Why Do Some Men Have Breasts, and Is It Something to Worry About?
Key takeaways:
Many men will notice breast tissue at some point in their life, and often it’s a normal part of growth and development.
Sometimes breast growth in men may be a sign of an underlying health problem, such as kidney disease, liver disease, or a hormonal imbalance.
Men with new or changing breast development should talk with their healthcare provider, especially if it causes psychological distress and worry.
You might be surprised to learn that boys are born with breast tissue, just like girls. Due to hormonal differences, male breast tissue typically does not develop in the same way as female breast tissue. But it’s still possible (and common) for boys and men to develop breast tissue at different times in their lives.
There are a few reasons for this. While many causes of “man boobs” are harmless, sometimes it can be a sign of an underlying health issue or a side effect of medications. But how can you tell when to worry about male breast development? Let’s dive right in.
Types of ‘man breasts’: Gynecomastia vs. pseudogynecomastia
There are two types of male breast development:
Gynecomastia is abnormal breast growth caused by a growth of glandular breast tissue. Hormonal changes typically cause it, and it can be normal during different stages of growth and development.
Pseudogynecomastia is abnormal breast growth caused by fat cells. Weight gain usually causes it.
It can be difficult to know if you have gynecomastia or pseudogynecomastia. With gynecomastia, people usually feel firm and rubbery tissue around the nipples. Pseudogynecomastia may feel softer. It can be harder to notice when it happens with weight gain.
What causes breast growth in men?
There are many possible causes of male breast growth. Gynecomastia can be normal in different stages of growth and development (this is called “physiologic gynecomastia”). This kind of normal breast growth in men usually doesn’t need treatment.
Are male breasts a sign of another health condition?
Sometimes treatments or underlying medical conditions cause breast growth in men. Examples include:
Medications, such as spironolactone, some antipsychotics, and certain prostate cancer medications
Hormonal changes, such as high prolactin or low testosterone levels
Steroid use
Drug and alcohol use
Liver or kidney disease
Testicular tumors
Malnutrition or malabsorption
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How common are ‘man boobs’?
Breast growth in men is pretty common. In fact, most men will develop some breast tissue at some point during their life, especially in the later years of life. But it’s not just something that happens to older men. It can be pretty common in infants and adolescents, too.
There are reports of physiologic gynecomastia in:
60% to 90% of infants
50% to 60% of adolescents
70% of men 50 to 69 years old
When to see your healthcare provider
Anytime you notice a change in your body, it’s a good idea to talk with your healthcare provider. While gynecomastia can be normal, it may also increase the risk of breast cancer in men.
Unwanted breast development in men can also cause discomfort and psychological distress.
It’s especially important not to wait too long if you notice any of the following:
A breast lump or growth
Breast changes on one side
Breast pain
Emotional or psychological distress related to breast growth
Your healthcare provider can help you navigate emotional discomfort and check for any other potential causes of breast symptoms.
How do you treat male breasts?
The first step in treatment is figuring out the cause. When gynecomastia is part of normal development, it often resolves on its own with time.
If a medication causes breast growth, you and your healthcare provider can discuss the risks, benefits, and possible alternatives. Stopping the medication may reduce breast growth.
Sometimes male breasts do not go away on their own, and they may increase in size or cause other symptoms. If this happens, talk with your healthcare provider about treatment options.
There are some off-label medications to help treat gynecomastia, such as:
Bromocriptine (Parlodel)
Cabergoline (Dostinex)
Raloxifene (Evista)
Surgery is sometimes an option to reduce breast size. This may be the case when there’s a risk for cancer or when breast tissue gets in the way of daily activities. Experts do not recommend surgery until after puberty.
At the end of the day, the best way to treat gynecomastia depends on your specific situation, so talk to your healthcare provider for more personalized advice.
The bottom line
Boys are born with breast tissue, but it often goes unnoticed under the skin. Male breast development is common and even normal at certain times of life. But it can also be caused by medication side effects, weight gain, or an underlying medical condition.
If you notice new changes in one or both breasts, talk to your healthcare provider to understand the cause. Together you can find a treatment plan that works for you.
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References
Cuhaci, N., et al. (2014). Gynecomastia: Clinical evaluation and management. Indian Journal of Endocrinology and Metabolism.
Dickson, G. (2012). Gynecomastia. American Family Physician.
Johnson, R. E., et al. (2009). Gynecomastia: Pathophysiology, evaluation, and management. Mayo Clinic Proceedings.
National Health Service. (2021). What is gynaecomastia?
Niewoehner, C. B., et al. (2008). Gynaecomastia and breast cancer in men. The BMJ.
Rew, L., et al. (2015). A systematic review of literature on psychosocial aspects of gynecomastia in adolescents and young men. Journal of Adolescence.
Swerdloff, R. S., et al. (2019). Gynecomastia: Etiology, diagnosis, and treatment. Endotext.
