The mammary gland is laid in children of both sexes in the same way, but in adolescence, under the influence of female hormones - estrogens, iron takes on the form that we used to see in women. In men, it remains undeveloped.
Gynecomastia is a benign enlargement of the mammary (breast) gland in men. It is benign because, apart from a cosmetic defect, it does not bring any trouble to its owner. A malignant enlargement of the mammary gland is called “cancer”, 3–5% of those with breast cancer are men.
- True gynecomastia - the increase is due to the proliferation of glandular (milk-producing) gland tissue;
- False gynecomastia - occurs as a result of an increase in the amount of fatty tissue in the region of the mammary gland, and this is not gynecomastia in fact, simply because of an excess of fatty tissue during obesity, the breast becomes similar to the female.
True gynecomastia occurs as a result of an imbalance in the male body of male and female sex hormones in the direction of increasing the influence of the latter:
- Decreased blood levels of the male hormone - testosterone;
- Increasing the blood concentration of the female sex hormone - estrogen ;
- Disturbance of susceptibility of tissues to sex hormones. The content of hormones in the blood remains normal, but the sensitivity to testosterone decreases or the sensitivity to estrogen increases.
Stages of development
- The initial - lasts about 4 months. iron increases mainly not due to the multiplication of cells, but due to an increase in these cells in size. With adequate treatment, the process is reversible;
- Intermediate - active reproduction of glandular cells occurs. This stage continues from 4 to 8 - 10 months, full regression is not always possible, it all depends on the individual characteristics of the patient;
- Fibrous - connective tissue appears in the gland, fatty tissue grows around the glandular cells. The treatment is only surgical.
It is enough for the patient to look at himself in the mirror. The iron grows in size, the nipples swell, the male breasts look like a teenage girl.
1. Physiological gynecomastia. Appears in 60 - 80% of newborns from the effects of estrogen in the prenatal period. Independently passes during the first month of life.
2. Pubertal gynecomastia. It occurs in adolescence as a result of a temporary imbalance in the hormonal sphere. The most common form of this disease, in most cases, passes by itself and without consequences.
3. Symptomatic gynecomastia. Is a sign of any disease.
- Hormonally active tumors: testicles, adrenal glands, pancreas, pituitary, lungs and liver.
- Decreased production of testosterone (hypogonadism) - age-related hypogonadism, prostate adenoma, inflammation in the testicles, etc.
- Diseases causing a violation of the metabolism of estrogen and testosterone: hyperthyroidism (hyperthyroidism), diabetes, cirrhosis of the liver, renal or hepatic failure.
4. Medicinal gynecomastia. The mechanisms of imbalance between testosterone and estrogen when using drugs are very diverse, but the result is the same - an increase in the mammary gland. Gynecomastia may cause:
- antifungal drugs (ketoconazole);
- opiates (including methadone), amphetamine - so heroin addicts for the most part suffer from gynecomastia;
- anti-gastric ulcer - cimetidine, ranitidine;
- corticosteroids - the gynecomastia that they do not always cause is true, in some cases, because of these drugs, obesity occurs, which leads to false gynecomastia;
- alcohol, or rather alcoholism, is the cause of the toxic effect on the liver and the violation of the destruction of estrogen in it.
I will separately tell about one type of medicinal gynecomastia. It occurs when using anabolic steroids. At the same time, a part of the received drug “aromatizes” (chemical term) - turns into estrogen. For this reason, gynecomastia in bodybuilders taking androgenic pills is a side effect of their use.
Physiological gynecomastia does not require treatment, it passes by itself and without consequences.
Drug gynecomastia in most cases also passes without external intervention, with the abolition of the causative drug. But if the medication was taken for a long time, surgical treatment may be required.
Symptomatic gynecomastia requires finding and eliminating the cause, after which the need for surgical treatment is decided.
Restoration of hormonal balance with the help of drugs (androgens or antiestrogens) did not justify itself due to low efficiency and a large number of side effects.
Surgical treatment is used when the conservative is not effective. Do not forget that if a man’s chest looks like a woman’s, then this gives him serious mental discomfort, and the operation itself is not very complicated. After a well-performed mastectomy (removal of the mammary gland) recurrence usually does not occur, even if the cause is not eliminated.
Surgical treatment of gynecomastia - before and after
In case of false gynecomastia, besides total weight loss, liposuction may help, but after it the cosmetic effect may become worse than before.