My breasts are bigger than my girlfriend's. Is this turning into a girl or do I have a terminal disease?

I am a real man, but my breasts have grown bigger recently. There is a lump when I press it, and it hurts a little. My breasts will not keep growing and take me away from this beautiful world, right? Don't worry, the most common cause of this is male breast development (GM). GM does not mean that you are not masculine enough, nor is it a malignant tumor, it just means that the breasts are larger than other men.

Don't be surprised, most newborns and half of adolescent males will have GM. Look at the boy's chest in the picture below, does it look familiar?

Big breasts are different from big breasts

What should I do if I find my breasts are getting bigger? Let's first identify whether it is GM.

1 Is it really male breast development?

If there are lumps on both breasts, located just below the areola, feel a little elastic, move when pushed, and hurt a little when pressed hard, then it is very likely GM.

2

Men can get breast cancer too

There are other reasons for breast enlargement besides GM, the worst case is breast cancer. Although the risk of breast cancer in men is very small, it is necessary to rule out this possibility first.

Be alert if the following situations occur: the lump only appears on one side, not directly below the areola; the lump is adhered to the surrounding tissue and is difficult to move; small depressions or ulcers appear on the local skin like orange peel; the nipple is inverted or there is bloody secretion; lumps also appear in the armpits.

3

Just too fat

Similar to female breasts, male breasts contain not only glands but also fat. If it is not glandular hyperplasia but excessive fat deposition that causes breast enlargement, it is breast fat deposition. Simply put, it is too fat... At this time, the whole breast feels similar to the touch, and there is usually no clear lump.

When the above three are difficult to distinguish, ultrasound, X-ray, or even tissue biopsy may be needed to differentiate them.

Why did my breasts develop?

Since all men have mammary glands, why do other people's breasts look firm and square, but mine grow? Simply put, it's because the ratio of androgen to estrogen is not right.

Normal men also have estrogen in their bodies, and the levels are comparable to those of women. Estrogen stimulates breast growth, but the inhibitory effect of androgens is strong enough to prevent breast development in adult men. When androgens decrease, estrogen increases, the ratio of the two is unbalanced, or there are changes in the receptors that allow the hormones to work, the balance is broken and GM occurs.

1No need to worry about the normal maturation process

Most newborns have developed breasts and can even secrete milk for a short period of time. This is because the fetus is exposed to hormones that promote breast hyperplasia and lactation for a long time in the mother's womb. After the newborn is born, it is no longer affected by the mother's hormones, and the breasts usually shrink within a few weeks, which lasts until the age of 1.

The presence of GM in the neonatal period does not mean abnormal hormone secretion, nor will it affect the child's subsequent development.

Half of adolescent boys will develop GM, and the most common age is around 14 years old. At this time, growth and puberty are at their fastest stage, and the level of sex hormones increases significantly, leading to GM. Most boys' GM disappears after a few months, and the longest lasts for 2 years.

The occurrence of GM in newborns and adolescents is a common phenomenon in the normal maturation process. There is no need to worry too much and undergo unnecessary examinations.

2

Adult men need attention

Although GM itself does not have much impact on health and will not cause breast cancer, the presence of GM in male adulthood indicates changes in hormone levels, and the cause needs to be identified in time to avoid delaying the treatment of the underlying disease.

Find the cause of breast enlargement

If it is determined that breast enlargement in adulthood is due to GM, common causes include medications, systemic diseases, obesity, malnutrition and alcohol.

1 Drugs may "enlarge breasts"

First, you can check whether there are any drugs that may cause GM that you have been taking for a long time. Common types include cimetidine and proton pump inhibitors for the treatment of peptic ulcers, metoclopramide, an antiemetic drug, and finasteride and spironolactone for the treatment of prostate hyperplasia and hair loss.

Some bodybuilders have clear abdominal muscles but full breasts, which is a common side effect of abusing hormone drugs.

Taking the wrong medicine by mistake can also lead to GM, such as when a man mistakenly takes a female oral contraceptive, which can significantly increase the estrogen level in the body. Phytoestrogens do not necessarily have such an effect. We often hear that "soy milk can make your breasts bigger", but current research suggests that the large amount of phytoestrogens contained in soybeans will not lead to GM.

2

Other organs also affect the chest

Reproductive system diseases, endocrine system diseases (such as hyperthyroidism or hypothyroidism, etc.) and liver and kidney diseases may lead to abnormalities in the secretion, conversion or clearance of sex hormones. If you have been diagnosed with the above diseases, GM may be related to them.

3

You can't eat too much and you can't be too hungry

Obesity not only directly leads to local fat accumulation in the breasts, but is also often accompanied by androgen deficiency. Because adipose tissue can convert androgens into estrogens, excessive fat can increase the estrogen/androgen ratio.

Being too hungry or losing too much weight will make the body feel that it lacks energy and think that the external environment is not conducive to fertility, thus reducing the secretion of androgen to reduce energy consumption. Rapid weight loss reduces the fat on the chest, but may increase the glands.

4

Drinking alcohol can damage your liver and chest

Alcohol is toxic to cells that secrete androgens, and long-term heavy drinking can cause androgen levels to drop. Liver disease caused by drinking also affects the conversion of androgens, which together lead to GM.

Can breasts be smaller if they are big?

Most GM in neonates or adolescents will gradually disappear on their own without the need for excessive examination or any treatment.

If GM is caused by medication, try to stop taking it or switch to another medication. For diseases that cause GM, treat the cause. Breast development in the short term will be partially relieved after the cause is removed, and the degree of recovery depends on the size of the breast and the duration. Breast development is not easy to disappear on its own after it lasts for more than 1 year.

If the swelling does not go away, surgery can be performed to restore a nice breast shape.

References

[1] Kanakis GA, Nordkap L, Bang AK, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019;7(6):778-793.

[2] Breast Expert Committee of the Minimally Invasive Branch of the Chinese Medical Doctor Association. Expert consensus and operation guidelines for minimally invasive surgery for male breast development by laparoscopic surgery (2019 edition). Chinese Journal of Minimally Invasive Surgery. 2019;19(11):961-963.

[3] J Expert Panel on Breast Imaging: Niell BL, Lourenco AP, Moy L, et al. ACR Appropriateness Criteria® Evaluation of the Symptomatic Male Breast. Am Coll Radiol. 2018;15(11S):S313-S320.

Author: Dai Tianyi

Editor: odette