Gynecomastia is swelling of brain tissue that is triggered by hormonal imbalance in men or boys. It may affect one or both the breasts and cause their abnormal or uneven development. Although low levels of testosterone and higher levels of estrogen is the chief cause in most of the conditions, this disease can be triggered by other underlying conditions. It usually goes away without any medications.

Signs and symptoms of gynecomastia:-

* Swollen and tender breast tissue
* Pain
* Nipple discharge from one or both the breasts

Causes:-

Hormonal changes where there is decrease in the levels of testosterone accompanied by increases production of the feminine hormone estrogen is the chief cause of Gynecomastia. This hormonal imbalance can be triggered by various factors.

Testosterone is a masculine hormone and estrogen is a female hormone. However, both the men and women produce these hormones, just in different quantities. Testosterone is associated with development of muscle mass, body hair and deepness of voice. On the other hand, estrogen is responsible for breast development in the women. Men usually produce estrogen in smaller quantities but if it is produced in higher than normal amount, it can lead to Gynecomastia.

1. Gynecomastia in infants: – This condition can also be observed in infants or newborns because of their contact with mother’s estrogen levels. However, the breast development goes away within 2-3 weeks after the birth.

2. Gynecomastia during puberty: – This condition may also be observed in adolescent boys on account of age related hormonal changes. Swelling of brain tissues usually disappears within 6 months to 1 year.

3. Gynecomastia in old age: – It is usually observed in the age group between 50 to 80 years. It affects at least one in four men.

Medications:-

1. Anti- androgens like flutamide used in the treatment of prostate cancer or enlargement
2. Androgens
3. Anabolic steroids
4. AIDS medications like Efavirenz
5. Anti-anxiety medications like diazepam
6. Ulcer medications
7. Medications to treat cancer/ Chemotherapy
8. Calcium channel blocker medicines
9. Antibiotics
10. Antidepressants
11. Heart medications

Substance abuse:-

1. Alcohol
2. Marijuana
3. Heroin
4. Methadone
5. Amphetamines

Health conditions and underlying diseases:-

1. Hypogonadism
2. Aging men who are overweight
3. Klinefelter syndrome
4. Pituitary insufficiency
5. Adrenal or pituitary tumors
6. Hyperthyroidism
7. Kidney failure
8. Liver failure or Cirrhosis
9. Malnutrition

Risk factors for Gynecomastia:-

1. Puberty
2. Older age
3. Using anabolic steroids or androgens
4. Liver and kidney diseases
5. Hypothyroidism
6. Hyperthyroidism
7. Klinefelter syndrome
8. Hormonal tumors

Diagnosis of Gynecomastia:-

Diagnosis is done with the help of physical exam of swollen breast tissue, abdomen and genital. Additional tests mentioned below may also be prescribed.

1. Blood tests
2. Mammograms
3. Tissue biopsies
4. CT/MRI scan
5. Chest X-rays
6. Testicular ultrasounds

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