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Company logo: Elliot W. Jacobs, MD, FACS - Diplomate, American Board Of Plastic Surgery

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Estrogen and Gynecomastia: 3 Questions

man boobs New York

Once they understand that breast growth—both female and male—is triggered by estrogen, guys with gynecomastia often have some logical follow on questions. By the time we see patients with man boobs in New York, they are usually past worrying about how the excess tissue occurred and whether there might be non-surgical solutions. (Hint: the answer is “probably not.”) But we do answer questions online about the role of estrogen in gynecomastia and weigh in on some logical lines of thought.

Here are three leading questions men and teens often have.

1) Should I take testosterone?

Since estrogen causes breast tissue growth, a thought that would seem to make sense is that taking testosterone could counteract this effect. This is a very bad idea!

When the body senses it has more testosterone than it needs, it converts (or “aromatizes”) the testosterone into estrogen. Hence, the opposite of the desired outcome can occur: more breast growth. This is what happens to many bodybuilders who take courses of steroids to build muscles.

There are other undesirable side effects of testosterone treatment. When a guy takes extra testosterone, the body may decrease its natural production. Sexual function can be affected and emotions may run wild.

2) Are there other possible medication solutions?

Whether to try medication to reduce man boobs is a complex question. First and foremost, we hope no one is fooled into purchasing “supplements” online. They contain substances like caffeine, green tea extract, chromium and “special ingredients” that are secret. What should be no secret is they don’t work.

Prescription drugs that prevent breast cancer—tamoxifen is one—have shown some promise for treating gynecomastia. These medications work by interrupting estrogen reception by tissues in the breast, thereby reducing growth. To date, studies of these kinds of drugs in men have been relatively small, and the effects of taking estrogen receptor modifiers over decades are not yet known. Patients also have to weigh the possible side effects and the cost of the drug over time.

Aromatase inhibitors, drugs that stop estrogen production, have also been suggested as a possible treatment for gynecomastia. These drugs are often used by bodybuilders in an effort to prevent steroid conversion into estrogen. Whether they are effective for bodybuilders in preventing man boobs is a hot debate, and even less is known about whether aromatase inhibitors might safely treat breast growth after it has occurred.

Along with other gynecomastia experts, we believe that because the human endocrine system is so complex and delicately balanced, people should not attempt to alter it on their own. Only an experienced endocrinologist, oncologist or other expert should prescribe a course of treatment that alters hormone levels.

3) Could I be infertile?

In rare cases, gynecomastia is associated with a disorder that may affect fertility. Klinefelter’s Syndrome is an example. In this condition, the patient has an XXY chromosome configuration rather than the usual male XY. The extra X chromosome can bring with it some “feminine” traits, such as scant body hair and breast growth. Occasionally an XXY man is infertile. Read more in our article on Klinefelter’s here.

If a guy suspects there may be an underlying medical condition with man boobs as a side effect, he should consult his primary care physician and perhaps go on to see specialists. Few causes of gynecomastia, however, including when gynecomastia is of unknown origin, affect fertility. Most men do not need to worry about this.

We understand that it’s tempting for a guy to consider trying non-surgical ways to combat gynecomastia. Even though male breast reduction surgery is still the most reliable way to banish moobs safely and completely, no one really wants to go under the knife.

We also know that cosmetic surgery is not for everyone. We have consulted with guys with man boobs in New York for decades and some men elect not to have the procedure. We are happy to share our expertise in coping with the condition and can steer guys to online support communities, good compression garments and more. If we can be of help in any way, just let us know.

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