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Gynecomastia, or enlargement of the mammary gland, is the growth of tissues in the breast and nipples. We divide it into physiological and pathological. Breasts are the basic, visible at first glance, attribute of femininity. The problem arises when this attribute begins to apply to a man
Problem gynecomastia
Bartosz, a young man in his XNUMXs, decided to remove the fat remaining in his breasts when physical exercise in the gym was not effective.
– Sometimes it just is. You cannot tell adipose tissue to disappear from this place and not anywhere else – he explains his decision. He also admits that his breasts protruding under his shirt were the cause of his complexes.
In Bartosz’s case, the problem was primarily adipose tissue. A bigger problem for a man is when there is an overgrowth of the proper tissue of the mammary gland. To get rid of this tissue, surgical intervention is required. It cannot be eliminated by diet or exercise. First things first.
What is gynecomastia?
Gynecomastia is a disease involving enlargement of the mammary gland and occurs in men of all ages. It appears in almost half of the male population, but it manifests itself at different stages of life and to varying degrees (cases of excessive enlargement of the nipples, even in newborns, have been reported). It is assumed that about 30% of healthy men struggle with idiopathic gynecomastia, i.e. one in which the cause cannot be determined.
However, the concept should be distinguished lipomastia od gynekomastii. The vast majority of patients suffer from the first ailment, which is caused by excess fatty tissue accumulated in the breast area. Gynecomastia, on the other hand, is also based on glandular tissue.
Also read: “What’s wrong with me? I don’t want to look like a woman! » The male problem of female breasts
Symptoms of gynecomastia
The main symptom of gynecomastia is the enlargement of male breasts. As mentioned earlier, gynecomastia is an enlargement of glandular tissue rather than fat tissue. Gynecomastia usually occurs on both sides, but can be one-sided in some cases. The enlargement may be greater on one side, even if the condition is affecting both sides. Breast augmentation may be accompanied by a feeling of tenderness and increased sensitivity, although there is usually no severe pain.
The causes of gynecomastia
The cause of proper gynecomastia is improper hormonal balance, we are talking about the concentration of androgens and estrogens (in the case of gynecomastia in adolescent boys, the problem often disappears by itself within a few or several months), although in medicine it is also said about the influence of the pituitary gland (hypopituitarism), thyroid gland (overactive thyroid gland) and adrenal glands (tumor of the adrenal gland).
Medicines can also cause enlargement of the breast glands – incl. drugs for infertility and oligospermia, drugs treating stomach ulcers, drugs used in the treatment of hypertension (e.g. spironolactone), in the treatment of mycosis (e.g. ketoconazole) or gastric ailments (e.g. ranitidine or omeprazole), as well as anabolics used by bodybuilders. Possible causes are also drugs for rheumatoid arthritis, drugs for the treatment of pulmonary tuberculosis, drugs for the treatment of prostate cancer (used hormonal treatment), anti-anxiety drugs such as diazepam (Valium), and even some drugs or lichen fluid. hair.
Gynecomastia can also occur in the case of liver cirrhosis, which in turn results from a significant slowing down of the metabolism of sex hormones (estrogens and androgens) at that time.
Sometimes gynecomastia is also the result of excessive growth of adipose tissue and connective tissue. This is due to the production of female hormones in adipose tissue, and if there is too much of this tissue, the amount of estrogen produced also increases, which in turn contribute to the formation of gynecomastia. Gynecomastia can develop in HIV-infected men receiving a treatment regimen called highly active antiretroviral therapy.
Interestingly, gynecomastia is also influenced by some products that have an estrogenic effect (for example beer), and hypersensitivity to these substances may cause gynecomastia. In such cases, they should be excluded from the diet.
Gynecomastia – a growing problem
In 2009, the British media wrote about the huge problem of gynecomastia among adolescent boys. The problem may not come as a surprise, as the British are currently one of the most obese nations in the world, and the young generation seems eager to adapt to poor eating patterns. Surgeon Christian Duncan, who specializes in obesity-related cases, told DailyMail that he operated on at least 20 obese boys with gynecomastia in a year.
– In my office and on my operating table there are boys who have a problem with real gynecomastia! They used to be individual cases, now there are more and more of them. I am also concerned that this problem will only increase. I am convinced that poor diet and obesity make the hormones work badly and the problem of gynecomastia arises – says Duncan with conviction.
In English, the term “Moobs” (a combination of the words “men” + “boobs”) has been adopted, which in colloquial language means male tits. Gynecomastia in adolescent boys creates additional problems of non-acceptance by peers, ridicule and bullying over appearance.
In the article “Nice tits” published on Huffingtonpost.com in June this year, we can read a moving story of a young man (Colin Slattery), to whom gynecomastia has caused many worries and distress. The text is also a petition to the US government to make the removal of gynecomastia covered by social security. Slattery argues that gynecomastia could be the cause of a real tragedy in a man’s life. Most people have no idea what real gynecomastia is. Few have the courage to speak about it publicly, writes Colin. – Gynecomastia is a cause of great shame for a man, depression, depression, suicide attempt, social exclusion – he adds. Slattery recalls that at some point in his life, he gave up any physical activity so as not to have to wear just a T-shirt. He wore several layers of clothes so that the protruding breasts did not stand out from under the clothes. Colin Slattery is 23 today and cannot afford to pay for surgery to get rid of gynecomastia and improve his quality of life.
Colin’s case is extreme, but not as rare as you might think. In the UK, 2008 gynecomastia removal surgeries were performed in 323. In 2009, there were as many as 581 of them. In turn, in the United States, in 2008, there were 18 thousand. such operations, which placed gynecomastia in fourth place in the popularity category of plastic surgery procedures for men, after liposuction, nose surgery and eyelid correction.
How to deal with gynecomastia?
Gynecomastia can be a “standalone” condition or the result of another condition. If we are dealing with the second case – the cause is treated. In 50 percent. in cases of gynecomastia, the cause cannot be determined. It is then called idiopathic. If gynecomastia is not a symptom of breast cancer, then it does not need to be treated. Surgery and other aesthetic medicine treatments are there to make the patient feel better and regain self-confidence.
Bartosz decided on the CoolSculpting by Zeltiq treatment, which is mainly used to eliminate fat on the abdomen and thighs. – The clinic consulted with the distributor of the device in the USA whether it could also be used on the breast. There were concerns whether the cold (the procedure works on the principle of cryolipolysis, freezing and expelling fat cells – ed.) Would not adversely affect the nipples. However, there were no contraindications, so I went for the procedure – says Bartosz, who is 1,5 months after the procedure. – After three weeks, my chest is 6 cm smaller. And this is not the end, because the final effect of the treatment is about 2 months. – I am very pleased with the effect and would decide again. It is not embarrassing for a man – just take care of himself – he emphasizes. Bartosz was also convinced of the procedure by its low invasiveness.
CoolSculpting is not the only way to get rid of gynecomastia. For men who feel uncomfortable with protruding breasts, plastic surgery can help. If we are dealing, as in the case of Bartosz, with gynecomastia, then liposuction is a good solution.
If they are both adipose and glandular tissue, then the surgeon has to remove both tissues, the latter with a cut. Breast ultrasound is needed to find out what tissue we are dealing with. It is the basic examination after which the surgeon can make a decision about the procedure. After both treatments, the patient has to wear a special vest for some time. Nevertheless, it can return to normal functioning fairly quickly.
– A lot of men from abroad come to Poland to remove the problem of gynecomastia – says Tomasz Zdun, project manager of the medical tourism booking service. – Clinics that cooperate with our service offer the removal of both lipomastia and gynecomastia proper. The price of the first treatment is approx. 3,5 – 4 thousand. PLN, and the second – 7 – 8 thousand. zloty.
Finally, it is worth mentioning that while some men suffer and struggle with the complexes of having breasts, others enlarge them. At the other extreme of gynecomastia, there are plastic surgeries of placing male implants in the chest. Who and in what situations decides on this type of operation? Usually men who care a lot about the appearance and proportions of their body. And for the ideal ones, they lack male implants, which are supposed to add masculinity to them (price approx. PLN 11-12 thousand).
If gynecomastia results from the use of drugs, they should be discontinued, if possible, or replaced with substitutes devoid of such effect (e.g. use eplerenone instead of spironolactone). When gynecomastia is caused by disease (e.g. liver, kidney, or thyroid disease), the focus is on treating the disease in question. On the other hand, when gynecomastia concerns an obese person, it is recommended to reduce body fat using properly selected exercises and diet.
It should be remembered that the surgical treatment of gynecomastia is reimbursed by the National Health Fund only if it is necessary for the health and life of the patient. Such treatment is in most cases carried out only in men who have not been successful in reducing body fat, changing the diet and pharmacological treatment.
The National Health Fund only refunds the classic gynecomastia surgery, liposuction is not financed.
In the case of pharmacological treatment of gynecomastia, drugs are administered depending on the cause of the disease. The most common drugs in pharmacological treatment are: clomiphene designed to block estrogen receptors, thereby stimulating the production and secretion of testosterone; testosterone affecting the balance between the concentrations of androgens and estrogens (it is not used in the case of significant obesity, because it may exacerbate symptoms); tamoxifen and raloxifene, which locate estrogen receptors in the mammary glands, which in turn significantly reduce gynecomastia and pain caused by gland enlargement; aromatase inhibitors, which block the enzyme that is responsible for converting testosterone to estrogen in adipose tissue.
Diagnosis of gynecomastia
To diagnose gynecomastia, the patient should be carefully examined. For this purpose, palpation of the male mammary glands and imaging tests are used. Most often, ultrasound of the mammary glands is performed, thanks to which it can be determined whether there has been an overgrowth of glandular tissue. In addition, an ultrasound of the abdominal cavity is also performed to examine the adrenal glands, kidneys and liver, as well as an ultrasound of the testicles or an ultrasound of the thyroid gland.
In addition, sometimes laboratory tests are also performed, such as liver tests, TSH, LH and FSH levels, and blood counts. Thanks to the appropriate series of tests, it is possible to determine what is the cause of gynecomastia, and thus it is possible to choose the right treatment.
Also read: Testicular Hormonal Failure – Definition. Types of hypogonadism
Gynecomastia and breast cancer
Breast cancer, although associated mainly with women, also affects men (according to the data out of 100 cases of breast cancer, one is male). Sometimes gynecomastia on only one side may be a symptom of breast cancer. In this case, the key is to act as quickly as possible, because it is in men that this tumor can quickly spread to the walls of the chest.
Gynecomastia and diet and exercise
The best way to get rid of enlarged breasts in men is aerobic exercise, thanks to which you can burn the most fat in the shortest possible time. According to specialists, it is good to supplement such exercises with strength training (muscles burn fat to grow). It is recommended to exercise for at least 30 minutes three to five times a week. Exercise can also take the form of walking, cycling or running.
In addition to exercise, it’s also a good idea to consider changing your diet. In the case of gynecomastia, it is recommended to eat zinc-rich foods, such as sesame seeds, pumpkin seeds, peanuts or oysters. Zinc is also rich in beef, veal liver and lamb. The aforementioned peanuts and fish also contain healthy unsaturated fats, which in turn help increase testosterone levels. In addition, specialists believe that men with gynecomastia should consume watermelons and avoid soy and processed products.
The text comes from EksMagazyn – the only women’s magazine that undresses men.
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