The human body changes with age. In men, the body will undergo many different changes as they grow older, especially after puberty. In some men, developing enlarged breasts is common as they mature. Such an enlargement is generally transient, firm, bilateral, and smooth with symmetrically positioned areola. In a few cases, however, the breasts enlarge and become tender. This is a common condition known as gynecomastia.

The enlargement of the breast in men is triggered by proliferation in the skin stromal cells and not due to expansion in the ducts. The primary cause for gynecomastia is impaired effects of androgen or overproduction of estrogen.

A noticeable sign of gynecomastia is the subtle presence of excessive tissue around the nipple region or exaggerated enlargement of the breasts.

Primary Causes of Gynecomastia


Obesity is the leading cause of gynecomastia because by being overweight, the level of estrogen in the body increases. As a result of the increase in estrogen, the breast tissue will begin to enlarge.

In addition to the increase in estrogen in overweight individuals, there will also be an excess of skin and tissue distributed all over the body. Some men may try to exercise to improve the condition, but this alone does not always work in most cases of gynecomastia.

If you’re not obese but are recovering from malnutrition, gynecomastia may manifest under these circumstances, as well. Malnutrition induces a shift in one’s internal hormonal balance.

Hormonal Imbalance

The primary cause of gynecomastia is an imbalance between the two sex hormones: testosterone and estrogen. Growth in bone tissue within the breast region is regulated by estrogen. In men, there is a basal level of estrogen produced but the predominant hormone is testosterone.

When the level of testosterone dips or estrogen increases, there is a noticeable increase in breast size. Reduced levels of testosterone is commonly caused by disorders in the male sex organ. Such conditions may be genetic like Klinefelter’s syndrome or due to infection. Cancer in the testes or renal failure can also cause gynecomastia.


A few drugs which lead to gynecomastia are calcium channel blockers. These include a few that are commonly used to manage hypertension such as Procardia, diuretics with an associated anti-androgenic activity like Aldactone, ACE inhibitors like enalapril and Capoten; antibiotics like ketoconazole, isoniazid and metronidazole; anti ulcer drugs like Zantac and Prilosec.

The Natural Aging Process

As men grow older, the production of testosterone will begin to decrease as well. Older men produce minimal amounts of testosterone naturally and when combined with increased body fat, there is an increased chance of hormone imbalances. The imbalance can result in gynecomastia.

Gynecomastia is an innocuous condition without any health implications, but is a concern when you notice eccentric or localized swelling in the breasts with nipple discharge or when there is radiating pain.

Gynecomastia could alternatively be an indicator of hypogonadism like testicular atrophy, delayed puberty, lowered proportion of lean body mass and erectile dysfunction. If gynecomastia is induced due to drugs or medication, the condition goes into remission when you stop using the medication responsible.

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To learn more about the procedure, contact the Plastic Surgery Institute of Dayton to set up a consultation. Our surgeons are highly skilled and ready to assist you from start to finish.