What Causes Gynecomastia in Puberty?
Gynecomastia can happen when a boy has too much breast tissue during puberty because of too much estrogen or not enough testosterone. It is a normal — and usually short-lived — state to be in, but one that can be difficult for teenagers. However, understanding more regarding why gynecomastia occurs during puberty can calm many concerns and also recognize when it's required to seek clinical advice.
Gynecomastia during Puberty: What You Need to Know
Gynecomastia is an imbalance between estrogen (the female hormone) and testosterone (the male hormone). Gynecomastia in Puberty means hormone levels are all over the place, and in some boys, estrogen levels briefly exceed those of testosterone, resulting in some breast tissue developing.
Note that gynecomastia is not to be confused with pseudogynecomastia, caused by obesity and excess fat deposits in the breast area. Gynecomastia also involves genuine glandular breast tissue enlargement, not only fat.
What mainly causes gynecomastia in puberty?
Hormonal Imbalance
Most of the time, gynecomastia in puberty is a temporary hormonal imbalance. The body goes through a whole lot during the stage of adolescence in a bid to get ready for adulthood.
While testosterone levels vary, estrogen levels, in some cases, rise above normal.
This extra estrogen causes breast tissue to grow.
As puberty advances, testosterone production normalizes, and the condition typically corrects itself.
When to Seek Help:
If gynecomastia does not resolve after two years.
If it brings about pain, tenderness, or emotional turmoil.
Obesity and Excess Fat
Gynecomastia is associated with hormonal imbalances, however excess fatty tissue can lead to the problem. Fat tissue produces an enzyme called aromatase that converts testosterone to estrogen.
Higher estrogen levels due to being overweight in boys may contribute to breast tissue development.
Obesity may also cause pseudogynecomastia, a phenomenon which describes fat deposit in the chest area that resembles development of breast tissue.
Prevention & Management:
Exercising and eating a healthy diet can help maintain a healthy weight, which may prevent gynecomastia.
Losing weight can help get rid of chest fat, but it won’t eliminate the glandular tissue in true gynecomastia.
Medications and Drugs
When teenagers use certain drugs, substances, and medications, hormonal balance may be disrupted and gynecomastia can result.
Common Medications that May Lead to Gynecomastia:
- Antidepressants and anti-anxiety medications
- Steroids (especially the anabolics,[2] commonly used for bodybuilding)
Certain antibiotics
- Drugs for ulcers, acid reflux, or epilepsy
- Things Which Can Lead To Gynecomastia:
- Marijuana
- Alcohol
- Recreational drugs, like heroin and amphetamines
What to Do:
If a teen is taking one of these medications and has gynecomastia, consult with a doctor about alternatives.
We do know that they prevent hormone imbalances by avoiding steroids and recreative drugs.
Genetics and Family History
Gynecomastia has a genetic component. These include having a close male relative, such as your father or an uncle, who had gynecomastia during puberty.
This doesn’t necessarily mean gynecomastia is inherited, but it does suggest that the genetic makeup of some boys might make them particularly sensitive to hormonal fluctuations.
Can It Be Prevented?
Genetics cannot be altered, therefore the disease should be monitored early, and a healthy diet can reduce the severity of symptoms.
Liver or Kidney Conditions
Gynecomastia can also be linked to underlying medical conditions, but those are less common in teens.
Liver disease alters the metabolism of hormones, leading to excess estrogen.
Kidney disease or being on dialysis can balance hormones out of whack.
When to Be Concerned: Gynecomastia in Puberty
Seek a doctor’s advice if gynecomastia occurs with unexplained weight loss, fatigue or swelling.
Hormonal Disorders (Endocrine Disorders)
Hormonal imbalance occurs when there is a disruption in the endocrine system responsible for the production of hormones, which is the cause of gynecomastia.
Endocrine Disorders That Commonly Cause Gynecomastia:
- Underproduction of testosterone (hypogonadism)
- Thyrotoxicosis (excessive thyroid hormone raises estrogen levels)
- Disorders of the pituitary gland (which regulates hormones)
What to Do:
If gynecomastia is severe and persists, hormone tests may be necessary to look for endocrine disorders.
Nutritional Deficiencies and Unhealthy Eating
- Nutrient deficiencies due to a poor diet have consequences on hormones.
- Malnourishment or undergoing extreme dieting will lower levels of testosterone, allowing estrogen to take a stronger lead.
- Soy (which contains phytoestrogens) could have a minor effect on our estrogen levels, but not much.
Solution:
A balanced diet including proteins, healthy fats and vitamins promotes a healthy hormone environment.
Chronic Stress and Mental Health
Stress induces the release of cortisol, a hormone that hinders testosterone production.
Estrogen imbalance occurs due to high cortisol levels.
Hormones can also be affected by anxiety and depression medications.
Stress Management for Hormonal Balance:
Regular exercise, mindfulness and proper sleep can help hormonal stability.
Is Gynecomastia something that needs to be treated?
Pubertal gynecomastia usually goes away on its own over the course of a few months to two years. But you should get evaluated by a doctor. If gynecomastia does not go away, gynecomastia surgery (male breast reduction) might be suggested.
If gynecomastia is impacting your self-esteem and doesn’t resolve on its own, it’s important to consult with a qualified professional.
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Dr. Preeti Yadav is a renowned specialist in performing gynecomastia surgery in Gurgaon along with being a plastic and cosmetic surgeon in Gurgaon. She specializes in adult and teen gynecomastia and has years of experience performing male breast reduction with customized procedures to allow her patients to feel confident again.
Gynecomastia should not control your self-image!
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