Understanding gynaecomastia: what causes enlarged male breasts?

Understanding the causes of gynaecomastia is the first step in addressing the condition. At iQonic, we’re committed to helping you understand the underlying factors that contribute to gynaecomastia, including hormonal imbalances, medication side effects, and lifestyle influences.

Hormonal imbalances: the primary cause of gynaecomastia

Hormonal imbalances are the most common cause of gynaecomastia. The condition arises when there is an imbalance between the hormones oestrogen and testosterone in the male body. Oestrogen, which is responsible for the development of female breast tissue, is present in men in small amounts. However, when the levels of oestrogen become too high relative to testosterone, it can lead to the enlargement of male breast tissue.

• Puberty: During puberty, boys experience significant hormonal changes, and it’s common for gynaecomastia to develop during this time. In most cases, the condition resolves on its own as hormone levels stabilise.
• Ageing: As men age, testosterone levels naturally decline, and oestrogen levels may increase, leading to a higher risk of developing gynaecomastia. This is common in men over the age of 50.
• Health conditions: Certain health conditions, such as hypogonadism, hyperthyroidism, and tumours that affect hormone-producing glands, can also disrupt the hormonal balance, leading to gynaecomastia.

Medication side effects: how drugs can contribute to gynaecomastia

Several medications are known to cause gynaecomastia as a side effect. These medications can interfere with the hormonal balance in the body or directly stimulate breast tissue growth. Some of the most common medications associated with gynaecomastia include:

• Anti-androgens: Used to treat prostate conditions, anti-androgens can block the effects of testosterone, leading to a relative increase in oestrogen levels.
• Anabolic steroids: While anabolic steroids are often used to build muscle, they can also cause significant hormonal imbalances, resulting in gynaecomastia.
• Certain antidepressants: Some antidepressants, particularly those in the SSRI category, have been linked to gynaecomastia due to their effects on hormone levels.
• Heart medications: Drugs such as digoxin and calcium channel blockers, commonly prescribed for heart conditions, can sometimes lead to breast tissue enlargement.
• Antibiotics and anti-ulcer medications: Certain antibiotics and medications used to treat ulcers and acid reflux have been associated with gynaecomastia in some patients.

If you’re concerned that a medication you’re taking may be contributing to gynaecomastia, it’s important to discuss this with your doctor. They can help you weigh the benefits and risks of your medication and consider alternative treatments if necessary.

Lifestyle factors: how habits and choices can influence gynaecomastia

Lifestyle choices can also play a significant role in the development of gynaecomastia. Factors such as diet, exercise, and substance use can all impact hormone levels and contribute to the condition.

• Obesity: Excess body fat can lead to higher levels of oestrogen, as fat tissue can convert testosterone into oestrogen. This is why gynaecomastia is more common in overweight and obese men. Maintaining a healthy weight through diet and exercise can help reduce the risk.
• Substance use: The use of certain substances, such as alcohol, cannabis, and drugs like heroin and amphetamines, can interfere with hormone levels and increase the risk of gynaecomastia. Limiting or avoiding these substances can be beneficial for overall health and may help prevent the condition.
• Diet and nutrition: A diet high in processed foods, sugar, and unhealthy fats can contribute to weight gain, which is linked to gynaecomastia. Focusing on a balanced diet rich in whole foods, vegetables, and lean proteins can help support healthy hormone levels.

Treatment options

Pubertal gynaecomastia often settles on its own, and if a medicine is the cause your doctor may be able to review it. Where enlargement persists, surgery can remove the excess fat (liposuction, from £4,250) or the firm glandular tissue as well (excision, from £5,250).

See your GP promptly if you notice a new lump, especially on one side, or nipple discharge or skin changes, so that other causes can be ruled out.

At iQonic, gynaecomastia surgery is performed by Dr Ali Arnaout, who will assess your condition and recommend the most appropriate treatment for you. If you’re concerned about gynaecomastia and want to learn more about your options, contact us to schedule a consultation.