DEAR DR. GOTT: I am a 66-year-old male, about 30 pounds overweight and developed gynecomastia about a month ago. My doctor did a testosterone check and it was well within the normal limits. Is this swelling and tenderness in the bests going to last the rest of my life or will it subside? Are there any “home remedies” for gynecomastia? I also have some depression, sleep problems and a little flushing.
Two years ago I started taking a prostate drug (can’t remember the name of it) that caused the same problem but I stopped taking the drug and it went away. It wouldn’t be affecting me now would it? I really hope you can answer this; it’s driving me crazy.
Thanks for all you do. Our family has been reading your articles for as long as you have written them.
DEAR READER: Gynecomastia is enlarged breast tissue in males. It may also be accompanied by pain, tenderness to touch and nipple discharge. It can occur in one or both breasts or with one being more severely affected than the other.
By far, the most common cause is a decrease in the male hormone testosterone which allows the minute levels of estrogen normally present to have a stronger effect on the body. This hormone imbalance can occur for a number of reasons. In infants it is typically due to lingering estrogen from the mother, in young boys puberty is usually blame and in men, it most commonly occurs between the ages of 50 and 80 as a result of naturally declining testosterone levels due to aging.
Other causes include medications (ulcer meds, tricyclic antidepressants, anti-anxiety drugs, AIDS meds, anabolic steroids, antibiotics, chemotherapy, heart medications, androgens, methadone, and anti-androgens), alcohol, street drugs (heroin, marijuana, amphetamines), hormone-altering tumors, kidney failure, hyperthyroidism, liver failure/cirrhosis, malnutrition/starvation, hypogonadism, and certain plant oils (tea tree, lavender, etc.). In some, fatty breast tissue (pseudogynecomastia [the result of weight gain, not a disease]) or symptoms of a breast abscess or breast cancer may mimic those of gynecomastia.
Most cases resolve over time without treatment. If there is an underlying condition, such as hyperthyroidism, etc., medication to treat the cause will reduce the breast swelling. Significant and bothersome breast enlargement that persists following treatment or a reasonable observation time may be helped with surgery. Liposuction can remove excess breast fat. Mastectomy removes the breast gland tissue.
My advice is to return to your doctor. If your testosterone level is normal, there must be another cause that needs to be looked into such as increased female hormones. You don’t mention if you are on any other drugs, but do mention depression, being overweight, sleep problems, and flushing. Over-the-counter, herbal or prescription medications you may take for these conditions must be thoroughly investigated to determine if they are the culprit, as well as any of the above health conditions I mentioned. You may also benefit from counseling or a gynecomastia support group (which can be found online at www.gynecomastia.org) to help you deal with the condition.
