Gynecomastia: what it is and what you can do now

Gynecomastia is the enlargement of breast tissue in males. It can be soft or firm, one side or both, and sometimes it hurts. If you’ve noticed new breast growth, a lump under the nipple, or tenderness, this page spells out the common causes, simple tests, and realistic treatment choices so you know what to do next.

Common causes and what to check first

Start by thinking about recent changes. Hormone shifts are the most common cause: puberty, aging, low testosterone, or high estrogen activity can all trigger growth. Certain drugs are frequent culprits — anabolic steroids, spironolactone, some anti-androgens, finasteride, certain antipsychotics, and some heart medicines. Alcohol, marijuana, and herbal products with estrogen-like effects can also play a role.

Medical issues that matter include liver disease, kidney failure, and rare tumors that change hormone levels. Pubertal gynecomastia often clears up on its own within 6–24 months. In older men, or when medication or disease is to blame, it may persist unless the cause is treated.

Quick tests, red flags, and simple self-care

Your doctor will usually do a focused physical exam and ask about medicines and substance use. Basic blood tests often include testosterone, estradiol, LH, FSH, liver and kidney panels, and sometimes hCG if a tumor is suspected. An ultrasound of the breast or chest wall is the usual imaging first step. Mammograms are less common but used if cancer is a concern.

Seek urgent care if the lump is hard, fixed to skin or chest, causes bloody nipple discharge, or grows quickly. Male breast cancer is rare, but those signs need prompt attention.

Simple daily steps can help: stop or switch suspect medications with your doctor’s OK, avoid anabolic steroids and excess alcohol, try weight loss if you’re overweight, and use a compression vest for comfort during activity. These moves won’t always shrink glandular tissue, but they reduce fat-related enlargement and ease symptoms right away.

Treatment choices depend on cause and how much the condition bothers you. If it’s recent and mild, watchful waiting for several months is reasonable. For painful or persistent gynecomastia, medications that block estrogen effects (like tamoxifen or raloxifene) can reduce size and tenderness, especially in early stages. Aromatase inhibitors are used less often and usually in specific situations.

Surgery is the most reliable option if tissue is long-standing or if appearance is a major concern. Options include liposuction (removes fat) or gland excision (removes firm tissue) and sometimes both. Talk to a board-certified plastic surgeon experienced with male chest surgery about scars, recovery time, and expected results.

If you’re unsure where to start, book a visit with your primary care doctor or an endocrinologist. They’ll guide necessary tests and next steps. If cosmetic change is the main issue, consult a plastic surgeon for options and timing. You don’t have to accept ongoing pain or embarrassment — there are clear, effective paths to feel like yourself again.