Gynaecomastia - Exploring the Facts

Gynaecomastia - Exploring the Facts

What is Gynaecomastia?

Gynaecomastia, also known as "man boobs", is the swelling or enlargement of breast tissue in males. It is characterised by developing a rubbery or firm mass of breast tissue around the nipple area, which can affect one or both breasts.

Gynaecomastia is very common, affecting more than half of all males during puberty and as many as two-thirds of men over 50 years old. It can occur naturally during certain life stages, such as infancy, puberty, and older age, due to hormonal changes. In most cases, Gynaecomastia is not serious and may resolve independently, but it is essential to see a doctor to determine the underlying cause.

Gynaecomastia Stats

What Causes Gynaecomastia?

Gynaecomastia can be caused by various factors that lead to an imbalance between the hormones estrogen and testosterone, with relatively higher levels of estrogen compared to testosterone.

Common causes of Gynaecomastia include:

Physiological Causes

  • Infancy (due to maternal estrogen exposure)
  • Puberty (hormonal changes during adolescence)
  • Older age (decreased testosterone levels with aging)


Certain antidepressants, anti-ulcer drugs, cardiovascular medications, chemotherapy agents, and anabolic steroids can disrupt the estrogen-testosterone balance and cause Gynaecomastia.

Chronic Diseases

  • Liver disease (e.g., cirrhosis)
  • Kidney disease (chronic renal failure)
  • Malnutrition
  • Hyperthyroidism


  • Testicular tumours (e.g., germ cell tumours, Leydig cell tumours) that secrete hormones like human chorionic gonadotropin (hCG) or estrogen precursors
  • Adrenal tumours that produce estrogen
Gynaecomastia Australia

Genetic Conditions

Klinefelter syndrome (a genetic disorder involving an extra X chromosome).

Obesity and Alcohol Abuse

  • Increased adipose tissue can lead to higher estrogen levels
  • Alcohol abuse can cause liver disease and hormonal imbalances

Idiopathic (Unknown Cause)

In some cases, the cause of Gynaecomastia remains unknown.

It's essential to consult a doctor to determine the underlying cause of Gynaecomastia, as it can sometimes be a symptom of a more serious condition, such as a hormone-secreting tumour or chronic disease.

High Cholesterol

How is Gynaecomastia Treated?

Gynaecomastia can be treated through various approaches, depending on the condition's underlying cause, severity, and duration. The treatment options include:

Watchful Waiting

  • No treatment may be necessary for physiological Gynaecomastia occurring during puberty or older age as it often resolves on its own within 1-2 years.
  • Monitoring the condition and addressing any underlying causes is recommended.


Medications may be prescribed to treat recent-onset or tender Gynaecomastia by addressing the hormonal imbalance. Commonly used medications include:

  • Tamoxifen (an estrogen antagonist) - effective in up to 80% of cases for partial to complete resolution.
  • Aromatase inhibitors (e.g., anastrozole) - block the conversion of testosterone to estrogen.
  • Clomiphene (an antiestrogen) - can lead to a partial reduction in breast size in about 50% of cases.

Treating Underlying Conditions

  • If Gynaecomastia is caused by an underlying medical condition (e.g., liver or kidney disease, hyperthyroidism, tumours), treating the primary condition may resolve the breast enlargement.
  • For hypogonadism (low testosterone), testosterone replacement therapy may be prescribed.


  • Surgical intervention may be recommended for long-standing or severe cases of Gynaecomastia, or when medical treatment is ineffective.
  • Surgical options include:
    • Liposuction: Removes excess breast fat but not the glandular tissue.
    • Mastectomy: Removes the breast gland tissue, often through small incisions.
    • Combined liposuction and mastectomy may be performed in some cases.

Lifestyle Changes

For Gynaecomastia caused by obesity or excessive alcohol consumption, weight loss and reducing alcohol intake may help alleviate the condition.

It's essential to consult a healthcare professional to determine the appropriate treatment plan based on the individual's specific circumstances and to address any underlying causes or concerns.

Gynaecomastia Treatment from Dr Clem Bonney

As a GP and Occupational Physician, Dr Bonney is well-placed to assess, advise and treat Gynaecomastia.  Dr Clem Bonney assists men with this condition to develop an understanding of the condition and develop a plan to investigate and choose the correct treatment option for the man.