Gynecomastia: Causes, Diagnosis, and Treatments

Teenage boy sitting at counter.

Gynecomastia is a medical condition in boys and men where an imbalance of hormones causes enlarged breast gland tissue.  The imbalance may occur for a variety of reasons but is ultimately caused when estrogen levels are too high in relation to testosterone levels.  Gynecomastia can affect one or both breasts evenly or unevenly.

Gynecomastia isn’t a serious medical problem and it may even resolve on its own.  However, if the condition persists, medical treatments are available especially in situations of underlying endocrine conditions.

Common Causes

As stated above, gynecomastia is typically caused by an imbalance between the male hormone, testosterone, and the female hormone estrogen.

While testosterone controls male traits like increased body hair and muscle mass, estrogen controls female traits, like breast growth.   Thus, when estrogen levels are too high in males, breast growth can be abnormally activated.

happy baby.Natural Causes   

It is important to note that males and females naturally produce both estrogen and testosterone.  It is the imbalance that causes gynecomastia.

There are times in a male’s life when gynecomastia occurs in a normal, natural manner.  These times include:


Health conditions including the following diseases can also cause gynecomastia:

In the case of endocrine-related conditions in children, Dr. Joshua Smith, our pediatric endocrinologist, will be exceptionally helpful.

Herbal Products

There are a few herbal products used in shampoos, soaps and locations that have been linked to gynecomastia.  They include:

Illicit Drugs

The following illicit, “street drugs” can cause gynecomastia:


pill bottles.

The following medications can also cause gynecomastia:

Ultimately, gynecomastia is triggered by the increase or decrease in the balance of the hormones testosterone and estrogen in males.

These changes can be caused by conditions that block the effects of testosterone, reduce testosterone or increase your estrogen level.

Diagnosis and Treatment


To establish a proper diagnosis for gynecomastia, Dr. Joshua Smith, will utilize his pediatric endocrinology expertise to perform a thorough physical exam, review medical history and medications and carefully evaluate your child’s symptoms.   Common symptoms include:

After a physical examination, that may include a careful examination of breast tissue, abdomen, and genitals, Dr. Smith may order preliminary tests.  Laboratory and/or imaging tests help identify hormone levels and any abnormal tissue.   Preliminary tests may include:

Additional tests may also include:

Dr. Smith will use these tests to ensure male breast swelling is gynecomastia and not another condition with similar symptoms like:


In many cases, no treatment is needed for gynecomastia, and symptoms diminish over time. However, if it is determined that an underlying endocrine-related medical condition is the cause, Dr. Smith may prescribe medications or other treatments.

Emotional Support

Another consideration with gynecomastia is the emotional unrest or embarrassment felt by a male with enlarged breast glands.  It is normal for a boy or man to have unsettled feelings about this condition.  The emotional and caring support of family or professional counseling may be helpful to stabilize emotional well-being.

Pediatric Endocrinology Specialist

If your child is experiencing any of the gynecomastia symptoms described above, call Dr. Joshua Smith for an appointment, or fill out the form below.

Dr. Smith is the region’s only specialist in pediatric endocrinology and is specifically trained to properly diagnose and treat gynecomastia.

Effective treatments, if necessary, are available, but remember, early intervention can prevent future problems in many cases.

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