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It’s abnormal for men to have big breasts, say endocrinologists

Men with enlarged breasts may have to go for medical evaluation as medical professionals emphasised that breast enlargement in men also known as gynaecomastia is abnormal.

Consultant endocrinologists who examined the condition during an exclusive interview with PUNCH Healthwise advised men with big breasts to seek immediate medical attention, warning that the enlargement could be a sign of underlying health issues.

The specialists emphasised that while breast development in males could be benign, adding that it could stem from hormonal imbalances, liver or kidney disease, certain medications, or tumours and could necessitate breast tissue reduction surgery.

They stressed that early diagnosis was essential for addressing potential health concerns and exploring treatment options, warning that ignoring this sign might lead to complications or prolonged discomfort.

The experts urged men experiencing breast development to consult a healthcare professional to understand the cause and receive appropriate guidance and care.

According to Johns Hopkins Medicine, gynaecomastia is characterised by the overdevelopment or enlargement of breast tissue in children and adults with male anatomy, resulting in larger and often uneven breasts.

This condition, it stated, commonly occurs during puberty when preteens and teenagers experience hormonal changes, and this can also affect newborns and adults as they age.

Also, the National Library of Medicine, a medical journal, indicated that breast development in males could occur normally during three phases of life, shortly after birth in both males and females, due to high foetal blood levels of oestradiol and progesterone produced by the mother that stimulates breast tissue in the newborn. Others are puberty and old age, which may start at age 60.
A Professor of Anatomy and Reproductive Endocrinology, Oladapo Ashiru, emphasised that the development of breast tissue in men could be abnormal and warrants medical evaluation.

Ashiru, who is the Chief Medical Director, Medical-Assisted Reproductive Technology, Lagos, noted that while this condition might sometimes be normal, resulting from hormonal imbalances or the consumption of certain oestrogen-rich foods, it was crucial to seek immediate medical attention to determine if there was an underlying issue.

As a consultant reproductive endocrinologist who co-pioneered in vitro fertilisation research in 1984 and successfully delivered Africa’s first test-tube baby in 1986, Ashiru highlighted that hormonal imbalances could lead to future infertility.

He said, “The development of breast tissue may be normal or abnormal. If it occurs due to excess body fat, it is typically normal. However, if it is not related to weight, it can be abnormal and requires immediate attention, as it may indicate an underlying health issue.

“I advise anyone experiencing this condition to consult a medical practitioner. It can sometimes result from consuming processed foods that contain estrogen. Hormonal imbalances can lead to fertility challenges.”

Ashiru, a fertility expert, also urged parents of children with developing breast tissue to seek medical advice, as it might signal a serious medical condition if overlooked.

Dr Oluwakemi Ashubu
Sustaining this line of thought, another consultant paediatric endocrinologist at the University College Hospital in Ibadan, Oyo State, Dr Oluwakemi Ashubu, emphasised that male breast development should not be overlooked, as it might indicate an underlying medical condition.

She noted that gynaecomastia could be concerning in certain cases while advising individuals to seek medical help as soon as they notice any unusual changes in their bodies, rather than assuming the issue would resolve.

Ashubu stated, “Visit a hospital and let the experts determine whether you should be concerned or not. Ignoring it now could lead to more significant expenses and complications in the future. It may be a symptom of something serious, depending on the individual’s medical history, which will help us decide if it’s something to worry about or if it can be resolved with appropriate action.”

She warned that if such symptoms were overlooked and were signs of hormonal imbalance, it could lead to infertility problems in the future.

The endocrinologist explained, “Sometimes, breast development in men may result from reactions to certain medications. Individuals with renal diseases, like kidney problems, who take specific drugs, may experience this.”

“However, if the breast tissue returns to normal after discontinuing the medication, it is typically not a concern, Ashubu explained.

She noted that for these individuals, it might not be an issue, but if the breast tissue remains enlarged after stopping the medication, it raises alarms and requires clinical evaluation.

The expert continued: “In this part of the world, we don’t take fertility lightly, whether in males or females. We may need to conduct more investigations to determine the underlying cause and provide treatment to reduce the breast tissue.

“If breast development occurs during puberty, it may not be a cause for concern, as it often results from hormonal changes as boys transition into adolescence and adulthood. Typically, their breast size should return to normal after this stage. However, if the enlargement persists, it warrants further investigation to determine the underlying issues.”

She noted that if breast enlargement happens during puberty or is a side effect of certain medications, particularly those used for renal problems, physicians often do not view it as a concern.

Ashubu explained, “However if breast tissue remains enlarged after puberty, it is important to seek medical help. There are several factors we assess to understand why this is occurring.

“In cases of renal problems, I have managed patients who experienced breast enlargement while on certain medications, but once they discontinued the medicines, their breasts returned to normal. Similarly, those who were overweight saw their breast tissue flatten after losing weight.

“I have also observed that some boys develop breast tissue during puberty, which often resolves as they complete their developmental changes. However, I have not had to investigate further in those instances.

“The only time we don’t take immediate action is during puberty. If a child is overweight, we recommend weight loss. For those on medications for kidney issues, we look for alternatives that serve the same purpose without causing breast enlargement.”

She emphasised that in such cases, collaboration with their doctors to identify the best alternatives becomes pivotal as this issue can impact their psychological well-being and self-esteem.

“If you notice any changes in your body that you have never seen before, seek medical advice right away. Don’t assume it would resolve on its own; let an expert assess the situation.

“Neglecting these symptoms could lead to infertility in the long run if there is an underlying hormonal imbalance,” she added.