Gynecomastia In Teens: Causes, Signs, Diagnosis & Treatment

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Gynecomastia in teens is common and happens mostly due to hormonal changes and is characterized by excess breast tissue growth. All men have some glandular breast tissue physiologically. However, for some men, it grows more than in others, resulting in breast development that makes the breasts appear more prominent (1).As the condition happens due to hormonal changes, in most cases, it resolves on its own. However, in some cases, certain underlying medical conditions may lead to gynecomastia or breast swelling in men. To know the exact cause of gynecomastia, consult a professional healthcare provider. Read on as we discuss the causes, diagnosis, and treatment of gynecomastia in teens.

How Common Is Gynecomastia In Teens?

Adolescent gynecomastia is a common condition and starts around the age of ten. Nearly half of all adolescent boys between the ages of 12 and 16 develop gynecomastia in either one or both breasts. Gynecomastia recedes on its own within a few years. By the age of 17 years, only 10% of teenage boys may have persistent gynecomastia (2) (3).

How Long Does Gynecomastia In Teens Last?

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Gynecomastia may last for a few months or a few years during puberty. It begins during early puberty and may fade away during middle adolescence. Usually, the breasts reduce within six months to two years (4).

What Causes Gynecomastia In Teens?

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Fluctuating hormone levels (estrogen and testosterone) during adolescence is the main cause of gynecomastia in teens. During these fluctuations, elevated estrogen levels could cause enlarged breasts (2). Pubertal gynecomastia is mainly a physiological phenomenon. Pathological gynecomastia is rare and occurs due to an absolute or relative estrogen excess.

In rare cases, gynecomastia could occur due to the following reasons (1) (5).

• Klinefelter’s syndrome (congenital disorder)

• Over-the-counter medications

• Side effect of certain drugs (antidepressants, antibiotics, or cancer medications)

• Intake of illegal drugs (heroin, marijuana, or steroids)

• Adrenal gland or pituitary gland tumors

• Cancers of lung or testicles

• Thyroid diseases

• Diseases of kidney or liver

Things to know

Medicines such as cimetidine, ketoconazole, metronidazole, and herbs such as lavender, tea tree oil, and dong quai may be linked to breast growth in males (12).

Some obese teenagers may develop gynecomastia due to the accumulation of fat tissue instead of glandular tissue in the breasts. This is called pseudogynecomastia (false gynecomastia), which is independent of puberty and related hormonal changes.

What Are The Symptoms Of Gynecomastia In Teens?

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Gynecomastia in teens can be identified due to the enlargement of either one or both breasts. It may begin as a slight lump beneath the nipple. Breast tenderness may also be present (5).

The following symptoms may be present if the breast enlargement is due to non-hormonal reasons (3).

• Nipple discharge

• Bleeding

• Mastalgia (breast pain)

Quick tip

Applying cold compresses may help comfort tender, swollen breasts (12).

How Is Gynecomastia In Teens Diagnosed?

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A physical examination is a primary method of diagnosis. The pediatrician may check the teen’s medical history and suggest any of the following tests to confirm gynecomastia (5) (6).

• Breast ultrasonography

• Urine tests

• Biopsy of the breast tissue

• Mammogram of the breast

• Blood tests to check for any hormone imbalance and liver profile

What Is The Treatment For Gynecomastia In Teens?

Gynecomastia in teens usually goes away in a few months to a couple of years. If the enlargement is due to puberty, no treatment may be recommended. However, if extreme hormonal imbalance is identified, an endocrinologist may suggest hormonal therapy (5).

If gynecomastia is due to other reasons, the treatment could depend on the cause and may include (7):

• Weight loss

• New medications (based on the illness)

• Discontinuing or changing previous medical treatment

• Breast reduction surgery

Quick tip

Discontinuing bodybuilding nutritional supplements or medicines may help reverse gynecomastia (12).

What Are The Complications Of Gynecomastia In Teens?

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Benign gynecomastia due to hormonal changes doesn’t cause any complications. However, teens with gynecomastia may face emotional challenges. Increased self-consciousness regarding their appearance might make a teenager skip school and social events. It may even affect their mental health. In addition, adolescents with gynecomastia may frequently opt for loose clothing to hide their physique. These constant thoughts on embarrassment may lead to anxiety and depression (2).

Dr. NRB Shuvo discusses his teenage years, recounting the challenges he faced with bullying due to gynecomastia. He says, “I used to avoid confrontations by laughing and somehow changing the topic. But inside I was deeply scarred by this constant bullying.

Whenever I went to take a bath in the bathroom, I always looked at the mirror and asked the Creator to heal me, many a time with wet eyes. There wasn’t a day when I hadn’t thought about it. Every day in the past 13 years, a total of 4845 days, I’ve wanted to get rid of it.” He eventually went on to have breast reduction surgery (i).

Complications may arise after undergoing surgical treatment for gynecomastia. These risks may include (8):

• Anesthesia-related risks

• Bleeding

• Scarring

• Irregular breast shape

• Internal damage to the structure beneath the breast

• Death of fat tissue around the breasts (fat necrosis)

• Heart and lung complications

• Compromised wound healing

• Infection and pain

Infographic: Psychosocial Effects Of Gynecomastia In Teenage Boys

Gynecomastia can negatively affect teenage boys if it is not managed on time. Even teens with mild or moderate gynecomastia tend to have similar psychosocial issues as in severe cases. Timely management may help prevent these mental health issues. Go through the infographic to know the psychosocial impact of gynecomastia in adolescent boys to identify and manage them on time.

Illustration: Momjunction Design Team

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Dr. Arva M BhavnagarwalaMBBS, DNB

Dr. Arva Bhavnagarwala did her post-graduation from Masina Hospital in Mumbai and worked at Jaslok Hospital and Research Center as a Clinical Associate. With seven years of experience, she currently practices pediatrics at her private clinic in South Mumbai and is attached to Masina Hospital as a consultant pediatrician. Dr. Bhavnagarwala is a National Advisory Board Member of Indian Pediatrics,...more

Sindusha MSMSc (Food & Nutrition)

Sindusha is a clinical nutritionist with over two years of experience in diverse fields of nutrition. She did her Masters in Food Science and Nutrition from Avinashilingam Institute for Home Science and Higher Education for Women and has qualified UGC-NET. She interned as a quality control analyst and as a dietitian during her graduation. She was a part of several...more

Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to...more

Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer. Her research work was published in international journals and publications, such...more