Gynaecomastia is an unusual non-cancerous growth of one or two breasts in males due to unnecessary sprouting of breast tissue as a consequence of the hormonal imbalance between androgen and oestrogen.
This particular concern leads to significant physiological distress. It is normal among newborn babies due to the influence of oestrogen from his mother.
In the adolescence period, men can face this problem due to hormonal ups and downs. An older person may have Gynaecomastia if he is highly obese.
In maximum cases, men do not need diagnostic analysis. It is generally happening due to abnormal hormonal fluctuation, which increases the concentration of oestrogen and androgen.
Liver disease, kidney disease, thyroids directly influence hormones and their activity. Some specific medication and alcohol may cause breast enhancement.
Another severe disease such as metabolic dysfunctions, Klinefelter syndrome, lack of testosterone production promotes Gynaecomastia.
This particular complication may occur even if the level of oestrogen and androgen is correct, but the ratio is disturbed.
Which hormones are responsible for Gynaecomastia?
Oestrogen, Testosterone, and Androgen are the three primary sex hormones present in our body. Any kind of disturbance in their ratio cause Gynaecomastia in male.
Oestrogen regulates female traits, responsible for breast growth. Testosterone is responsible for male characteristics, including the development of muscle and body hair.
The pituitary gland of the male body produces a small amount of oestrogen, a high amount of testosterone. But in the case of females, oestrogen production must be increased. If male oestrogen level gets increased, it dominates the testosterone level and that cause Gynaecomastia.
Testicular Leydig cells and adrenal cortex produces the testosterone hormones. Half the amount of circulating testosterone hormone is bound with globulin and albumin protein.
Only free hormone molecules are active. Globulin is a sex hormone-binding protein that prefers to bind with testosterone than oestrogen. So increased amount of globulin interrupts the regular ratio of active testosterone and oestrogen hormones.
Testosterone hormones can easily change their conformation with the enzyme. For example, enzyme 5alpha reductase converts testosterone into androgen, dihydrotestosterone.
How do hormones affect the male breast?
Male breast tissue has three kinds of receptors, such as Oestrogen, Progesterone, and Androgen. Oestrogen promotes duct development, whereas progesterone supports alveolar outcomes.
But the permissive anterior pituitary hormones, including FSH, LH and growth hormones, regulates the developmental process. Androgen hormone nullifies the effect of oestrogen hormone.
When testosterone hormone binds with globulin and albumin, the sex hormone-binding proteins, the concentration of free active hormone get reduced.
The reduced amount of testosterone can not antagonise the effect of oestrogen, and consequently, Gynaecomastia takes place.
There are two types of Gynaecomastia:
Overall, 80% of newborns have breast tissue, the outcome of oestrogen transfers from mother and placenta, and progesterone. The effect of these two hormones remains up for prolonged years.
At the age of 15-16, nearly 60% of boys have Gynecomastia. That really goes away within 1-2 years.
It happens because in puberty, the Luteinizing hormone ad FSH hormone, in association with growth factors, and growth hormones, stimulates Leydig cells to produce testosterone hormone. Gynaecomastia happens due to a delay of complete testosterone production.
Gynecomastia develops with age when obesity takes place, as the testosterone level decreased. Doctors also agreed that breast enlargement is interlinked with increased body mass index and obesity.
Non-physiological Gynecomastia develops with the disorder and the side effects of the drug, which reduced the testosterone concentration. Some drugs convert testosterone into oestrogen.
A high concentration of Oestrogen ad sex hormone-binding globulin reduces the free testosterone level in the male body. This induces Gynecomastia or male breast abnormalities.
Disease linked with Gynaecomastia
Low androgen level
- Kalman’s syndrome
- Increased prolactin Hormone
- Pituitary gland abnormalities
- Viral orchitis
- Spinal Cord injury
- Myotonic dystrophy
- Klinefelter’s syndrome
- Abnormalities in testosterone synthesis
High androgen & increased oestrogen level
Testicular feminisation, Leydig cell tumour, human chorionic gonadotrophin producing tumour, congenital adrenal hyperplasia
- Testicular feminisation
- Leydig Cell tumour
- Congenital adrenal hyperplasia
- Human Chorionic gonadotrophin Hormone.
High Oestrogen level
- Active chromosomal mutation
- Feminising adrenal cancer,
- Aromatase tumour,
- Sertoli cell tumour,
- Starvation & Refeeding.
- Increase concentration of sex hormone-binding globulin reduced the concentration of active testosterone level
- High Oestrogen hyperthyroidism is responsible for Gynaecomastia.
Cirrhosis, kidney disease, idiopathic.
Drugs associated with Gynecomastia
Some drugs are also responsible for Gynecomastia.
Ketoconazole, metronidazole cytotoxic drugs, spironolactone reduce the androgen level and block testosterone synthesis.
Bicalutamide, nilutamide, flutamide, eplerenone, spironolactone, cyproterones are the androgen receptor blockers. Induce Gynaecomastia.
Dutasteride, proton pump inhibitors like Cimetidine, ranitidine, and marijuana are responsible for Gynaecomastia.
A high level of androgen increased the concentration of Oestrogen level; apart from these anabolic steroids, excess testosterone replacement, contraceptives with androgen lead to Gynaecomastia.
If a man uses a high amount of oestrogen containing cream or lotion, his testosterone production gets affected. Soy products, lavender oil, tea tree oils, Isoflavones are phytoestrogens. They slowly increase the estrogen level of the male body, and it may cause Gynaecomastia.
Gynecomastia can be corrected by male breast reconstruction, which is performed in the best cosmetic surgery in Dubai. If you are struggling with this problem, take consultation from an experienced cosmetic surgeon from Dubai.