Gynecomastia in teenagers, just like in adult males, can be embarrassing but it’s normal. In fact the statistics show more than 50% of pubescent boys and teens are affected by the condition. Man boobs, as it is colloquially known, usually manifests when you go through puberty so in some cases swelling of the chest can show up in boys as young as 10 and up to 13 or 14 years of age.
The most obvious symptoms are enlarged breasts. There are no specifics involved as far as size goes, but you will notice that your breasts are not flat and they swell in shape similar to that of a woman’s. Apart from the size, boys will notice that their breasts have a firm or rubbery feel, and there could also be a breast bud on one or both breasts. These buds are usually about the size of a quarter or a nickel and appear during puberty. There’s no need to worry about this though as it isn’t permanent and will go away.
Pubertal Gynecomastia Causes
Teenagers with man boobs are not unusual as noted above, and there’s a scientific explanation for it. Gynecomastia is a sign of the physical changes taking place in the male body during puberty. There are many possible reasons for man boobs, but when it comes to teenagers, it is almost always due to hormonal changes resulting in physical changes.
To better understand this, understand that male breast enlargement starts when you’re a baby. This is considered as level one of male breast development, while the second level occurs during the aforementioned puberty stage. Following puberty there is a natural decline and male breasts should return to their normal state. It is when you’re between 60 to 80 years old that the final stage can take place as breast tissue starts growing. The term pubertal gynecomastia only applies when the conditions manifest during the puberty stage of course.
In the case of newborn babies, estrogen is derived from the mother so it’s not uncommon to see breast buds even in baby boys. This should not be cause for worry because these buds will disappear after six months. In some preteen boys man boobs may be brought about by a tumor that produces estrogen though it’s rare. Going back to the buds, there are cases wherein it has lasted for two years, but most likely disappear after a year.
How is Diagnosis Performed?
Because the symptoms are so obvious, there’s usually no need for a diagnosis. If tests will be performed it’s going to include a medical examination and a check of your medical records and what meds you have been taking. At least that’s how it’s usually done if both breasts are enlarged. But if only one breast is swollen and is hard or tender, your doctor might recommend a biopsy just to make sure there aren’t any other reasons for it.
It’s hard to emphasize this enough: males can develop breast cancer as well so if you notice one breast has a lump, inform your doctor immediately. This becomes even more urgent if you have close relatives that have cancer. A biopsy can determine if it’s cancerous or not so have it checked immediately.
Is Treatment Necessary?
As uncomfortable as man boobs may be, it usually doesn’t require medical treatment. When breast enlargement manifests in male teens or prepubescent boys, there’s no need to do anything because more often than not it’s going to go away on its own. During puberty there is increased interaction between estrogens (female hormones) and androgens (male hormones), and yes, males also have a bit of estrogen.
Puberty is marked by changes in the human body, and one of those is development of the breast tissue. However this is normal and it should only be a cause for concern if the breast enlargement does not stop after puberty and continues as you enter adulthood. If your breasts continue to swell, then that’s real gynecomastia and not just the condition associated with puberty, so it requires treatment.
Barring that condition however, gynecomastia in teens will cease to be a problem as you exit puberty. The extraneous tissue responsible for breast swelling will flatten out even if you don’t take any medications. In fact you’re probably going to make things worse if you take steps to prevent it because you’re preventing your body from reaching its natural growth potential.
Teenagers should never take medications or drugs that will suppress it without the supervision and consent of a doctor. Remember too that if you’re overweight with excess body fat, your condition might be more appropriately termed pseudogynecomastia. There’s a big difference between the two and have to be dealt with appropriately.
If the condition is brought about by an increase in estrogen and / or low testosterone levels, your doctor may recommend hormone therapy. The last recourse is surgery, but this is almost always applicable only in adult gynecomastia cases and only if the other treatments don’t work.
If the cause is due to excess weight and poor diet, the best recourse is to change your diet and lifestyle and exercise regularly. This is probably going to be difficult for many, but it is the best option, and unless your dietary habits change, the problem will not go away. Even if you have surgery and have the fats removed, they will return if you don’t change your lifestyle.
Are There Other Possible Causes of Gynecomastia?
As was pointed out above, the most common cause of man boobs among boys and teens is puberty, and unless there’s evidence to indicate otherwise, that must be the assumption. However, there are other possible causes such as drug abuse, genetic deficiency or the side effect of a medication you’re taking for another medical condition. And of course if you’re overweight the excess fat will be deposited in various parts of your body such as your arms, thighs and chest.
Why is Gynecomastia Common in Teenagers?
The most likely culprit is hormones and to be more specific, estrogens. Estrogen is the hormone that fosters the primary female characteristics, just as testosterone produces the male characteristics. Estrogen levels in females are higher, but some boys have a higher level of estrogen and this is what leads to the growth of their breasts. This doesn’t mean they’re going to develop other female characteristics however, and when puberty ends these estrogen levels will drop back to normal.
Teens man boobs are a common condition but not all males develop it. As was pointed out earlier, man boobs affects more than half of male teenagers so there’s no need to worry if you have it. At the same time, don’t fret if your breasts are normal and don’t swell up during puberty. The level of swelling varies as well but regardless of the size your breasts will flatten around the time you enter your 20s.
Though the symptoms may be similar, pubertal and adult gynecomastia are two different things and should not be confused with one another. Adult gynecomastia has many other possible causes such as hormonal imbalance, thyroid problems or cancer of the pituitary gland. There is also evidence that smoking, marijuana and heroin abuse can lead to breast enlargement in adult males.
The use of the following medications can also lead to gynecomastia, both in teens and adults:
- Dexamethasone, prednisone and other steroids
- Cimetidine and other medications used as ulcer treatment
- Phenytoin and other medications used as epilepsy treatment
- Some types of heart medication like digitalis might lead to breast swelling as well
- The drugs used in chemotherapy may also lead to gynecomastia. Alkylating agents, which are a special group of anticancer drugs, are also known to cause breast swelling in men.
- Antiandrogen drugs like spironolactone, cyproterone and flutamide may induce breast enlargement
- Antidepressant and antianxiety drugs like Valium and tricyclic antidepressants carry a lot of side effects, and one of those is gynecomastia
Keep in mind that just because you take one or more of these medications doesn’t mean you will develop gynecomastia. It simply means that if you get man boobs, you should look into these drugs as among the possible culprits.
When Should I See a Doctor?
You should only see a doctor is if you feel physical pain in your chest or if you think the enlargement is due to medication you’re taking. You might also want to see a specialist if the condition persists beyond puberty. During your appointment, inform the doctor what medications you’re taking and if you’re unweight. Only then will your doctor decide if yours is just a case of teenagers with man boobs or something else.
However the bottom line is, gynecomastia in teenagers is usually not a serious issue as it is part of growing up.