healthy production of testosterone. Poor diets may shift the hormonal balance in favor of estrogen.
What Can You Do about Gynecomastia?
Luckily, there are a lot of ways you can go about addressing your man boobs. We’ll guide you through the whole process.
First of All, Can Man Boobs Go Away Naturally?
We get this question a lot, and, honestly, the best answer is this: if you’re past your teenage years and still experience gynecomastia (after making sure it is indeed gynecomastia), the condition will probably not go away as expected.
Basically, if you’re in your 20s or 30s and still have man boobs, it’s a good sign that gynecomastia is a part of a larger hormonal disbalance. Hence, you’d have to address the problem that is causing said disbalance; but expecting for the moobs to go away naturally is probably not the right way to go about it.
Especially if you’re conscious about your male breasts and are looking for effective, immediate measures.
Here’s the right way to go about it:
Step 1: Visit the Doctor
First things first, you’ll need to establish that it is truly gynecomastia that’s not giving you rest. It is not uncommon for natural body fat to be mistreated as male boobs. In rare cases, the lumps in your chest turn out to be tumors.
Visiting your family doctor or a certified physician will allow you to get to the root of the problem.
The doctor is likely going to:
- Look for physical symptoms. Doctors encounter gynecomastia all the time, and they know exactly what male boobs look and feel like. During the appointment, your doctor will conduct a visual and physical examination of your chest cavity. They’ll ask you about symptoms such as pain and swelling in the breasts, increased skin tenderness, and will look for lumps beneath the skin.
- Examine your health history. The medical community is well informed about the common causes of gynecomastia (some of them outlined in this article), hence they’ll look into your history of medical conditions for clues. They will also ask you about any medications you take, and any other symptoms you may experience. It is important that you share all of this information willingly with the doctors.
- Conduct a number of tests. Before finalizing their diagnosis, some doctors may ask you to do a few tests to make sure you indeed have gynecomastia. A mammogram will help them see underneath your skin and identify breast tissue. Blood tests will help establish your testosterone levels and other parameters. In some cases, an MRI or a chest X-ray may be performed for additional information.
This will lead to certain conclusions, such as:
- Whether or not you indeed have gynecomastia
- What is the root cause of the condition
- What would be the best approach to get rid of male breasts
Step 2: Medical Treatment and Lifestyle Changes
Although it may be tempting to jump straight into surgical breast reduction options, we highly advise on listening to what your doctor has to say about medications and lifestyle changes you may benefit from.
There’s a simple reason why: male breasts don’t just grow. They’re a symptom of a wider condition, which causes the hormonal disbalance in your body.
Hence, if you don’t consider medications or lifestyle changes, the surgery may not provide long-lasting results.
Based on your diagnosis, you may be offered a number of treatments:
- Testosterone therapy. While still relatively new, testosterone therapies have been proven extremely effective for a tens of thousands of men across the world. Multiple studies have found that exogenous testosterone administration in testosterone-deficient men restores muscle mass, libido and—you guessed it—body composition (which means it can help you get rid of man boobs.)
- Clomiphene. Often combined with reduction mammoplasty (surgical breast reduction), clomiphene has been both academically and clinically shown to be effective in dealing with gynecomastia. In this study of twelve boys aged 12-19, a three-month course of clomiphene resulted in a mean reduction of 36% in breast size.
- Tamoxifen (Nolvadex.) Another popular drug used to reduce male breasts is tamoxifen. During a trial study of 10 patients, 7 of the trial subjects experienced a significant reduction in breast tissue after a one-month course. It must be noted that this type of therapy is mostly used when gynecomastia presents severe pain for the patient.
- Danazol. A synthetic derivative of testosterone, danazol works for gynecomastia patients through its effects on the testes: it slows down the production of estrogen in male bodies, restoring the E-to-T balance in your body. However, due to its direct interaction with the hormonal system, it is less commonly used in therapy than other treatment measure.
It is important to remember that these treatment methods are often used in combination with reduction mammoplasty (surgical breast reduction), and not instead of.
Basically, the medications will help restore the hormonal balance in your body, while the surgery will provide an instant, dramatic benefit.
The end result is an instant, but lasting reduction of breast tissue in the man’s body.
It should also be noted that you’ll be advised certain lifestyle changes to help with your gynecomastia:
- Cut down on alcohol
- Quit recreational marijuana
- Exercise more
- Eat testosterone-boosting foods
- Balance out your diet
The medications will provide tangible results, but it’s the lifestyle changes that will turn your breasts back to normal for good.
Step 3: Explore Your Surgical Options
If you don’t want to sit around waiting for your meds and lifestyle changes to kick in, you can start exploring surgical options to produce dramatic change in the chest area.
Basically, there are two popular choices when it comes to surgical reduction of gynecomastia-induced breasts: ultrasonic lipoplasty and male breast reduction.
When Is Liposuction Enough?
Liposuction is a very simple procedure with minimum recovery time. Here’s how it goes:
- A small incision is made in the chest area
- A small cannula (tube) is placed into the fat deposit
- The fat is “suctioned out” of the body
The benefits of liposuction for gynecomastia patients are:
- Quick recovery time (2-3 days before returning to work in most cases)
- Very small incision—hence, the almost invisible scar
- Great incision-to-reduction value
Liposuction is usually enough when patients:
- Have developed only small breasts
- There is no significant skin stretching and sagginess
When Should You Go for a Full-on Male Breast Reduction?
For more pronounced cases of gynecomastia, you might need a full on breast reduction with tissue extraction and skin removal. Here’s how the procedure goes:
- A larger incision around the areola will be made (around the nipple)
- A significant amount of fatty tissue will be removed
- The excess skin will also be surgically removed
This procedure is best suited for a male who is experiencing significant breast development. Most patients will be able to return to work within 1 week after the surgery.
Full breast reduction is best suited for someone who:
- Has developed large, saggy breasts
- Has significant amounts of skin stretching and sagginess
Final Verdict: Surgery In Combination with Medications Will Provide Best Results
It may be tempting to visit the surgeon’s office first thing, but we’d like to emphasize the importance of restoring the hormonal balance in your body.
If you’re truly after a long-lasting change, it’s best to focus on treating the root cause of the problem, and using the surgery as a means to accelerate the process, but not the end solution.