Causes of Gynecomastia

The male breast is not just a cutaneous appendage of the chest. This tissue has a highly differentiated structure, which is different from the female breast. The ducts of the milk glands are absent.

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Causes of Gynecomastia

The male breast is not just a cutaneous appendage of the chest. This tissue has a highly differentiated structure, which is different from the female breast. The ducts of the milk glands are absent. Lactotrophs and lipid-containing myoepithelial cells are present in the glandular tissue. The male breast varies considerably in size and shape from individual to individual and even from one side to the other within a person.

Male breast enlargement is a phenomenon that affects half of the male population. The term “gynecomastia” is used to describe benign breast hyperplasia in men, which is not caused by an underlying disease.

Male breasts usually consist of connective tissue and fat, but no mammary tissue. In puberty, gynecomastia occurs more frequently due to a temporary imbalance between estrogens and androgens. It occurs in newborns and older people as a result of normal hormonal changes in the body. Also certain diseases or drugs can lead to increased estrogen levels and thus to enlarged male breasts.

Gynecomastia is not an independent clinical picture, but is a symptom of a disturbed relationship between estrogens and androgens. The possible causes of this endocrine change are manifold. However, gynecomastia is a common, physiological normal variant in certain stages of life (in newborns, during puberty or in old age).

Gynecomastia is defined as the nonphysiological hypertrophy of the mammary glands in men. It therefore involves a change in the relationship between the female sex hormone estrogen and the male sex hormone testosterone.

About 70 percent of men suffer from gynecomastia at some point in their lives. In about 90 percent of cases it develops during puberty. However, it can also occur in older men. In many cases, however, this phenomenon is not noticed by those affected or they do not recognise its importance.

The most common cause of gynecomastia is puberty, which usually occurs during puberty at the age of 13 to 17 years. It has been shown that up to three quarters of those affected have typical symptoms such as swelling and tenderness of the breast tissue. In most cases it resolves spontaneously within two years without any medical treatment being required.

Gynecomastia is a common endocrinological disorder in men that occurs in newborns, during puberty, in old age and as a side effect of certain drugs. Gynecomastia can also be associated with various underlying diseases, such as tumors of the testes or adrenal glands, liver cirrhosis or hypogonadism. In about 15% of cases no cause can be found in the initial examination.

The first signs of gynecomastia are swelling and tenderness under one or both nipples due to the formation of breast tissue that has to be distinguished from fat deposits in the area (“pseudogynecomastia”) by palpation (palpation). The formation of breast tissue can also occur without tenderness and without visible changes (so-called “subclinical” gynecomastia). In very rare cases, the glandular tissue may also develop unilaterally.

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