Gynecomastia causes are several and typically involve a combination of weight gain and history of hormone imbalance. The main hormonal imbalance involves the imbalance between testosterone and estrogen. The exact cause is a combination of low testosterone and high estrogen.
The imbalance of these two hormones routinely occurs during puberty as evidenced by a large number of gynecomastias in teenagers. The next peak in gynecomastia occurs after the age of 50 when men tend to undergo decreased testosterone production that is associated with decreased libido.
The next most common cause of testosterone and estrogen imbalance is related to the consumption of marijuana. Marijuana encourages your body to increase estrogen production which directly stimulates the breast glands to grow. Another supplement that was popular until a few years ago amongst bodybuilders was exogenous androgen taken to stimulate muscle growth.
A final common culprit has been extreme alcohol intake. Miscellaneous medications that increase, reduce, or block the action of testosterone include prostate enlargement, prostate cancer, certain antibiotics, stomach ulcer medications, and/or depression medications. Finally, rare endocrinological causes can be a cause of gynecomastia.
Gynecomastia patients must undergo a comprehensive evaluation of gynecomastia causes prior to undergoing gynecomastia surgery. This includes an evaluation by their primary care physicians to complete a breast examination. They also need a thorough interview to appreciate any history of taking drugs, supplements, and/or drugs that need to be stopped prior to undergoing surgery.
Next, laboratory workup is necessary to not only evaluate hormone levels but also to rule out other causes of elevated estrogen such as certain cancers. If patients present with breast pain, they may consider an MRI to rule out breast atypia or cancer.
Finally, gynecomastia patients must undergo an examination by Dr. Mowlavi to document their gynecomastia causes and characterize their gynecomastia signs and breast changes. This will help customize their unique gynecomastia surgery in order to optimize their gynecomastia surgery outcome.
Please see this 33-year-old male underwent bilateral gynecomastia repair to improve breast appearance when wearing road bike attire.