Treatment options for gynecomastia

Gynecomastia, otherwise known as male breast enlargement, is a lot more common than people might think. It’s found in about a third of the U.S. male population and about 65% of boys undergoing puberty get it in some form.

There are varying levels of severity for gynecomastia. In very extreme cases, a man will develop a full breast, but even milder cases can be a cause of social distress, especially among adolescents who may be embarrassed or bullied by their peers.

How is gynecomastia treated?

Although most often the reasons for development of gynecomastia remain unknown, it can be caused by hormonal imbalance between circulating male and female hormones, so the first step in treating gynecomastia is determining the reason for this imbalance. 

The first thing we check for is the possibility of pituitary, adrenal or testicular tumors that may be causing a hormone imbalance. In these cases, the gynecomastia is more of a symptom of an underlying issue, and it should resolve when the underlying condition is treated.

Often, the hormone imbalance is a natural aspect of a certain developmental stage, which is why gynecomastia is so common among boys undergoing puberty. In cases like this, the main treatment is simply to monitor the situation, as it’ll usually resolve itself within a year. However, surgical intervention, such as liposuction, may be considered if the patient’s situation is severe – either in terms of physical characteristics or mental health risk.

If there’s a hormonal imbalance that isn’t caused by a tumor or a developmental stage, the patient should see an endocrinologist to assess and correct the hormone imbalance, often with medical treatment. Once the hormone imbalance is treated, the gynecomastia should resolve.

Certain medications and recreational drugs, such as marijuana, can cause gynecomastia as a side effect. The gynecomastia should resolve itself when the patient is taken off the medication or stops using the drug.

Overall, observation and reassurance are the first line of treatment after ruling out immediate risks. Surgical intervention is usually unwarranted, although in some situations it’ll be both indicated and appropriate.

When should you see a doctor?

It’s never a bad idea to see the doctor just to make sure it’s not a symptom of something more serious.

Jeffrey Janis is a plastic surgeon at The Ohio State University Wexner Medical Center.