Gynecomastia describes the enlargement of male breast tissue, you’ve no doubt heard this embarrassing condition referred to as manboobs.

Gynecomastia, or gyno for short, often results from a natural hormonal imbalance during puberty or later in life as we age and lose testosterone, or as a direct result of hormonal treatments or therapies to replace or enhance testosterone.

While rarely medically threatening, gynecomastia can be extremely embarrassing.

Causes of Gynecomastia

Gynecomastia may occur during four distinct stages of a man’s life:

  • As an infant. Many infants are born with enlarged breasts or nipples related to their mother’s estrogen levels. This swelling will often subside two to three weeks after birth.
  • During adolescence and puberty. This period before and during puberty is known as a time of “raging hormones” and the imbalances of testosterone and estrogen may cause a temporary swelling of breast tissue in boys. Over time (6-18 months) this temporary gynecomastia will resolve itself without treatment.
  • As an adult. Swollen breast tissue and breast mass in male adults may be caused by prescription medications like antibiotics, antidepressants, anti-anxiety medications, chemo drugs, heart medications or androgens and steroids and similar performance enhancing drugs. Additional causes include alcohol and drug abuse.
  • As an older adult (50-80). The occurrence of gynecomastia increases as testosterone levels fall secondary to aging, especially in overweight or underweight men. These hormonal changes cause changes in tissues, glands and fat storage which all contribute to breast mass. Weight loss and muscle wasting in men of advanced age also contribute.


Health Conditions That Contribute to Gynecomastia

There are a number of chronic health conditions that adversely affect normal hormone balance and may contribute to gynecomastia, including the following.

  • Kidney failure and hemodialysis interfere with the production and release of many beneficial hormones, and those that are released are filtered and altered in the blood stream during necessary dialysis treatments.
  • Hypogonadism or the reduced production of testosterone by the testes will greatly increase the risk of breast enlargement in men.
  • Hyperthyroidism causes an overproduction of thyroxine, speeding up your metabolism and changing the delicate balance between estrogens and testosterone. This leads to an increase in female traits including breast tissue.
  • Tumors of the testes or glands, specifically the adrenal glands or pituitary gland, can alter hormone production and hormonal balance leading to female traits in males.
  • Liver disease including cirrhosis of the liver will cause hormone swings directly related to liver dysfunction and medications taken for cirrhosis increase gynecomastia risks.
  • Poor diet and malnutrition may contribute to gynecomastia as your body needs the right combination of nutrients to produce and maintain your testosterone levels. Add to that the increasing estrogen levels in processed foods like soy, sugar, dairy, and soy-fed meats and your estrogen levels rise as your natural testosterone falls, resulting in breast mass.

Gynecomastia Treatments

Treatments vary according to the underlying cause of the breast tissue formation.

  • Gynecomastia caused by hormonal imbalances experienced by adolescent boys between the ages of 9-14 need not be treated as the imbalances will correct themselves during or soon after puberty.
  • Gyno caused by the natural loss of testosterone as we age and the resulting hormonal imbalances and increase in estrogen can be partially offset by a strict diet eliminating foods containing estrogen and estrogen mimics combined with regular moderate exercise.
  • Breast mass caused by the long term use of anabolics (steroids) experienced by athletes or bodybuilders is often more permanent and may require more advanced treatments including surgery.

Gynecomastia in Bodybuilders

What causes gynecomastia in bodybuilders?

Athletes, weightlifters, and bodybuilders may be drawn to anabolic steroids including testosterone or synthetic testosterones in an effort to increase strength and muscle mass.

Steroids increase strength and the ability to build muscle tissue and enhance the anabolic state, helping the body produce energy and convert nutrients to cells and tissue. Training while using steroids will allow you to lift more weight, work longer and harder and literally promote anabolic growth.

Unfortunately, using these anabolics, which include testosterone, causes unnatural levels of hormones in your body, resulting in serious imbalances. If you are injecting testosterone into a body that is producing its own level of the hormone, your body will eventually reduce the amount produced naturally.

Your body becomes confused by the imbalances and may increase the small amount of estrogen in your body to offset the increased testosterone.

High levels of testosterone can cause high levels of estrogen, and estrogen increases breast tissue, fat storage and similar female traits. Additionally, at the end of your anabolic cycle, as you stop your injections your testosterone level drops dramatically as your estrogen level, which may lead to even more breast tissue formation.

Breast tissue and breast mass caused by steroid use and the resulting estrogen imbalance is very often permanent and can only be corrected by surgical removal.

This is not simply accumulated fat that can be removed through diet or exercise, only surgery.

Surgical Solutions for Gynecomastia

Bodybuilders’ gynecomastia surgery options include:

  • Liposuction – using tubes and suction to remove fat and breast tissue below the nipple. This is often the first choice for removal of mild gyno symptoms. More advanced stages require surgical incision.
  • Mammaplasty Surgery or Mastectomy – using a small incision around the areola (nipple), the breast and glandular tissues are removed. This advanced, more radical procedure is necessary if the breast tissue is hard and liposuction is unsuccessful.

Post-surgery, many bodybuilders now wear custom fitted vests provided by their plastic surgeons to help promote healing and shaping of the chest. Demand for gynecomastia surgery is growing, and according to the American Society of Plastic Surgeons, it was the fourth most popular men’s cosmetic surgery procedure in 2015.

Avoiding Gynecomastia

What steps can bodybuilders take to reduce their risk of gynecomastia?

Gynecomastia affects nearly one in three adult males. While not a great health risk, male breasts can be embarrassing.

You can reduce your risks by avoiding the temptation of anabolic steroids, limiting your consumption of alcohol and drugs, exercising regularly and limiting or eliminating estrogen promoting foods like dairy and soy from your diet.

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