​Gynaecomastia

The increase in breast tissue in a man is referred to as Gynaecomastia. This growth is usually non-cancerous and is the result of imbalance between the hormones oestrogen and testosterone. For those of you who are unfamiliar with these names, they are specific hormones (chemicals in body) having a central role in the development of gender specific characteristics, which serve as differentiating traits but are not directly part of the reproductive system. So a larger muscle mass and more body hair in males are stimulated by testosterone, while breast formation is triggered by oestrogen. Although testosterone is predominant in males, small amounts of oestrogen are also produced normally within their body.  

Any situation that elevates oestrogen levels, or blocks the effect of testosterone, or lowers testosterone levels can lead to Gynaecomastia. There are three points in life when such changes may occur naturally:

  • In infancy – male babies are commonly affected by their mother’s oestrogen and are born with prominent breasts. It takes approximately two to three weeks for it to resolve by itself. 

  • During puberty – most cases are seen in young boys but swelling is temporary and recedes within a few months to a few years.

  • Older men – between 50 to 80 years of age are frequent afflicted, especially those who are overweight.

You may come across the term “Pseudogynaecomastia”. It means a false depiction of breast tissue enlargement that actually occurs due to enlargement of fat in the chest area, often seen in <obesity>. 

On the other hand, it is vital to understand that true Gynaecomastia may present itself as a symptom of another disorder. Causes include liver disease, various cancers (of <breast>, lung, testicles, adrenal, and pituitary), thyroid disease, kidney failure, malnutrition, starvation and certain congenital syndromes (existing since birth). Numerous medications, drugs of abuse (alcohol, heroin, marijuana etc.) and some herbal products (plant oils) have also been identified as causative agents. Steroids taken to improve athletic performance or body building put the user at risk of Gynaecomastia. ​​

You would notice the obvious growth of one or both breasts, which may or may not be painful to touch (breast tenderness). 
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

Your doctor will start off with a bunch of questions and then proceed to a physical examination. This may be followed by one or more of these tests:

  • Blood tests

  • Urine test

  • CT or MRI scan

  • Ultrasound of testes

  • Biopsy

It is understandable that you may be embarrassed by Gynaecomastia and want to it to go away. Your medical evaluation will assist your doctor to choose the best route of management. In some cases it is best to wait for natural regression of the growth and follow up after a few months. If another disorder is suspected to be the culprit, the respective service line (for example GI and Surgery Service Line​) at The Aga Khan University Hospital will be involved in providing you with optimal care. 

Certain medications can be prescribed for this disease and the option of surgical removal of excess breast tissue is also available. However, all physicians at The Aga Khan University Hospital are highly trained professionals and your individual assessment will guide them to choose an appropriate treatment plan. Your preferences will be taken into consideration and advice given will be to suit your best interests. 

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage