Gynecomastia, or “man boobs,” is an embarrassing, but surprisingly common condition. Though rarely life-threatening, gynecomastia can result in low self-esteem, poor self-image and social isolation.

So, what exactly causes gynecomastia?

In most cases, the cause of enlarged male breasts is idiopathic (meaning no definitive cause), in other cases, it can be attributed to a hormone imbalance.

Both men and women produce androgens (male hormones) and estrogens (female hormones), which are responsible for determining male and female sex characteristics.

For men, estrogen typically takes a back seat to androgen production. However, when there is an imbalance between male and female hormones, men can develop female characteristics like enlarged breasts.

Below are some of the most common causes of gynecomastia:

1)      Puberty

Hormone changes during puberty are one of the most common causes of gynecomastia in adolescence. In most cases, excess breast tissue is only temporary in teenage boys – lasting between six months and two years. For this reason, male breast reduction surgery is not usually recommended until adulthood.

2)      Aging

Similar to puberty, aging men can experience an imbalance of sex hormones. Testosterone levels tend to decrease over time – making enlarged male breasts a common occurrence for men over the age of 50.

3)      Alcohol Abuse

Years of alcohol abuse can result in liver damage, which can change the way the body metabolizes hormones – resulting in breast enlargement. Additionally, excessive alcohol consumption often goes hand-in-hand with malnutrition, another common cause of breast enlargement.

4)      Drug Side Effects

There are a variety of medicines that may cause gynecomastia-like side effects. Generally speaking, the risk of developing gynecomastia is relatively low, but it is possible for the following medications to cause enlarged male breasts:

• Antiandrogen drugs (e.g., flutamide, cyproterone, and spironolactone)
• Psychiatric drugs (e.g., antidepressants)
• Medicines used to alleviate ulcers (e.g., cimetidine)
• Medicines used to treat epilepsy (e.g., dilantin)
• Chemotherapy drugs
• Steroids

Though not a prescribed medication, studies have also shown tree oil and lavender oil (common in shampoos, soaps and lotions) to increase the risk of childhood gynecomastia.

5)      Obesity

Carrying around an unhealthy amount of extra weight can affect your appearance in more ways than one. Gynecomastia occurs when an extra layer of fat tissue develops over normal sized male mammary glands. Excess fat also stimulates the body’s production of estrogen – which can spur additional breast tissue growth.

How to Treat ‘Man Boobs’

Ultimately the treatment depends on the cause.

If alcohol abuse, obesity or certain medications are causing enlarged male breasts, then a change in lifestyle may be the best treatment. However, if lifestyle changes aren’t enough, male breast reduction is a surgical alternative that combines excision (with a scalpel) and liposuction to remove excess tissue from the chest.

Male breast reduction is typically an outpatient procedure (meaning no overnight stay) that can be performed in an hour and a half or less. Most men who have undergone surgery are very happy with the final results and experience improved quality of life.