Breasts in men
The breasts can enlarge if you are overweight, simply because fat has settled there. They can also enlarge because the actual breast tissue is overdeveloped; this is called gynaecomastia.
To decide which it is, lie flat and grasp your ‘breast’ tightly between your thumb and forefinger. Then gradually move your finger and thumb towards the nipple. If you can feel a firm, rubbery disk-like mound of tissue which is more than 2 cm across, and which seems to be stuck to the back of the nipple and to the pink area surrounding the nipple (areola), it is likely that the breast tissue is overdeveloped. The area may feel tender. Usually both breasts are equally affected, but sometimes development of one is more obvious than the other.
If one breast is more enlarged than the other, ask your doctor to check it; breast cancer is rare in men, but it can occur. If there is no distinct mound of tissue under the nipple, it may simply be that you are too fat.
How breasts develop
Even a newborn baby has some basic breast tissue, which started to develop when it was a 6-week-old fetus. Before puberty, the breasts are the same in girls and boys. They consist of tiny branching tubes embedded in packing tissue. The glands for making milk have not yet formed.
At puberty, hormone levels start to rise. In females, the main hormone is oestrogen (the ‘female hormone’). Oestrogen makes the tubes thicken, lengthen and become more branched, and also stimulates the development of glandular lobules.
In men, the main sexual hormone is testosterone. This is made mainly in the testicles. The level of testosterone rises at puberty to 30 times the level it was previously. Men normally also have a small amount of oestrogen; at puberty, it rises to only three times the level it was before. This often makes the breast tissue grow slightly in teenage boys (see below), but eventually the high levels of testosterone take over completely and prevent the oestrogen having any further effect on the breast. Therefore glandular lobules do not form in men. Instead, the breasts flatten out, and remain as a collection of tubes in packing tissue, just as they were before puberty.
Breast growth in teenage boys
Teenage boys sometimes notice that their breasts are enlarging and/or are tender. This is nothing to worry about, and happens to about half of all boys at some time. It does not mean you are changing sex! It can start anytime after the age of about 10, and the breasts may be quite large by the age of 13 or 14. In the mid-to-late teens, they start to become smaller again, and will usually have flattened out by age 18 or 19.
|
Results of some surveys of breast enlargement in normal teenage boys |
|
| Normal teenage boys examined | Those with breast enlargement |
| 1865 American scouts, aged 10-16 | 39% |
| 993 Turkish schoolboys, aged 9-17 | 7% |
| 29 American schoolboys, at puberty | 69% |
| 681 Italian schoolboys, aged 11-14 | 33% |
| 135 Swiss youths, aged 81/2-171/2 | 22% |
| 377 American schoolboys, aged 10-15 | 49% |
| Source: New England Journal of Medicine 1993;328:490-5 | |
Why it happens. At puberty, the testosterone level does not rise steadily. Over the first few teenage years, it continually fluctuates wildly and, on some days, the level will dip quite low. These dips in testosterone allow the small amount of oestrogen that circulates in the blood of all men, to have an effect on the breast. This stimulates the growth of the packing tissue and tubes, so that the breasts enlarge. In men over about 15 years of age, the testosterone settles at a more steady, high level. This prevents the oestrogen from having an effect any longer, and the breast tissue usually starts to shrink.
What if the breasts remain enlarged? In only a few men, the breasts remain enlarged at the end of the teen years. This is not usually because there is anything wrong with the male hormones, but because the enlarged breast tissue has remained hypersensitive to the tiny normal amounts of oestrogen, or else is not responsive to the ‘shutting down’ effect of testosterone. Occasionally, a rare medical condition may be responsible, so consult your doctor to check your hormone levels. If everything is normal (which it usually is) a surgeon can remove the excess breast tissue.
Breast enlargement in men
It seems that breast tissue is very sensitive to the balance between oestrogen and testosterone in the blood. If there is either a fall in the testosterone level or a rise in the oestrogen level, the breasts will be stimulated to grow.
Obesity is a common cause. If you are overweight, the breasts will of course be larger because they are more fatty. In addition, fat produces oestrogen which stimulates breast development.
Medications are the other most likely reason. Some drugs have an oestrogen-like effect on the breast, and some block the effect of testosterone. Oestrogens are easily absorbed through the skin; men have developed breasts after using anti-balding scalp creams containing oestrogen, and even by absorption through the skin of the penis from a partner using a vaginal oestrogen cream.
Drugs that can cause breast enlargement in men
Hormones
- Oestrogen
- Body-building steroids
Psychiatric drugs
- Phenothiazines (such as chlorpromazine)
- Tricyclic antidepressants (such as amitriptyline)
- Benzodiazepines (such as diazepam)
- Opiates
Drugs for hypertension or heart problems
- Calcium-channel blockers (such as nifedipine, verapamil)
- ACE inhibitors (such as captopril, enalapril)
- Digoxin
- Amiodarone
- Spironolactone
- Methyldopa
Drug misuse
- Alcohol
- Marijuana
- Heroin, methadone
- Amphetamines
Drugs for duodenal ulcer
- Omeprazole
- Cimetidine
- Ranitidine
Antibiotics and antifungal drugs
- Isoniazid
- Metronidazole
- Ketoconazole
Alcohol abuse upsets both sides of the oestrogen–testosterone balance. It stimulates the liver to clear testosterone from the blood, so testosterone levels fall. It probably also reduces the ability of the liver to break down oestrogens, so levels rise. Fortunately, the liver can often recover if alcohol intake is reduced.
Tumours are a rare cause of breast enlargement. Breast cancer can occur in the male breast, but is usually on one side only. Tumours in other parts of the body can sometimes produce hormones that make the breasts grow and may also cause erection problems and/or oozing of milk from the breast. If you have these symptoms, it is essential that you see your doctor straight away.
Breast cancer in men
Breast cancer can occur in men. It kills about half the men who get it, whereas only about one-quarter of women with breast cancer die from the disease. This difference is because men with breast cancer do not go to their doctor early enough. Therefore men are dying from breast cancer because:
- they did not know about the disease
- they were too embarrassed to seek help.
And by the time they get treatment, the cancer has spread. This is a shame, because breast cancer is just as treatable in men as in women if it is found early enough. So if you have the slightest worry that you might have a lump in your breast, see your doctor straight away so that you can have tests and treatment if necessary. Other signs of breast cancer include a sore or rash on the nipple, discharge from the nipple, the nipple turning in, or a change in shape of the breast.
If you are a woman reading this, try to educate the men in your life about male breast cancer.
Old age. It is natural for men’s breasts to enlarge in old age. This often seems to happen over a few months, after which no further enlargement occurs. The reason is partly that less testosterone is produced in old age. Also, in old age, the body often contains a higher proportion of fat, which produces oestrogens. In about 50% of people, the breasts will become smaller again in time.
What your doctor can do about breast enlargement in men
See your doctor if you think your breasts are enlarging, even if you have worked out the most likely cause. Your doctor will be able to:
- check whether the actual glandular breast tissue is overdeveloped, or whether the enlargement is simply fat
- check your testicles (because they make most of the testosterone)
- decide whether any drugs are likely to be responsible
- do blood tests to measure various hormones, including testosterone. The treatment will depend on the reason for the growth. It may simply be a matter of losing weight or cutting down your alcohol intake. If the problem is a low testosterone level, testosterone can be given by injection or as a patch. Tamoxifen – a drug that interferes with the action of oestrogen – is used by some specialists to reduce gynaecomastia. Another possibility is danazol, a drug that promotes the effect of testosterone. Danazol can have troublesome side effects, such as weight gain, acne, muscle cramps and nausea. The excess breast tissue can also be removed by surgery.
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated:
Friday, February 26th 2010
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Comments on this article
Posted by Optionalgggggggggggggggggg on 09/03/2010 at 05:20:44 am
pls give some solution
Posted by Tahir on 26/01/2010 at 07:38:00 am
Hi I am 26 male and doing a job in a company, I have very small breast since I was 14, but still it remain at the age of 26. When ever I press it with fingers it reduces to a normal male body but after few mints it again look small breast. I have no pain in any side. I am worried becasue of it kindly suggest the mdeician.
Posted by daz on 01/12/2009 at 08:13:00 pm
hi iam a 29 yo male!ive had this prob sinse i was around 15, it started as little lumps under my nipples quite sore, it never went away, they now look like little cones, iam paranoid to hell, i am quite muscley person, and if they were gone i would be over the moon because they just look so out of place! i would love to take my daughters swimming and stuff, but couldnt handle the looks of other people!!!! how much is the sergery does anybody know???????? HELP
Posted by siyabonga on 29/11/2009 at 10:08:00 pm
im a 21 yr old guy, my breasts hv enlarged since the age of 15. so nw ds affect me a lot cos i cant even take my top off infront of people. it affect my sexual life as wel cos i dnt feel comfortable when my gf is moving her hands towards my chest. when it comes to sex i have to thnk hw an i going to hide my breasts. my gf is so toutchy she jst dnt understant y i hv 2 stop her whn shes abt my chest plz im desperate 4 help ths is the same reason y i hv to quit soccer cos my teamates wud have 2 make fun of me being a boy with breasts
Posted by laurence on 05/09/2009 at 07:52:00 pm
my son has developed a hard feel under one of his breasts. he is 14. my husband says he had the same at that age with also only one breast and that this is just a normal part of puberty. Is he right? or should I be woried ?
Posted by Bobby on 01/09/2009 at 04:26:00 am
personally I've worn a bra since I was like 16-17, started out w/ a type of "runners nipple" (look it up). Even when I was a 36 waist was a 38b bra. It has always been hard on me (especially when in Navy) Went many years fighting it and having emotional probs, but I have come to terms w/ it finally. My wife knows and is simi ok and I wear my bra everyday -makes my chest more comfortable. To all that have this problem, I wish them good luck and just accept it -will make it so much better.
Posted by rajaryan on 31/08/2009 at 05:17:00 pm
i m 26 yrs man , i need some advice on sex life and medical i am going to get married in six month .i have some problem in my chidhood i used play with my self ( i used suck my own chest) that was the worst mistake had done in my life because of that my chest area grown little bit the areola region had beome dark and size of one rupee coin is it possible to get my chest in shape by any medical treatment if it is possible plz suggest me i am worried how i will face my patner plz help me
Posted by waild on 08/08/2009 at 11:03:00 pm
i have breasts probloem what i have to do to remove it ?
Posted by angel on 06/08/2009 at 11:52:00 am
i have 38B breasts but am relatively slim so they are quite noticable. I have come to like having them. there si nothing to be ashamed of & in fact many girls seem to enjoy touching them & comparing them to their own breasts! Id NEVER consider having a mastectomy like some guys do!
Posted by sunny on 03/08/2009 at 07:06:00 pm
i hav breast n i feel really sham.and i am hinking to get surgery.is surgery is safe for me?
Posted by Anonymous on 28/06/2009 at 04:45:00 pm
I've needed to wear a bra for jogging for several years. I'm grateful that I've gotten less hostility than I did when this started.... PS: in my case its a hormonal imbalance related to my medical history, not anything I had any control over. I'm grateful.
Posted by Anonymous on 12/04/2009 at 06:32:00 pm
I am a 17 year old male who has found a little bump located below the skin on the bottom part of the outer rim of the nipple. I am concerned as to what this bump may be. The small area around the bump is a little sore, however there are no other symptoms. The bump is not visual in the mirror and there is no redness. The bump feels about the size of a small pea, maybe half the size of a pea. Does anyone have any diagnosis?
Posted by saf on 10/04/2009 at 06:22:00 pm
my left breast has started growing, its beginnig to look like a female breast, its hard but there arent any small lumps its just one bif lump under my nipple, now my right breast it getting bigger, the tissue under my right nipple feels hard but alot bigger than before- this has been going on for over a year- im worried it maybe cancer please help.
Posted by sbrown on 31/03/2009 at 12:07:00 pm
I sympathise with you. My son is 16, over 6' tall, plays rugby to a high level, is very muscular, eats well and works out every day but still has large breasts & nipples and is very embarrassed. He feels he has put up with it long enough, I would find the money for surgery as it is affecting him so much but I dont think that's possible until he is over 18. I know how you feel, you want to help them cope with it but you cant. Good luck!
Posted by kevin on 29/03/2009 at 06:07:00 am
i think he's a bit over weight so he should try losing fat by eating healthy food and most importantly running or swimming and doing floor excercises
Posted by Anonymous on 09/03/2009 at 11:50:00 am
Hi, My son is 17yrs old and his breast has been large since he was a kid, I know this is a source of embarrassment for him as it shows no sign of going away. We have been to the doctor and he shares the same opinion as your article, "it will go away as he get's older", but I am worried it is not going away. He is 5' 8" tall and weighs 170 lbs and eats very healthy. Can you tell me if weight training for your chest would be helpful at this time? or suggest some sort of approach to helping him get rid of this condition, it just makes us as parents feel so helpless.. Thank you, Wilfred
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