Gynecomastia is a common and mostly benign condition. It is very rare for it to have negative health implications, but it is typically a cause of psychological and emotional distress. There are numerous reasons for an onset of the condition. Some are natural, such as age-related changes in hormonal balance. It can also be induced by the use of drugs.
The most common cause of gynecomastia is spontaneous generation. Roughly half of teenage boys experience it with the onset of the puberty, and for half of those cases, it will persist into adulthood. It is thought that this it likely due to a sensitivity to their own body’s natural anabolic hormones, including natural testosterone metabolites.
Older men in their late 50s can also suffer spontaneous gynecomastia. The incidence in this group can be as high as 70%. This is likely due to a decline in testosterone production, combined with a decomposition of testosterone into estrogen-like compounds. This can result in the development of breast tissue.
Gynecomastia can be triggered by a wide array of prescribed and recreational drugs, however, typically it only occurs from sustained use. Medication used to treat high blood pressure or heart problems can have this side effect. Examples include Digoxin, Spironolactone, ACE (angiotensin-converting-enzyme) inhibitors, and CCBs (calcium channel blockers).
Medication for managing depression such as tricyclic antidepressants and Diazepam can trigger the condition, as can antiretroviral drugs (for HIV), and some antibiotics (for example, metronidazole, minocycline, isoniazid).
Hormonal preparations such as testosterone and anabolic steroids are used for a variety of medical purposes, as well as by athletes and bodybuilders to improve performance. However, excess drug not used by the body can end up converted to estrogens or their agonists, which in turn can trigger gynecomastia.
Prostate cancer medication such as anti-androgens can impair the synthesis of male anabolic hormones, including testosterone, and cause breast development.
Recreational drugs (for example, cannabis and heroin) and alcohol can induce glandular tissue proliferation after a long-term abuse.
Serious health issues can cause gynecomastia due to their effects that alter the body’s natural hormonal balance. Examples include hypogonadism, hyperthyroidism, kidney failure, liver failure, cirrhosis, and certain tumors (testes, adrenal glands, or pituitary gland).
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