Breaking Down Gynecomastia Symptoms, Causes and Risk Factors

gynecomastia symptoms

Gynecomastia is excessive male breast tissue swelling caused by a hormonal imbalance, particularly in testosterone and estrogen levels. While men primarily produce testosterone, a small amount of estrogen is also present.

In puberty or as testosterone levels decline with age, an elevated estrogen-to-testosterone ratio can result in enlarged breasts in Men.

Approximately half of adolescent boys and two-thirds of men over 50 experience this condition. If the enlargement is due to fat deposits instead of glandular tissue, it’s termed “pseudogynecomastia.”

Gynecomastia symptoms

The symptoms of gynecomastia include the following:

  • Enlargement of either one or both breasts.
  • Breast growth can occur uniformly or unevenly about the nipple.
  • The texture may be rubbery or firm.
  • Touching the breast or nipple may cause pain or tenderness.
  • A sign of gynecomastia could be the presence of a fatty tissue lump beneath the nipple, which may occasionally be tender or sore.
  • Breast swelling may occur unevenly, with one side becoming larger.
  • Discharge from the nipple of one or both breasts.

Gynecomastia causes

Causes of gynecomastia Include:

  • Early pubertyIn early puberty, boys may have a temporary hormonal imbalance with higher estrogen than testosterone levels, leading to gynecomastia.


  • Diseases and conditionsElevated androstenedione production from adrenal glands, increased conversion to estrogen, and reduced liver clearance of adrenal androgens results in decreased free testosterone. This hormonal imbalance, favouring estrogen, contributes to gynecomastia.


  • Male hypogonadism Primary hypogonadism results in reduced testosterone production due to insufficient sex hormone production.


  • Hyperthyroidism Hyperthyroidism elevates sex hormone-binding globulin, causing an increase in estradiol levels.


  • Maternal transfer Newborn boys may experience gynecomastia due to exposure to maternal estrogen transmitted through the placenta. Breast buds are standard in newborns and typically resolve by six months, although it may sometimes persist.


  • Certain cancers, like lung, pituitary gland, or adrenal gland tumours, can contribute to gynecomastia.
  • Obesity


  • Certain medications can cause gynecomastia, including:
  1. Anabolic steroids and androgens.
  2. Anti-androgens.
  3. HIV drugs.
  4. Anti-anxiety drugs.
  5. Heart medications.
  6. metoclopramide (Reglan)
  7. Ulcer drugs.

Risk factors for Gynecomastia

Several factors can elevate the risk of male gynecomastia, including:

Genetic risk factors include

 Klinefelter’s syndrome

Using several drugs, including:

  • Anti-androgens
  • Gonadotropin-releasing hormone (GnRH) agonists
  • 5-alpha reductase inhibitors

Diseases such as:

  • Testicular neoplasms
  • Liver and renal damage
  • Hyperthyroidism
  • Hypogonadism

Gynecomastia can occur during adolescence or in individuals aged 60 years and above.

Diagnosis of gynecomastia

The diagnosis is primarily made through physical examination and assessment of the patient’s symptoms.

Assessment for gynecomastia involves examining signs of feminisation, indicators of liver disease, regional lymph nodes, breast characteristics, overlying skin conditions, and thyroid evaluation.

To comprehensively assess the condition, your doctor may recommend various blood and radiology tests:

  • Kidney function test
  • Liver function test
  • Thyroid function tests
  • Serum levels evaluation, including testosterone (total and bioavailable), LH, FSH, prolactin
  • estrogen (oestradiol) measurement
  • Tumour markers for germ cell neoplasms (β-hCG)
  • Adrenal androgen levels assessment (serum DHEA-sulphate or urinary 17-ketosteroids)
  • A low-dose X-ray of the breast (mammogram) may be conducted to examine any abnormalities.

Gynecomastia treatment

Man boobs reduction treatment options:

Observation and Monitoring:

Gynecomastia may spontaneously resolve, especially during puberty, as hormonal imbalances often correct themselves. Medical intervention becomes essential if the condition persists or causes notable emotional distress in teenagers.

Medication Therapy:

In uncommon instances, medication therapies like Selective estrogen Receptor Modulators (SERMs) and Aromatase Inhibitors may be employed to regulate hormones and mitigate the growth of breast tissue in males with gynecomastia.

Surgical Intervention:

Typically, surgery is considered the aptest and almost permanent solution to gynecomastia. 

Gynecomastia surgery, or male breast reduction, involves removing excess glandular tissue and fat to achieve a more contoured chest. The procedure typically includes liposuction and excision techniques, providing effective and long-lasting results. 


This involves making a small incision, inserting a thin tube (cannula) to suction out fat, and often removing glandular tissue through the same incision. Liposuction alone is seldom practical, especially in moderate to severe cases.


Choose Professor Dr. Robert Heirner for male breast reduction surgery in Dubai

Dr. Robert Hierner, is a nationally and internationally renowned specialist in male breast reduction in Dubai, or gynaecomastia surgery in Dubai.

A highly distinguished plastic surgeon in Dubai, born in Germany, he has garnered an exceptional international reputation, particularly for his expertise in gynecomastia surgery in Dubai.

After completing certifications, specialisations, and fellowships across the UK, the US, Belgium, and Germany, he settled in Dubai.

Serving as an exclusive gynecomastia surgeon in Dubai, he brings over 30 years of extensive experience and a broad educational background from renowned national and international centres.

Famous for his professional skills, he is also the editor and author of a five-volume standard textbook for Plastic Surgery in German.

Book an appointment now.