Gynecomastia, man boobs, bitch tits, man breasts or gynaecomastia is breast enlargement in males due to the development of abnormally big mammary glands. It begins with a small lump beneath the nipple, which can be tender for some cases. Usually the enlargement is to both breasts but can also be to single breast only for some cases. There are cases which are due to fat deposition only which is termed as pseudogynecomastia. This man boobs problem can happen to any babies, teenagers or adult males.
In babies, gynecomastia problem is caused by hormone estrogen passed from the mothers during pregnancy, which normally will disappear within one month time after birth.
Teenagers should learn more on what is gynecomastia early as almost two-thirds of them will experience gynecomastia during their puberty and the good thing is it will also disappear on its own later in life without any treatment. The median age for gynecomastia among teenagers is 14. Their breasts are asymmetric or uneven with slight tenderness. In very rare case, the breasts can develop till size cup D. The main cause is imbalance between estrogen and androgen action on the breasts due to increase production of sex steroid. However, some of them may be due to obesity.
In adult, most of the man boobs problems are due imbalance of sex hormones (more female hormone estrogen or lack of male hormone testosterone) and obesity. There are other possible causes ie. certain prescription of drugs, liver or lung cancer, cancer of adrenal glands, breast cancer, cancer of testicles, steroid, alcohol and marijuana.
In aging adult, one third of males aged 50-80 will experienced it too. Mostly are caused by decreased in hormone testosterone production, side effects from prescription drug or tumor. This gynecomastia will cause water retention, decrease of sex drive and shrinkage of testes.
There are 2 common classification methods for gynecomastia according medical experts.
Simon Hoffman classification categorizes them according to breast volume and skin redundancy
Grade 1: Minimum enlargement of the breast tissue
Grade 2A: Moderate enlargement of the breast tissue without skin redundancy
Grade 2B: Moderate enlargement of the breast tissue with moderate skin redundancy
Grade 3: Massive enlargement of the breast tissue with expressive skin redundancy
Geschikter and Copeland classification categories according to cause and effect
1. Type 1: usually occurs during puberty due to hormonal imbalance with feminine characteristics for the man breast
2. Type 2: similar to the Type 1 form with nodules of either glandular or fibrous tissue extend in the breast
3. Type 3 or true gynecomastia: increase of both glandular and adipose tissue, similar to the female breast in size and shape
4. Type 4 or pseudogynecomastia: increase of adipose tissue without compromise of the glandular tissue, usually encountered in the adult man
There are other possible causes of gynecomastia regardless of their ages ie.
i) Estrogen exposure (female hormone from our environment eg. water, food, contraceptives, creams )
ii) Androgen exposure (body-building hormones)
iii) Klinefelter’s syndrome, a condition in which a male has an extra X chromosome
Generally, man boobs is not harmful but for some cases, it is a symptom for other serious illnesses.
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Below are sample of severe gynecomastia pictures.
The above pictures of gynecomastia shown breasts have glandular and adipose tissue with extra skin redundancy. Their size and shape are resemble female breasts. Extreme gynecomastia can cause formation of milk.
It was record in a letter from the Bishop of Cork to the Earl of Egmont, Fellow of the Royal Society, written in 1738, quoted by O’Conne11 as this “There was an old Man about 70 years of Age, industrious, till deprived of his Strength by Age. “He asked me for Charity, and I gave him half a Crown. The Man, out of Gratitude, had returned to show me a Curiosity, which was that of his Breasts, with which he affirmed he had once suckled a Child of his own: His wife, he said, died when the Child was about Two Months old: The Child Crying exceedingly while it was in Bed with him, he gave it his Breast to suck, only with an Expectation to keep it quiet: but, behold, he found that the Child in time extracted Milk; and he affirmed, that he had Milk enough afterwards to rear the Child. I looked at his Breasts, which were then very large for a Man: but the Nipple was as large as or larger than any Woman’s I ever saw. Some Ladies were then passing by, so I sent him off in Haste, and have not seen him since.”
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