Gynecomastia: Why Breast Tissue Grows in Men, and What Treatment Can — and Can't — Do
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
TL;DR: Gynecomastia is an increase in breast gland tissue in boys and men, caused by a hormone imbalance between estrogen and testosterone. It affects more than half of male newborns, is common during puberty, and appears in up to 65% of men aged 50 to 80 [1]. It often resolves on its own, but medicines, hormone-blocking drugs, and surgery are options when it does not [2].
Quick Answer: What Is Gynecomastia?
Gynecomastia is an increase in breast gland tissue in boys or men caused by an imbalance of estrogen and testosterone, affecting one or both breasts. More than half of male babies are born with it, and it affects about 24% to 65% of men ages 50 to 80. It often goes away; otherwise medicines or surgery may help. [1] [2]
What the research says
Watching and waiting is a guideline-backed first step. Clinical practice guidelines from the Italian Society of Andrology and Sexual Medicine, built on a systematic review and graded with the GRADE system, recommend observation for physiological or recent-onset gynecomastia, drug therapy only in selected idiopathic or painful cases, testosterone replacement only in men with proven hypogonadism, and surgery for long-standing fibrotic gynecomastia or significant psychological distress (Pozza et al., Journal of Endocrinological Investigation, 2026 [3]).
Some medicines raise the risk sharply. A meta-analysis of 14 randomized trials in 4,525 dialysis patients (13 using spironolactone, one using eplerenone) found that mineralocorticoid receptor antagonists raised the risk of gynecomastia and breast pain in men more than fourfold (risk ratio 4.23, p < 0.001) (Zhu et al., Renal Failure, 2026 [4]).
The emotional impact is real but poorly measured. A systematic review of 22 studies identified 23 patient-reported outcome measures for gynecomastia and compared 908 items across five domains. It found significant gaps in capturing quality of life and social outcomes, and its authors cite a lifetime prevalence of 65% (Vaile et al., Annals of Plastic Surgery, 2025 [5]).
What Is Gynecomastia?
In people assigned male at birth, the body mainly makes the sex hormone testosterone, along with small amounts of the hormone estrogen. Testosterone controls traits such as muscle mass and body hair. Estrogen controls traits that include the growth of breasts. Gynecomastia (guy-nuh-koh-MAS-tee-uh) can happen when the amount of testosterone in the body drops compared with estrogen [1].
Gynecomastia is an increase in the amount of breast gland tissue in boys or men. An imbalance of the hormones estrogen and testosterone causes it. It can affect one or both breasts, sometimes unevenly.
It is important to distinguish the condition from pseudogynecomastia, which is an increase in fat — not gland tissue — in male breasts. People with pseudogynecomastia, especially those with obesity, can have breast fat that looks like gynecomastia, but it is not the same condition [1].
Term | What It Means |
Gynecomastia | Increase in breast gland tissue caused by a hormone imbalance |
Pseudogynecomastia | Increase in breast fat, not gland tissue — often seen with obesity |
Normal ratio | Testosterone dominates in males; estrogen is present in small amounts |
Imbalance | Testosterone drops relative to estrogen, or estrogen rises |
Most often, gynecomastia is not a serious problem. But it can be tough to cope with. People with the condition sometimes have pain in their breasts, and many feel embarrassed [1].
Symptoms: What Gynecomastia Feels and Looks Like
Gynecomastia does not always cause symptoms. When it does, the signs center on the chest [1].
Symptom | Details |
Swollen breast tissue | Enlargement in one or both breasts |
Tender breasts | Tenderness to the touch |
Pain | Especially common in teenagers |
Sensitive nipples | Particularly when rubbing against clothes |
When to See a Doctor
Some chest changes deserve prompt medical attention. See a member of your health care team if you have swelling or tenderness, or any of the following [1]:
Warning Sign | Why It Matters |
Fluid from one or both nipples (nipple discharge) | May signal a condition other than simple gynecomastia |
A firm or hard lump | Raises concern for male breast cancer |
Dimpled skin on the breast | May signal a condition other than simple gynecomastia |
Pain or tenderness that persists | Worth evaluating regardless of cause |
Causes: Why Estrogen Outweighs Testosterone
The decrease in testosterone can be caused by conditions that lower testosterone or block its effects. Or it can be caused by conditions that raise the estrogen level [1].
Natural Hormone Changes
Gynecomastia appears at three natural stages of life, and each usually resolves on its own [1].
Life Stage | What Happens | Typical Outcome |
Infancy | More than half of male babies are born with enlarged breasts due to estrogen exposure during pregnancy | Swelling usually goes away within 2 to 3 weeks after birth |
Puberty | Hormone changes cause somewhat common gynecomastia | Most often resolves without treatment within 6 months to 2 years |
Adulthood (ages 50–80) | Hormone changes, especially in overweight men | About 24% to 65% of men in this age group are affected; most have no symptoms |
Medicines That Can Cause It
A surprisingly long list of prescribed medicines can cause gynecomastia by shifting the hormone balance [1].
Medicine Category | Examples |
Anti-androgens (for enlarged prostate or prostate cancer) | Flutamide, finasteride (Proscar, Propecia), spironolactone (Aldactone, Carospir) |
Anabolic steroids and androgens | Used for delayed puberty or muscle loss from another disease |
Antiretroviral medicines (HIV) | Estrogen-like properties, especially efavirenz |
ADHD medicines containing amphetamines | Adderall and similar products |
Anti-anxiety medications | Diazepam (Valium) |
Tricyclic antidepressants | Older class of antidepressants |
Some antibiotics | Various antibiotic types |
Opioids | Used to treat chronic pain |
Ulcer medicines | Nonprescription cimetidine (Tagamet HB) and omeprazole (Prilosec) |
Chemotherapy | Drugs used to treat cancer |
Heart medicines | Digoxin (Lanoxin) and calcium channel blockers |
Stomach-emptying medicines | Metoclopramide |
Recreational Drugs and Alcohol
Substances that can cause gynecomastia include alcohol, anabolic steroids used to build muscle and improve athletic performance, amphetamines, marijuana, heroin, and methadone (Methadose) [1].
Health Conditions
Certain health conditions that affect the balance of hormones can either cause or be linked with gynecomastia [1].
Condition | How It Shifts the Balance |
Hypogonadism | Lowers the amount of testosterone the body makes — examples include Klinefelter syndrome and pituitary insufficiency |
Aging | Hormone changes, especially in people who are overweight |
Tumors | Testicular, adrenal, or pituitary gland tumors can make hormones that shift the balance |
Hyperthyroidism | The thyroid makes too much of the hormone thyroxine |
Kidney failure | About half of people receiving dialysis develop gynecomastia due to hormone changes |
Liver failure and cirrhosis | Hormone changes and cirrhosis medicines are linked with gynecomastia |
Malnutrition and starvation | Testosterone levels drop while estrogen levels stay the same |
Herbal Products
Some plant oils used in shampoos, soaps, or lotions have been associated with gynecomastia. These include tea tree or lavender oil, likely due to compounds in the oil that may mimic estrogen or affect testosterone [1].
Risk Factors
The main factors that raise the likelihood of developing gynecomastia are summarized below [1].
Risk Factor | Notes |
Puberty | Natural hormone changes make it somewhat common |
Older age | Hormone levels shift with aging |
Obesity | Especially linked with gynecomastia in older men |
Anabolic steroid use | Used to improve athletic performance or build muscle |
Certain health conditions | Liver and kidney disease, thyroid disease, Klinefelter syndrome, and some tumors |
Complications
Gynecomastia has few physical complications. The bigger burden is often mental health: the condition may lead to mental health concerns due to changes in how the chest looks [1].
Diagnosis: Confirming It Is Gynecomastia and Not Something Else
To find out whether you have gynecomastia, a member of your health care team starts by asking questions about your symptoms and any medicines you take. You are also given a medical exam to check your breast tissue, stomach area, and genitals [2].
Tests then help find a possible cause, look for conditions with similar symptoms, and check for breast cancer [2].
Test | What It Involves |
Blood tests | Check hormone levels and overall health |
Mammograms | An X-ray of the breast |
CT scans | A series of X-rays taken from different angles |
MRI scans | Imaging that uses a magnetic field and radio waves |
Testicular ultrasounds | Sound waves create images of the testicles and surrounding tissue |
Tissue biopsies | A tiny piece of tissue is removed and checked in a lab |
Conditions That Can Mimic Gynecomastia
Your health care team will confirm that the breast swelling is gynecomastia and not another condition [2].
Condition | How It Differs |
Pseudogynecomastia (fatty breast tissue) | Breast fat that looks like gynecomastia, especially with obesity — more testing is not needed once diagnosed |
Breast cancer | Uncommon in men, but possible; one-breast enlargement or a firm lump raises concern |
Mastitis | Inflamed breast tissue that sometimes involves an infection |
Lipoma | A slow-growing, fatty lump that is not cancer |
Treatment: From Watchful Waiting to Surgery
Gynecomastia often goes away over time without treatment. If it is caused by a medical condition, that condition may need treatment. If you take a medicine that may be the cause, ask your health care team about your choices — the doctor may have you stop the medicine or try a different one [2].
Teenagers often need no treatment at all. A teen's health care team may recommend checkups every 3 to 6 months to see if the condition is improving on its own. Gynecomastia in teens often goes away without treatment in less than two years [2].
Treatment may be needed if gynecomastia does not improve on its own, or if the condition causes pain, tenderness, or embarrassment [2].
Medicines Used for Gynecomastia
Medicines used to treat breast cancer and other conditions may help some adults with gynecomastia [2].
Medicine | Notes |
Tamoxifen (Soltamox) | Used for breast cancer; may help gynecomastia |
Raloxifene (Evista) | Used for breast cancer; may help gynecomastia |
Aromatase inhibitors, such as anastrozole (Arimidex) | Blocks estrogen production |
In the United States, these medicines are approved by the Food and Drug Administration. However, they have not been approved specifically for use in people with gynecomastia [2].
Surgery to Remove Extra Breast Tissue
You may still have enlarged breasts after waiting for gynecomastia to go away on its own or after taking medicine for it. If appearance or other symptoms bother you, surgery may be a treatment choice [2].
Surgery Option | What It Removes | Key Points |
Liposuction | Removes breast fat, but not the breast gland tissue itself | Fat-focused removal |
Mastectomy | Removes the breast gland tissue | With smaller amounts of gland tissue, small incisions may be used, which lessens recovery time |
Combined approach | Liposuction and mastectomy together | Sometimes the two procedures are combined |
Coping and Support: Managing the Emotional Side
For people with gynecomastia, having enlarged breasts can be stressful and embarrassing. The condition can be hard to hide. Sometimes it is a challenge to romantic relationships. During puberty, gynecomastia can make teens a target for teasing from peers, and it can make activities such as swimming or changing in the locker room traumatic [2].
Whatever your age, if you have gynecomastia, you might feel unhappy with your body. The following steps may help [2].
Coping Step | How It Helps |
Get a checkup | Some people worry their symptoms come from a more serious condition; it can be a relief to learn that gynecomastia is the cause |
Get counseling | Talk therapy can help manage anxiety or depression caused by gynecomastia, and help you talk with your partner or family members so they understand what you are going through |
Reach out to family and friends | It may feel embarrassing to talk about it, but explaining your situation and asking for support can strengthen relationships and ease stress |
Connect with others who have gynecomastia | It might feel good to talk with people who understand what you are going through; websites such as Gynecomastia.org can help you connect |
Prevention: What You Can Control
Several factors within your control may lower the risk of gynecomastia [1].
Prevention Step | Recommendation |
Avoid recreational drugs | Do not use anabolic steroids, amphetamines, heroin, or marijuana |
Limit or avoid alcohol | It helps not to drink; if you do drink, keep it to no more than two drinks a day for men |
Review your medicines | Ask your health care team if any medicine you take can contribute |
Skip estrogen-mimicking oils | Tea tree and lavender oil in shampoos, soaps, or lotions have been associated with gynecomastia |
Conclusion: Usually Harmless, Sometimes Treatable
Gynecomastia is far more common than most men realize — it touches more than half of male newborns, appears during puberty for many teenagers, and affects up to 65% of men between 50 and 80. In most cases it causes no symptoms and resolves on its own without any treatment.
The key is a proper medical evaluation. A firm lump, nipple discharge, or dimpled skin can signal something more serious than gynecomastia, and blood tests and imaging can confirm what you are dealing with. If the condition persists and causes pain, tenderness, or embarrassment, effective options exist — from adjusting medicines to hormone-modulating drugs and surgery.
If you notice breast swelling or chest changes, schedule an evaluation with your health care team rather than assuming it will simply pass.
Frequently Asked Questions
What is gynecomastia?
Gynecomastia is an increase in the amount of breast gland tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. It can affect one or both breasts, sometimes unevenly. It is different from pseudogynecomastia, which is an increase in breast fat rather than gland tissue.
How common is gynecomastia?
It is very common across all ages. More than half of male babies are born with it (usually resolving within 2 to 3 weeks after birth). It is somewhat common during puberty, and about 24% to 65% of men ages 50 to 80 have it, though most adults with the condition have no symptoms.
What causes gynecomastia?
It develops when testosterone in the body drops compared with estrogen — through natural hormone changes (infancy, puberty, aging), certain prescribed medicines, recreational drugs and alcohol, health conditions such as hypogonadism, hyperthyroidism, kidney failure, or liver cirrhosis, or plant oils like tea tree and lavender.
Does gynecomastia go away on its own?
In many cases, yes. Breast swelling in infants usually resolves within 2 to 3 weeks after birth, and gynecomastia in teenage boys often goes away without treatment in less than two years. Adults may need medicine or surgery if it does not improve.
Is gynecomastia the same as breast cancer?
No, but some signs overlap. Breast cancer is uncommon in men, yet enlargement of one breast or a firm, hard lump raises concern for male breast cancer. Nipple discharge and dimpled skin also warrant prompt evaluation. A doctor can confirm the cause with exams, blood tests, and imaging.
What is the difference between gynecomastia and pseudogynecomastia?
Gynecomastia is an increase in breast gland tissue caused by a hormone imbalance. Pseudogynecomastia is an increase in breast fat only, often seen in people with obesity. It is not the same condition, and once pseudogynecomastia is diagnosed, more testing is usually not needed.
Can medicines cause gynecomastia?
Yes. A wide range of medicines can cause it, including anti-androgens (finasteride, spironolactone), HIV antiretrovirals like efavirenz, ADHD amphetamines, anti-anxiety drugs like diazepam, tricyclic antidepressants, some antibiotics, opioids, nonprescription ulcer medicines (cimetidine, omeprazole), chemotherapy, heart medicines, and metoclopramide.
How is gynecomastia treated?
Often no treatment is needed — teens are typically monitored with checkups every 3 to 6 months. If a medicine is the cause, stopping or switching it may help. For persistent or distressing cases, doctors may use tamoxifen, raloxifene, or aromatase inhibitors such as anastrozole (approved medicines, but not approved specifically for gynecomastia), or surgery via liposuction, mastectomy, or both.
Is gynecomastia surgery worth it?
Surgery is a treatment choice when enlarged breasts persist after watchful waiting or medicine, and appearance or symptoms bother you. Liposuction removes breast fat but not gland tissue, while mastectomy removes the gland tissue — often through small incisions that shorten recovery. The two can also be combined.
How can I reduce my risk of gynecomastia?
Avoiding anabolic steroids, amphetamines, heroin, and marijuana, and limiting alcohol to no more than two drinks a day, may lower your risk. It also helps to review your medicines with your doctor and avoid plant oils such as tea tree or lavender in shampoos, soaps, or lotions.
References
Mayo Clinic Staff. Enlarged breasts in men (gynecomastia) - Symptoms and causes. Mayo Clinic. October 26, 2023. https://www.mayoclinic.org/diseases-conditions/gynecomastia/symptoms-causes/syc-20351793
Mayo Clinic Staff. Enlarged breasts in men (gynecomastia) - Diagnosis and treatment. Mayo Clinic. October 26, 2023. https://www.mayoclinic.org/diseases-conditions/gynecomastia/diagnosis-treatment/drc-20351799
Pozza C, Selice R, Barbonetti A, et al. Management of gynecomastia in adolescence and adults: the clinical practice guidelines from the Italian Society of Andrology and Sexual Medicine (SIAMS). Journal of Endocrinological Investigation. 2026;49(10):2583-2610. PMID 42258023. https://doi.org/10.1007/s40618-026-02915-2
Zhu Y, Li J, Huang Z, et al. Mineralocorticoid receptor antagonists in dialysis patients after ACHIEVE and ALCHEMIST: updated systematic review and meta-analysis of 14 randomized trials. Renal Failure. 2026;48(1):2656561. PMID 42056760. https://doi.org/10.1080/0886022X.2026.2656561
Vaile JR, Cordray H, Terry PH, et al. Content and readability analysis of patient-reported outcome measures for gynecomastia: a systematic review. Annals of Plastic Surgery. 2025;95(6):744-751. PMID 41263895. https://doi.org/10.1097/SAP.0000000000004482
Further Reading and Credible Sources
For readers who want authoritative reference material on gynecomastia and related hormone conditions, the following organizations publish reliable, regularly updated patient information:
This article is for general informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about any medical condition.
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