It is estimated that approximately 40-60% of the male population suffer from the phenomenon commonly referred to as “man boobs”, but what exactly are they?

Gynaecomastia

There are generally two types of man boobs (also commonly known as man breasts or “moobs”). The first is a medical condition called gynaecomastia. This term literally means “woman-like breasts” and is an enlargement of the male breast gland. It can be caused by many factors that affect the balance of oestrogen and testosterone in the male body. All men produce a little oestrogen, which is usually thought of as a female hormone, but when the levels of this hormone are too high or testosterone is too low, the breast tissue can develop and become enlarged and painful.

This is a very common condition and usually affects teenage boys who are going through puberty. Pubertal gynaecomastia almost always disappears within three years of its development. Surgical correction should not be undertaken in this age group unless the condition is very long lasting (several years) or unless there is gross enlragement of the breast causing major psychological problems. This type of gynaecomastia can also affect older men as their hormone levels change with ageing.

Other medical causes of gynaecomastia include prescription drugs such as treatment for AIDs-related illnesses, hormone abnormalities (for example in genetic disorders such as Klinefelter’s Syndrome) or tumours that can disrupt the normal hormone functioning. The use of illegal drugs such as heroin or marijuana have also been linked to excess breast growth in men because certain chemical in plants, called phytochemicals, can mimic the female hormones. Men on hormonal treatments for Prostate cancer often develop enlarged painful breasts. Gynaecomastia can also be caused by excess alcohol, using steroids (especially anabolic steroids in body builders) and other medications.

Testicular tumours can result in gynaecomastia, and testicular examination to exclude a lump is a basic part of the medical assessment of a patient with gynaecomastia. Similarly, some tumours of the pituitary gland (in the brain) can result in enlarged breasts, and blood test should be undertaken to exclude this as a cause. In a number of cases, the cause of gynaecomastia cannot be pinpointed because there are many ways in which the hormones can be affected. This is called idiopathic gynaecomastia.

Pseudogynaecomastia

The second type of man boobs are caused by being overweight. The physical appearance of the male breasts looks similar to that of gynaecomastia, but the breasts are enlarged because of excess fat rather than growth of the breast tissue. The phenomenon of man boobs caused by excess fat is called “pseudogynaecomastia”.

Breast size in these cases can usually be reduced by exercise and diet, although men are increasingly choosing to undergo liposculpture surgery to reduce their man boobs. Weight loss alone can sometimes leave the breast skin quite loose and so a breast lift or skin resection may help to improve the appearance of the man boobs.

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