Gynecomastia: Causes, Symptoms, and Treatment Options

Gynecomastia

Hello, doctor.
Recently, I've been researching a lot about gynecomastia and still have some uncertainties.
I found a hard lump under my right nipple and went to a surgical clinic for an examination.
The doctor said it is likely gynecomastia, and it appears to be a benign lump.
They also performed an ultrasound and mentioned that my right nipple is about twice the size of the left, with the lump measuring approximately 1 cm.
The doctor indicated that it is due to hormonal imbalance with excess estrogen and advised me to avoid fried foods and certain beverages.

I would like to ask if the lump could potentially go away.
The clinic doctor mentioned that if the excess estrogen is eliminated, it might disappear, is that correct? Additionally, the doctor warned that while it is currently benign, there is a possibility it could become malignant, and advised me to check it monthly.
However, I forgot to mention that my nipple has recently been retracting, but it returns to normal upon touching.
Is this also a symptom of gynecomastia?
I have maintained a normal body weight throughout my life and have never been overweight, but I am really worried about the possibility of developing breast cancer, especially since I am only 18 years old.
That’s about all my questions.
Thank you, doctor.

zero zero, 10~19 year old female. Ask Date: 2020/04/04

Dr. Li Zhonghuai reply Surgery

Hello! The likelihood of breast cancer in young males is extremely low.
The management of gynecomastia in males primarily involves three concerns: aesthetic issues, pain, and suspicion of malignancy.
Monitoring changes in size is advisable, and if there is an increase in size or persistent pain, surgical removal should be considered.
Of course, it is best to avoid junk foods that contain environmental hormones, such as fried and grilled foods, as well as sugary beverages.
Refrain from smoking and drinking alcohol.
Take care! Changhua Hospital cares about you!

Reply Date: 2020/04/04

More Info

Gynecomastia, or the enlargement of breast tissue in males, is a condition that can cause significant concern, especially for younger individuals like yourself. It is often associated with hormonal imbalances, particularly an increase in estrogen (the female hormone) relative to testosterone (the male hormone). Understanding the causes, symptoms, and treatment options for gynecomastia can help alleviate your concerns and guide you through this condition.

Causes of Gynecomastia
Gynecomastia can occur due to various factors, including:
1. Hormonal Changes: During puberty, hormonal fluctuations are common, and many boys may experience temporary gynecomastia. In adults, it can be caused by conditions that affect hormone levels, such as liver disease, hyperthyroidism, or tumors that produce hormones.

2. Medications: Certain medications can lead to gynecomastia as a side effect. These include anti-androgens, anabolic steroids, some antidepressants, and medications for heart conditions.

3. Substance Use: Alcohol, marijuana, and other drugs can also contribute to the development of gynecomastia.

4. Obesity: Excess fat can lead to increased estrogen levels, contributing to breast tissue growth.

5. Genetic Factors: Some individuals may have a genetic predisposition to gynecomastia.

Symptoms
The primary symptom of gynecomastia is the enlargement of breast tissue, which may be accompanied by tenderness or sensitivity in the breast area. In some cases, there may be a palpable lump beneath the nipple. It’s important to note that while gynecomastia itself is usually benign, any changes in the breast tissue, such as hard lumps or changes in the nipple (like retraction), should be evaluated by a healthcare professional.

Treatment Options
1. Observation: If gynecomastia is diagnosed as benign and not causing significant discomfort or psychological distress, doctors may recommend a wait-and-see approach, especially if it is related to puberty. Many cases resolve on their own.

2. Lifestyle Changes: Your doctor has advised avoiding certain foods and drinks, which can help manage hormone levels. Maintaining a healthy weight through diet and exercise can also be beneficial.

3. Medications: In some cases, medications that adjust hormone levels may be prescribed. For example, anti-estrogens or testosterone replacement therapy might be considered if hormonal imbalances are identified.

4. Surgery: If gynecomastia is persistent and causes significant discomfort or psychological issues, surgical options such as liposuction or mastectomy may be considered to remove excess breast tissue.

Monitoring and Follow-Up
It’s crucial to follow your doctor's advice regarding regular monitoring, especially since you mentioned a recent change in your nipple appearance. While the presence of a lump and changes in the nipple can be concerning, they are not always indicative of cancer, especially in the context of gynecomastia. However, any persistent changes should be evaluated further to rule out malignancy.

Conclusion
In summary, gynecomastia is a common condition that can be caused by hormonal imbalances, medications, or lifestyle factors. While it can be distressing, especially at a young age, many cases are benign and may resolve on their own. Regular follow-up with your healthcare provider is essential to monitor any changes and ensure appropriate management. If you have further concerns about breast cancer or other complications, don’t hesitate to discuss them with your doctor for peace of mind and clarity.

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