Most cases of gynecomastia occur during puberty, and usually get better on their own without treatment. This can take anywhere from 6 months to 2 or 3 years. For most newborns and teens, the condition doesn't last long and their breasts return to normal within 6 months to 2 years. However, if it persists, medications or surgery may be necessary.
The first sign of gynecomastia may be a lump of adipose tissue under the nipple, which can sometimes be tender or sore. It is a common, benign (non-cancerous) condition that mainly affects teenagers and older men, but can affect men of any age. Certain over-the-counter medications for ulcers, such as cimetidine (Tagamet HB), as well as vegetable oils used in shampoos, soaps, or lotions have been associated with gynecomastia. All men with or without a diagnosis of gynecomastia should be evaluated immediately if a lump or change in the breast is seen during the exam.
Gynecomastia is triggered by a decrease in the amount of the hormone testosterone compared to estrogen. Some medications, drugs (such as alcohol, marijuana, amphetamines, and heroin), anabolic steroids (taken to build muscle and improve strength), and other medications can also cause gynecomastia. If you have questions or concerns about gynecomastia, or if you have other risk factors for male breast cancer, talk to your doctor to make sure your treatment plan and follow-up program meet your needs. When you have gynecomastia, your doctor may refer you to a specialist known as an endocrinologist, who treats problems related to hormones and how they affect the body.
In most cases, gynecomastia resolves on its own with minimal treatment and with little risk of long-term complications. If your doctor suspects that you have gynecomastia, he or she will likely examine you to make sure there are no hard lumps, fluid drainage, or skin problems that could be signs of cancer. Rather, pseudogynecomastia is simply an enlargement of the tissue under the nipple in the chest wall due to the accumulation of fat. For example, some medications used for ulcers, heart conditions, benign prostate problems, and prostate cancer can cause gynecomastia.
If you're taking medications that can cause gynecomastia, your doctor may recommend stopping them or replacing them with another medication. Gynecomastia has also been associated with the use of illicit drugs, the consumption of alcohol and herbal supplements containing phytoestrogens. Newborns, boys going through puberty, and older men may develop gynecomastia as a result of normal changes in hormone levels, although there are other causes as well.