When man boobs are a health risk

I am 45-years-old and I have started developing man boobs. They have begun to sag. The truth is, I am embarrassed about how they look, especially when I wear tight clothes.

Is there something I can do about them? I am at a higher risk of getting breast cancer?

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Man boobs are a very common problem. In most cases, they are not ominous but they can be an embarrassing nuisance.

Male breasts have both glandular and fatty tissue (like female breasts) and both these tissues can enlarge with the correct stimulus.

There are two types of gynecomastia:

True gynecomastia: this is where you get increased breast glandular tissue.
Pseudogynecomastia (False gynecomastia): this is more common as it is associated with weight gain. In this case, you get increased amounts of fatty tissue in your breast. The breasts in this case tend to sag a little bit more than true gynecomastia.

CAUSES

It is important to understand why you may be developing man boobs.

• Aging: weight gain and testosterone reduction can result in development of man boobs.

• Weight gain: this can lead to pseudogynecomastia

• Liver disease: one of the tell-tale signs of liver disease is male breast enlargement. Usually, by the time gynecomastia occurs when there is some form of established liver destruction. You may also notice redness of the palms, easy bruising and a slight yellow tinge in your eyes.

• Kidney disease: reduction in kidney function result in the development of man boobs. Usually there are associated changes in urine production, blood pressure and fatigue.

•Thyroid problems: an overactive thyroid can result in gynecomastia. This may be accompanied by hand tremors, weight changes and mood swings.

• Tumours: unusual growths in the testes, pituitary (part of the brain) or adrenals (a hormone producing organ located above the kidney) may stimulate the formation of man boobs. This is because these tumours cause abnormal hormone production.

• Low testosterone levels: This can be due to aging, pituitary gland insufficiency or testicular problems.

• Herbal products: Some herbal products have phytoestrogens which cause the body to behave the same way as it would when stimulated by oestrogen produced by the human body. Use of these herbal products can result in development of man boobs.

• Alcohol and substance abuse: use of street drugs such as marijuana, heroin and amphetamines has been associated with development of man boobs. Alcohol abuse can have the same results.

• Steroid use: use of steroid based muscle builders or continuous use of steroid tablets for control of disease such as asthma or inflammatory conditions can lead to formation of man boobs.

• Medication: chemotherapy, HIV therapy, some anti-depressants, some ulcer medication, anti-hypertensives and heart medication can stimulate the formation of man boobs.

• Physiological: this does not apply to you but it is normal for new born and pre-teen boys to have some breast enlargement. In new born boys, it is due to circulating female reproductive hormones from their mother.

Gynecomastia and breast cancer

Gynecomastia usually does not automatically lead to the development of breast cancer. However, men with true gynecomastia have a slightly increased risk of developing breast cancer. This is thought to be due to increased levels of oestrogen in circulation in men with true gynecomastia. For this reason, all men who develop man boobs need to go for a good physical exam to ensure that there are no lumps in your breasts.

What should you do?

You need to go to your doctor for a physical exam. During your check up, your doctor will try and find out the cause of your man boobs. He/she will also check for any other abnormalities that may be in your breast.

If your doctor suspects that your man boobs may be as a result of hormonal problems, you will have several blood tests done. If you are on any medication, make sure you carry it with you so that your doctor can assess and see if it is the cause of your man boobs.

Urgent medical review

If you experience nipple discharge, pain, redness or if your breast swelling is one sided, seek medical review urgently.

The treatment

• Treat underlying problems: if your doctor finds an underlying cause for the development of your man boobs, you need to be initiated on treatment.

• Stop culprit drugs: if your regular medication has contributed to development of your man boobs, ask your doctor to initiate you on alternative drugs (if available).

• Weight loss: if excess body weight is the cause of your gynecomastia, you will have to shed the excess kilos in order to be rid of you man boobs. Combine weight training with cardio to ensure optimal results.

• Hormonal therapy: if your body has too much oestrogen, your doctor may start you on medication to block the effects of this hormone on your breasts. Men with low testosterone levels can benefit from testosterone replacement therapy.

• Surgery: If you have significantly large man boobs and there are no other underlying health issues that need correcting (or if they are not responding to treatment), your doctor may refer you to a plastic surgeon for removal of excess breast tissue.

This article was first published in the Business Daily.