Gynecomastia causes

Gynecomastia is caused by a variety of factors, including medical conditions, medications, substance use, aging, and several others. However, at the core of these causes is the subject of hormonal imbalance. 

Fluctuations in testosterone and estrogen levels can upset the body’s balance, resulting in male breast development. Understanding this fundamental principle and the factors that contribute to it is crucial in effectively managing gynecomastia.

At the Boston Gynecomastia Specialists, we are here to help get you going in the right direction. Schedule a personalized consultation today to meet with our doctors.

What Causes Gynecomastia?

Gynecomastia stems from an imbalance of estrogen and testosterone. This involves an excess of estrogen, a deficiency of testosterone, or a combination of both. It is important to understand this imbalance when thinking about ways to reduce gynecomastia.

Enlargement of male breast tissue, which is frequently caused by this hormonal imbalance, is the main sign of gynecomastia.

Moreover, it’s essential to understand that in numerous cases, the root cause of gynecomastia remains unknown. In such cases, hormonal imbalance may not serve as the primary reason.

It is also important to consider that man boobs can also be caused by excess adipose (fatty) tissue in the breast. This can be a standalone issue (pseudogynecomastia), or it can frequently be an issue in combination with excess breast gland tissue. If excess fat accumulation is the only problem in your chest area, true gynecomastia causes may not be the primary culprit.

Male infants might experience transient gynecomastia due to residual estrogen passed from their mothers during pregnancy. This condition typically resolves over time.

During puberty, hormonal fluctuations can trigger temporary gynecomastia. Fortunately, this issue usually resolves within a span of six months to two years as the body adjusts to hormonal changes.

Substance abuse such as alcohol, methamphetamine, marijuana, heroin, and methadone.

Various medications, including but not limited to anti-androgens, HIV treatments, anabolic steroids, anti-anxiety medications, chemotherapy drugs, ulcer medications, heart medications, and specific antibiotics.

As men age, there’s a gradual decline in testosterone levels This is a common occurrence, particularly after the age of 50.

While steroids can elevate testosterone levels, the body might react by converting excess testosterone into estrogen.

High body fat percentage can result in heightened fat accumulation in the chest area and elevated estrogen levels.

Various health conditions can contribute to or worsen gynecomastia. These include hypogonadism, specific cancers, hyperthyroidism, kidney or liver failure, cirrhosis, and malnutrition or starvation.

Infancy and Puberty

Infant boys and adolescents entering puberty may experience transient gynecomastia.

In infants, this is attributed to residual maternal estrogen and typically resolves within a few months. For adolescents, hormonal fluctuations during puberty lead to the condition, which generally resolves within 6 months to 2 years.

Gynecomastia is common in adolescent boys. As many as 60% of teenagers will have some signs of gynecomastia by the age of 14. It is largely due to the hormonal changes we all undergo during puberty.

This is a typical phase of puberty, and the symptoms typically subside within a span of two years. However, in some instances, the symptoms of gynecomastia may persist. In these cases, surgical intervention to address the issue may be necessary.

Substance Abuse & Alcoholism

The excessive use of certain substances can lead to cases of gynecomastia. Such substances include heroin, methadone, marijuana, methamphetamine, and other members of the amphetamine family.
Another substance abuse problem that is noticeably more common than illicit drug usage is alcoholism.
Beer, in particular, plays a significant role due to its high content of phytoestrogens. These are plant-based compounds known for their estrogen-mimicking effects.
While not conclusively proven, some scientists speculate that excessive intake of phytoestrogens may result in effects similar to those induced by elevated levels of true estrogen.

Aging

As men age, there’s a gradual decline in testosterone levels. This process typically initiates around the age of 30 and persists throughout life.

Individuals over the age of 50 are especially susceptible to developing gynecomastia. It’s estimated that up to 65% of men in this age bracket may develop senior gyno.

Anabolic Steroids

Professional bodybuilders frequently experience gynecomastia due to the use of anabolic drugs.

These steroids encourage testosterone production, which in turn may cause the body to convert excess testosterone into estrogen. In many cases, this can lead to bodybuilder gynecomastia.

High Body Fat Percentage

Two main factors explain why there are more cases of gynecomastia in people with higher body fat. First, there is an accumulation of fat in the chest area, and second, enhanced estrogen levels increase the chance of breast gland tissue formation.

On top of that, heightened levels of fat also can cause a decrease in testosterone and an elevation in estrogen levels. This is facilitated by an enzyme called aromatase, responsible for converting testosterone into estrogen. 

This conversion takes place mostly in adipose tissue, which makes up around 85% of the process. Therefore, the more fat tissue there is, the more prominent the possible increase in estrogen levels.

Hypogonadism

Hypogonadism refers to a condition characterized by insufficient levels of androgens (the male hormones).

This insufficiency may result from a number of different things, such as radiation exposure, mechanical trauma, or medical disorders that harm the testes. Alternatively, it may result from impairment of the pituitary gland or hypothalamus.

Chronic Diseases

Disorders affecting the liver and kidneys, along with hyperthyroidism, have the potential to disrupt hormonal equilibrium. This can result in elevated estrogen levels and diminished androgens.

Additionally, hyperthyroidism can induce an upsurge in androgen levels, which paradoxically triggers a rise in estrogen. This occurs as the excess androgens undergo conversion by the body.

Prescription Medications

Many cases of gynecomastia can be attributed to the use of prescription medications. These include:

  • Ulcer medications
  • HIV medications
  • Antipsychotics
  • Antidepressants
  • Certain heart disease medications
  • Antiandrogens
  • Hypertension medications

Consult with your doctor to determine whether the medications you are taking could potentially decrease testosterone levels or elevate estrogen production. It’s crucial to remember that even if these side effects do occur, you shouldn’t automatically stop taking your prescription. Instead, staying informed enables you to handle any possible hormonal shifts with the right actions.

Contact a Boston Gynecomastia Surgeon

Whether you are in Boston or any surrounding areas, feel free to schedule an appointment at the Boston Gynecomastia Specialists and let us help you achieve your ideal results.

Our compassionate team is here to provide personalized care and effective solutions tailored to your needs. Schedule your personalized consultation with our Boston gynecomastia surgeon and take the first step towards addressing your gynecomastia.


The Boston Gynecomastia Specialists is the premier Greater Boston Gynecomastia Center of excellence. We prioritize delivering exceptional care from your initial consultation to your recovery and beyond. We deeply value the trust you place in us and are committed to upholding the highest standards of patient care. Our team, led by Dr. Edwin Ishoo, a board-certified surgeon specializing in gynecomastia treatment, is devoted to achieving optimal surgical results for each individual. Recognizing that every person is unique, we personalize our approach to meet your specific needs. Whether you have questions or are ready to schedule your personalized in-person consultation, please don’t hesitate to contact the Boston Gynecomastia Specialists today. We’re here to support you every step of the way!

Boston Gynecomastia Specialists
1260 Cambridge st
Cambridge, MA 02139
(888) 380-322