Is it a disease for men to have big breasts?

It is said that breasts are the capital of women's pride. For women in real life, as long as they are within a reasonable range, everyone has a proud figure. In other words, the bigger the breasts, the better. But for male friends, big breasts are not a good thing. On the contrary, it may be caused by male breast hypertrophy. It is a common disease, and its occurrence will also have adverse effects on the male body.

Male breast enlargement is a common disease. Foreign literature reports that the incidence of asymptomatic breast enlargement that can be felt in the normal population ranges from 32% to 38%. Some literature reports that the incidence rate in adolescence can be as high as 67%, and the incidence rate in men over 50 years old can also be as high as 57%. The age of onset is almost seen at any age, from 7 to 85 years old. There is no significant difference in the incidence rate of left and right breasts, and bilateral breast enlargement is common.

Causes

1. Primary gynecomastia

It is more common in children and adolescents, often due to physiological endocrine disorders, with plasma estradiol levels higher than testosterone levels, resulting in a transient estrogen/androgen imbalance, or increased sensitivity of breast tissue to estrogen, also known as physiological male breast hypertrophy.

(ii) Secondary gynecomastia

1. Endocrine diseases

(1) Testicular diseases are caused by hypogonadism, very low androgen secretion, and changes in the ratio of testosterone to estrogen in the blood, which lead to male breast hypertrophy. ① Congenital testicular dysgenesis (Klinefelter syndrome); ② Complete testicular feminization; ③ Kallmann syndrome; ④ Orchitis, trauma and tumor; ⑤ Reifenstein syndrome.

(2) Adrenal diseases such as adrenal cortical hyperplasia, benign tumors, malignant tumors and decreased function. Such tumors can directly secrete estrogen or produce excessive estrogen precursors (such as androstanone), which are converted into effective estrogen in the tissues, increasing blood estradiol and causing breast hypertrophy.

(3) Thyroid diseases such as hyperthyroidism, increased concentration of sex hormone-binding globulin in plasma, excessive bound androgens, increased free estradiol (unbound estradiol), increased estrogen/testosterone ratio, and hormonal imbalance, which stimulates breast tissue proliferation and leads to male breast enlargement.

2. Other non-endocrine diseases

(1) Liver diseases such as hepatitis, cirrhosis, liver cancer, etc., accompanied by decreased liver function, often cause breast hypertrophy.

(2) Recovery period of chronic malnutrition: During malnutrition, the secretion of gonadotropin decreases. When malnutrition is corrected, a phenomenon reminiscent of second puberty occurs, and breast hypertrophy occurs, which is called "feeding-induced breast hypertrophy."

(3) Bronchogenic carcinoma and chronic lung diseases such as oat cell carcinoma, tuberculosis, and pectoris abscessus can cause breast hypertrophy due to local irritation.

(4) Chronic renal failure: Patients with uremia caused by chronic renal failure have been tested to have relatively elevated estrogen and prolactin levels in their blood, leading to breast development and hypertrophy.

(5) Diseases of the nervous system such as paralysis caused by high spinal cord lesions, syringomyelia, and hereditary movement disorders may be accompanied by breast hypertrophy.

(6) Long-term use of estrogen for treatment of prostate hyperplasia or prostate cancer may often cause male breast enlargement.

(7) Lymphatic system diseases such as lymphoma, malignant histiocytoma, myeloma and other reticuloendothelial system diseases are also rare causes of male breast development.

(8) Drug-induced breast enlargement: Gonadotropins such as chlorpromazine, cimetidine, methyldopa, metoclopramide, metronidazole, isoniazid, reserpine, meconium, and thyroid extract can bind to estrogen receptors and cause endocrine disorders in the body, which can lead to male breast development. However, the enlarged breasts can usually recover after stopping the drug.

(9) Other diseases such as cardiovascular disease (hypertension, heart disease), severe skin diseases (leprosy, exfoliative dermatitis), autoimmune diseases (rheumatic arthritis, rheumatoid arthritis), leptospirosis, ulcerative colitis, etc. may sometimes be accompanied by male breast development.

Clinical manifestations

The male breasts develop unilaterally or bilaterally in a female-like manner, with hyperplasia and hypertrophy. The nipples and areola are well developed. Under the areola, a disc-shaped, hard, and diffuse mass with a clear edge can be felt. The diameter is usually 2 to 3 cm. It has a certain degree of mobility and is not adhered to the skin. A small number of patients have bloating or mild tenderness, and a very small number may have nipple discharge.