Gynecomastia is a fairly common condition that involves enlargement of breast tissue in males. Most cases result from an imbalance in androgen and estrogen hormones due to a glandular disorder, steroid use, medication side effects, or cancer treatments. Since hormone levels fluctuate during puberty, it is often seen in boys between the ages of 10 and 18. When a specific cause is known, doctors can consider medications to boost androgen or suppress estrogen levels. Liposuction or breast reduction surgery is considered if medication proves an ineffective treatment for gynecomastia.
Treatment for gynecomastia is not always recommended for pubescent boys, as the condition often goes away on its own over the course of about three years. Hormones tend to come back into balance following puberty, and breast tissue becomes less prominent. If the condition worsens or persists for several years, doctors can conduct a series of tests to determine if a patient has an underlying medical problem.
Hypogonadism, a deficiency in testosterone and androgen production, is a common cause of gynecomastia in boys and adult males. Patients with the condition can usually benefit from medical remedies that stimulate testosterone production. Transdermal replacement therapy involves applying a patch or a gel to the skin that contains synthetic testosterone, which is continually released into the body to raise testosterone levels and promote higher natural hormone production. Parenteral therapy involves injecting testosterone directly into the body. With consistent treatment for gynecomastia, the breasts tend to shrink gradually over the course of several months or years.
If estrogen levels are higher than usual, treatment for gynecomastia usually entails daily oral medications to help regulate the hormone. Clomiphene is a drug that increases gonadotropin production in the pituitary gland, hormones that help to stabilize estrogen levels. Tamoxifen acts as an estrogen antagonist, preventing the hormone from stimulating breast tissue growth. These medications have proven very effective at relieving problems in as little as three months in most patients.
When medications are insufficient, surgical treatment for gynecomastia can be considered as well. Reduction mammoplasty, which is usually performed by a plastic surgeon, involves physically excising excess breast tissue. Liposuction is another option if high levels of fatty tissue are present in the breasts. It is possible for the breasts to begin growing again following such procedures, but most patients do not experience lasting problems. Occasionally, a surgeon will choose to perform a mastectomy to remove one or both breasts entirely, thereby preventing the condition from recurring.