A 14-year-old boy’s mother noticed something unusual about her son. His chest seemed to be getting larger, despite him being active in sports like football and swimming. Concerned, she realized her son was not obese, yet his breast size continued to grow.
As his behavior began to change, he became more self-conscious, crossing his arms over his chest and choosing larger clothes to hide his discomfort. He often stood in front of the mirror, inspecting his reflection and worrying about his appearance.
Seeking professional advice, they consulted a doctor who diagnosed the condition as gynecomastia, a condition where male breast tissue enlarges. This condition can develop for various reasons during adolescence.
What Is Gynecomastia?
Gynecomastia refers to the enlargement of breast tissue in boys, commonly seen in two stages: in newborns due to hormonal influences from their mothers and during adolescence (ages 12 to 16) as a result of hormonal changes. Dr. Mohamed Hunais, a pediatric specialist at Aster Clinic in Oud Metha, explained that gynecomastia can occur from both physiological and pathological causes.
Physiological gynecomastia, which typically happens during normal growth, may not need treatment as it often resolves on its own. On the other hand, pathological gynecomastia is linked to health issues and often requires attention to address the underlying causes, affecting boys of all ages.
Gynecomastia vs. Pseudogynecomastia
It’s important to distinguish between gynecomastia and pseudogynecomastia. Dr. Hunais emphasized that pseudogynecomastia occurs in obese individuals, where the breast enlargement is caused by fat rather than glandular tissue. He noted that pseudogynecomastia doesn’t involve a firm mass of glandular tissue like gynecomastia does. In cases where boys who aren’t obese gain weight and experience breast enlargement, it’s referred to as lipomastia, involving fatty tissue accumulation.
Causes of Pathological Gynecomastia
Several factors can contribute to pathological gynecomastia, including certain medications, hormonal imbalances like elevated estrogen levels or low testosterone, and medical conditions such as Klinefelter syndrome or congenital adrenal hyperplasia. Dr. Hunais also noted that issues like testicular and adrenal tumors, chronic kidney or liver diseases, and malnutrition could contribute to the condition. Additionally, obesity and medications like anti-androgens can worsen gynecomastia.
Managing Gynecomastia in Adolescents
Dr. Shahrzad Mojtabavi Naeini, a general practitioner specializing in aesthetics at International Modern Hospital in Dubai, explained that managing gynecomastia depends largely on the underlying cause. In many cases, simply observing the condition is enough, as it typically resolves when hormone levels stabilize.
Dr. Naeini emphasized that obesity is a significant contributing factor, as excess fat can lead to higher estrogen production, encouraging breast tissue growth in males.
Even for non-obese children, weight gain can cause the appearance of breast enlargement due to fatty deposits. Dr. Naeini recommends lifestyle changes such as maintaining a healthy weight through diet and exercise. In some cases, medication, such as hormone therapy, may be necessary, and surgery could be an option if gynecomastia persists or is severe. Without treatment, gynecomastia can lead to emotional and psychological distress.
Emotional and Social Impact
Dr. Salman Kareem, a psychiatrist at Aster Clinic in Discovery Gardens, highlighted the emotional struggles boys with gynecomastia often face. Feelings of embarrassment and shame about their bodies can lead to anxiety about being perceived as “different” from their peers. Boys may fear being ridiculed or teased, and this distress can affect their social interactions.
Dr. Kareem explained that the emotional toll often leads to reduced participation in physical activities, such as sports or swimming, which may cause social isolation and missed opportunities for physical activity.
Supporting Your Child Through Gynecomastia
Parents play a crucial role in helping their children cope with the emotional and psychological challenges of gynecomastia. Dr. Kareem urged parents to foster self-confidence and body acceptance in their children by encouraging coping strategies for social situations. Introducing anxiety management techniques and focusing on individual needs can help children navigate these challenges.
Parents should also collaborate with school counselors to address bullying and create safe spaces for physical education. Educating students about body diversity and sensitivity can help reduce the stigma surrounding gynecomastia, making children feel more comfortable and supported.
In some cases, when the emotional or physical impact is severe, surgical intervention might be necessary. Parents should be aware of when it might be appropriate to consider surgery and seek guidance from medical professionals to make informed decisions.
