Gynecomastia (popularly known as “gyno”) is an enlargement of the breasts in a man, produced by a benign proliferation of mammary glandular tissue. Its cause is an imbalance between the stimulating effects of estrogen (female sex hormones) and the inhibitory effects of androgens (male sex hormones) in the breast tissue, when the quantity of the first ones increase, or the second ones descend.
The mammary gland is regulated by the action of different hormones, including estrogen, progesterone, and prolactin. Both estrogen and progesterone stimulate the growth of the breast and the development of mammary glandular tissue. Before puberty there are no differences between the mammary glands of both sexes; however, starting at this moment, the hormonal changes that occur in the body favor the development of the mammary glands in women. In males, low estrogen levels are usually maintained, with the action of androgens predominating, so that the breasts do not develop.
True gynecomastia usually appears as a lump or an increase in breast volume, which may be unilateral (affects only one breast) or bilateral (both), and may be accompanied by breast tenderness or pain. It is important to make a differential diagnosis between true gynecomastia and other pathologies, basically two:
- Pseudo-gynecomastia: the increase in the size of the breast is produced by the deposit of fat tissue, without the proliferation of glandular tissue. It is common in men who suffer from obesity.
- Breast cancer: usually manifests as a generally unilateral mass, located eccentrically with respect to the nipple (while in gynecomastia it is usually concentric), firm consistency or hard to the touch (in gynecomastia it is soft), that is painless most of the times, and that can be associated with other symptoms such as changes in the skin, nipple retraction, breast secretion that can be bloody, or palpable lymph nodes, mainly at the level of the armpit. Breast cancer in men is uncommon (it accounts for less than 1% of breast cancers), however, it is essential to know how to differentiate it from gynecomastia.
What causes gyno?
Most cases of gynecomastia have a physiological and nonserious cause, but it is important to rule out some pathologies that can cause gyno and that can be serious. The mechanism by which breast growth occurs is not well known, although it is considered that the main cause is an imbalance between the estrogenic and androgenic action in the male breast (and not necessarily the blood hormone levels).
The causes that can produce a pathological gynecomastia are multiple and very varied:
Excessive estrogen production
Male bodies also produce typically feminine hormones such as estrogen even when there is no health problem present. However, in some cases, the levels of this substance are much greater than normal, which can cause gyno among other things. Some of the most common causes of an augmented estrogen level are the following:
- Estrogen-secreting tumors or their precursors: some types of tumors can alter the hormonal balance of the body, by producing estrogen in greater quantities than usual in the male body. Some of them include liver, lung and gastric cancer.
- Increased peripheral conversion of androgens to estrogens: some illnesses, such as obesity, cirrhosis, hyperthyroidism, malnutrition, chronic renal failure, hereditary disorders of aromatase, and adrenal feminizing tumors can cause sometimes gyno as one of their secondary effects.
Insufficient testosterone production
Another common cause for gyno is a lower – than – usual testosterone level, either on the body as a whole or just in the chest area. The reasons for this can vary, but the most common ones are the following:
- Congenital causes (present from birth): congenital anorchia (absence of testicles), Klinefelter syndrome, androgen resistance syndromes (testicular feminization, Reifenstein syndrome, or absence from the birth of androgenic receptors), Kennedy disease, a deficit of testosterone synthesis, pituitary or hypothalamic disease. When any of these illnesses are present, gyno is just one of the symptoms, not the main one.
- Acquired throughout life: orchitis, castration, testicular trauma, viral infections, chemotherapy or radiotherapy, renal failure, lifestyle choices. A lack of testosterone can be acquired through life due to a variety of reasons, and usually, require medical intervention to be cured.
Drug use
Although medical reasons are sometimes behind gyno, the most common cause of this problem is the use of several substances that alter body balance and composition. There are several types of drugs that can cause this effect; the most common ones are the following:
- Hormones: estrogen, testosterone, antiandrogens (cyproterone acetate, finasteride, ketoconazole, flutamide, spironolactone), anabolic steroids, HCG (human chorionic gonadotropin), growth hormone.
- Drugs used in neurology and psychiatry: haloperidol, diazepam, phenytoin, opioids, and tricyclic antidepressants can sometimes produce gyno as a side effect
- Other drugs: methotrexate, minoxidil, alkylating agents, penicillamine, digoxin, ACE inhibitors, amiodarone, metronidazole, theophylline, isoniazid, antiretrovirals, methyldopa, minocycline, amphetamines, reserpine, penicillamine, heroin, methadone…
In healthy males, drug use is normally the main cause behind gyno, especially in the case of athletes who take steroids in order to improve their performance or body composition. This is usually not the worst side effect of these substances, but it can nevertheless be very uncomfortable.
How can I get rid of gyno?
We must bear in mind that gyno is a hormonal imbalance and that any attempt to eliminate this problem without surgeries should face this imbalance and readjust it (even if it’s just partially). Therefore, the first measure should be to start an estrogen regulation therapy that favors an increase in androgen levels (especially testosterone) so that gynecomastia, at least if it’s not too severe, begins to disappear.
So, how do we increase the natural production of testosterone? First, we will look at some key lifestyle choices you can make in order to achieve this goal. Later, we will study the impact of food on your overall testosterone levels and your gyno problem.
1. Lifestyle choices
A good start to achieving this goal is to start an intensive exercise training program. This will generate testosterone levels that are directly proportional to the level of muscular stress in a workout.
Therefore, it is recommended to start training with weights focusing on compound exercises: those that involve 2 or more joints, such as squats. It is better to focus on whole-body training, before a single muscle. Other exercises that can help you achieve this goal are the bench press, the deadlift, and the military press.
For those who drink a lot of alcohol, there is some bad news: they must completely abandon its consumption, as it is known to decrease testosterone production and it allows estrogens to reach levels that are much higher than natural.
Another way of increasing testosterone levels is by having sex more often. Having sexual relationships with a partner can increase this hormone directly, as well as decreasing stress and anxiety by boosting our neurotransmitters (such as oxytocin and dopamine), which can have a positive indirect effect in our testosterone levels.
Resting is another key component in the increase of testosterone. Studies have shown that, when we are sleeping, our bodies repair the stress we have suffered during the day. This helps maintain a proper balance between estrogen and testosterone and is key while battling gyno.
2. Food
Although not many people know it, the food we take has a direct impact on our hormones and our body balance. Too often, we eat a lot of things that increase our estrogen levels, while decreasing testosterone production at the same time. Therefore, if we want to get rid of gyno, we need to watch what we eat.
Some types of food are known in the scientific community because they raise estrogen levels if they are consumed in great quantities. In this group, we can find the following types of food:
- Soy. The main ingredient in many diets, such as vegan and vegetarian ones, soy contains some components known as “phytoestrogens”. These substances can mimic the effect of true estrogens in the body, and can, therefore, worsen your gyno problem If you want to get rid of your man boobs, soy is one of the first things you have to eliminate from your diet.
- Sugar. This ingredient is regarded nowadays as almost evil, and there’s a reason for this. Sugar has a tremendous impact on your health, but just focusing on gyno, it is one of the most harmful things you can eat. Stop adding sugar to your diet and you will see almost immediate results.
What, then, can you eat to get rid of your man boobs? Vegetables such as spinach and broccoli, red meat, fish and coffee can help you boost your testosterone levels greatly. When paired with a good lifestyle, a healthy diet can help you achieve that flat chest you desire in a short amount of time.
