Causes
Gynecomastia can occur during puberty if levels of the hormones estrogen and testosterone become unbalanced. In addition to hormone imbalances, gynecomastia can develop at any age due to side effects of certain medications, such as high blood pressure medication, anabolic steroids, antidepressants, illegal drugs, chemotherapy drugs and medication used to treat tuberculosis. Obesity, tumors, chronic diseases and endocrine disorders can also cause breast enlargement in boys. While obesity causes breast enlargement, it is not considered gynecomastia because the breasts become enlarged due to extra fat deposits in the chest. Boys who have Klinefelter syndrome may develop enlarged breasts. The disease is characterized by an extra chromosome that can interfere with the production of testosterone. Testosterone is needed for the development of male sexual characteristics. Approximately one in every 500 to 1,000 newborn males have Klinefelter syndrome, according to the National Human Genome Research Institute, or NHGRI.
Role of Estrogen
Exposure to estrogen, either directly or indirectly, can cause gynecomastia. A study by Eric I. Felner, MD, and Perrin C. White, MD, of the Department of Pediatrics, Division of Endocrinology at the University of Texas Southwestern Medical Center, followed three boys with enlarged breasts due to the use of estrogen cream by their mothers. When estrogen cream use was discontinued by the mothers, the boys’ breasts became smaller within four months. The study was published in the April 2000 edition of “Pediatrics.” Exposure to tea tree or lavender oil can also trigger breast enlargement as these oils mimic the effects of estrogen.
Treatment
Waiting until the hormones become balanced again is the only treatment for gynecomastia caused by hormonal imbalances. Other cases of breast enlargement can be reversed by finding a new medication to treat a chronic disease, reducing exposure to estrogen, treating an underlying condition that is causing the problem or losing weight. In some cases, a boy’s breasts remain enlarged even after taking these steps, causing significant embarrassment. Wearing loose clothing can make the condition less noticeable, but it may be impossible to completely camouflage the condition. Breast reduction surgery may be an option for boys for whom medical treatment has been unsuccessful.
