Gynecomastia

Overview


Plain-Language Overview

Gynecomastia is a condition characterized by the enlargement of breast tissue in males. It involves the endocrine system, specifically the balance between male and female hormones. This condition results from an increase in estrogen activity or a decrease in androgen activity, leading to the growth of glandular breast tissue. It can affect one or both breasts and may cause tenderness or discomfort. While it is generally benign, it can impact self-esteem and body image. The condition is common during puberty and in older men due to natural hormonal changes. Other causes include certain medications, health conditions, and hormone imbalances.

Clinical Definition

Gynecomastia is defined as the benign proliferation of glandular breast tissue in males due to an imbalance between estrogen and androgen signaling. The core pathology involves increased estrogenic stimulation or decreased androgenic inhibition of breast tissue, leading to ductal and stromal proliferation. It is most commonly caused by physiological hormonal changes during neonatal, pubertal, or senescent phases, but can also result from drug effects, systemic diseases (e.g., liver cirrhosis, hyperthyroidism), or hormone-secreting tumors. Clinically, it presents as a palpable, firm, mobile subareolar mass that may be tender. Distinguishing it from pseudogynecomastia (fat deposition without glandular proliferation) and male breast cancer is essential. The condition is significant due to its impact on quality of life and potential indication of underlying pathology.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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