Gynecomastia is an enlargement or swelling of breast tissue
in males. It is most commonly caused by male estrogen levels that are too high or are out of balance with testosterone levels.
WHAT IS GYNECOMASTIA?
Gynecomastia can be defined as a condition in which the breast tissue in men overdevelops and sometimes grows unevenly. This is as a result of hormonal imbalances in the body that is responsible for sexual characterize. This usually occurs during puberty or adolescence hood, although it can occur in babies and elderly men, it is more prevalent in teen boys.
It is estimated to affect over 40-60% of teen boys, affects one or both breasts, and could be quite embarrassing to talk about it because of the societal stigma. They may experience slight pain. This could go away without treatment. 1 in 4 men around the age of 50 and 69 develop this condition with about 60%- 90% in children, 50%-60% in adolescents, and 70% in older men. It could be possible for one to have most symptoms of gynecomastia but have pseudo gynecomastia.
What is Pseudogynecomas?
This is the accumulation of excess fatty tissue around the breast, giving it a puffy and swollen look. This can be improved with exercise, and any means of weight loss, although in some cases it may be futile, as the fat may be resistant to the weight loss.
Gynecomastia In Infants
Gynecomastia occurs in infants due to the estrogen effect of the mother, hence the breast of the mother is swollen. It goes away after two to three weeks after birth
Gynecomastia During Puberty
This is the prevalent type of gynecomastia. It occurs due to the low level of testosterone and its activity in the male. The male produces a small amount of estrogen but when the estrogen level increases above normal, resulting in an enlarged breast. In most cases, this will disappear within 6months without treatment.
RISK FACTORS OF GYNECOMASTIA
The risk of gynecomastia include:
COMPLICATIONS OF GYNECOMASTIA
The complications of gynecomastia could result in psychological and emotional conditions due to societal stigma.
When To See The Doctor
You should see the doctor when:
- Increase in age
- Bodybuilding drugs that contain steroid
- Underlying diseases
- The swellings around the breast increases
- Increase in pains around the nipple
- Nipple discharge.
Most cases of gynecomastia resolve over time without treatment. But the underlying condition that causes the disorder may be treated. Underlying causes of gynecomastia may be hypogonadism, malnutrition, or cirrhosis. In situations where there is no apparent cause of gynecomastia other than normal hormone changes, the doctor may recommend periodic reevaluations, every 3 to 6 months to see if they will improve on their own.
Your doctor may recommend stopping any medication you are taking that promotes gynecomastia or substituting another medication. Gynecomastia often goes away without treatment in less than 2 years. Treatment may be necessary if its symptoms persist.
Medication used to treat breast cancer and other conditions may be of help for some men with gynecomastia. Such medications include:
- Medical and drug history
- Family history
- Physical exam. Evaluation of your breast tissue, abdomen, and genitals.
If gynecomastia does not respond to initial treatment, surgical procedures may be recommended.
Two surgical options for gynecomastia are:
- Danazol. A synthetic derivative of testosterone
- Tamoxifen (Sottamox)
- Clomiphene. It can be taken for up to 6 months.
- Aromatase inhibitors such as anastrozole (Arimidex)
- Testosterone replacement has been effective in older men with low levels of testosterone, but not effective for men with normal levels of the male hormone.
TREATMENT OF GYNECOMASTIA
The surgery involves the surgical removal of the excess fat. It usually involves liposuction of the excess fat. An incision is made in the margin of the nipple after the proper examination has been made and the presence of gynecomastia has been confirmed.
While preparing for surgery,
- Liposuction. This type removes the breast fat, not the breast gland tissue itself.
- Mastectomy: It removes the breast gland tissue. The surgery is always done using only small incisions. It has recovery time.
- Avoid medications that might cause bleeding during surgery
- Avoiding smoking while waiting for surgery
- Improve diet and nutrition
- You will be administered anesthesia or oral sedation
- Then an incision is made in the breast region and the excess fat is removed
- a drain is used to reduce the chance of fluid collections
- a compression vest is used to reduce the pain and reduce swelling
- you might need to avoid drinking after surgery
- you will be given pain medications
RECOVERY AFTER SURGERY
Cases involving liposuction, have a higher rate of recovery as you can recover within days. When surgery is used to remove the fat, it takes approximately, two to four weeks for healing to be complete.
COMPLICATIONS OF GYNECOMASTIA SURGERY
Although gynecomastia has a high recovery rate, complications can still occur and it involves
- you will need to rest after the surgery
PREVENTION OF GYNECOMASTIA
Gynecomastia can be prevented by:
- Fluid collections
- Loss of nipple skin
- Visible scarring
- Numbness of the nipple.
- Avoiding the risk of medications that contain steroids, androgens, etc,
- Avoid alcohol
- Avoid smoking
The symptoms of gynecomastia include:
- Pains and tenderness of the nipple
- Increase in swelling of the breast
- A rubbery lump feels on the nipple when touched.
• Pain or tenderness.
• Nipple discharge in one or both breasts.
The causes of gynecomastia vary but the primary cause of gynecomastia is a hormonal imbalance of estrogen and testosterone, which is When there is a decrease in testosterone and an increase in estrogen.
Other causes include:
- Genetic mutation
- Medications that contain steroids for bodybuilding
- Medications for the heart and stomach
- Any conditions that reduce the activity of testosterone
- Some times mental conditions also
- Alcohol, marijuana, heroin, could cause it.
- Underlying health conditions such as hypogonadism, hyperthyroidism, kidney failure, liver conditions, etc
- Malnutrition and poor diet
• cirrhosis of the liver,
• chronic kidney failure,
• disorders of the testes (male sex organs) including infection, trauma, or inborn disorders,
• testicular cancer,
• anti-androgen treatments for prostate cancer, and.
Does gynecomastia go away?
Generally, the swollen breast tissue goes away within 2 or 3 weeks after birth. Gynecomastia caused by hormone change during puberty is relatively common. In most cases, the swollen breast tissue will go away without treatment within 6 months to 2 years.
How do I know if it’s gynecomastia or fat?
To the touch, it feels like a rubbery lump under the nipple affecting one or both indicative appearance includes a resemblance to that of a woman’s breast.
What is the best medicine for gynecomastia?
Gynecomastia may be treated with medications, such as raloxifene (Evista) and tamoxifen (Sottamox).
What are the stages of gynecomastia?
Grade I: Small enlargement without skin excess.
Grade II: Moderate enlargement without skin excess.
Grade III: Moderate enlargement with minor skin excess.
Grade IV: Marked enlargement with excess skin mimicking female breast ptosis.
How does gynecomastia feel?
The main symptoms of gynecomastia are enlarged breasts. Your breasts may be tender as well. You may feel a slight bump or lump behind the nipple. gynecomastia?