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Low Testosterone and Male Breasts (Gynecomastia)

Highlights

  1. Low testosterone and gynecomastia are common conditions among men, especially as they age.
  2. Low testosterone levels can lead to reduced libido, low sperm count, erectile dysfunction, and enlarged male breast tissue.
  3. A variety of treatments are available, including medications and testosterone replacement therapy.

Low testosterone levels in men can sometimes lead to a condition called gynecomastia, or the development of larger breasts. Testosterone is a naturally occurring hormone. It’s responsible for male physical features and also affects a man’s sex drive and mood. When there is an imbalance of the body’s hormones in men, including testosterone, gynecomastia can develop. Both low testosterone and gynecomastia are often treatable. It’s important to first understand the underlying causes for each condition.

Understanding low T

Testosterone levels normally decrease as men age. This is referred to as hypogonadism, or “low T.” According to the Urology Care Foundation, 1 in 4 men over the age of 45 have low T. Having low testosterone levels can lead to several complications:

  • reduced libido
  • low sperm count
  • erectile dysfunction (ED)
  • enlarged male breasts, called gynecomastia

Understanding gynecomastia

The male body produces both testosterone and estrogen, although estrogen is usually found at low levels. If a man’s testosterone levels are especially low in comparison to estrogen, or if there is an excess of estrogen relative to testosterone, larger breasts may develop.

When boys hit puberty and there is a noticeable change in hormonal activity in the body, gynecomastia may appear. However, it may resolve itself with time and without treatment. The excess of breast tissue may be equal in both breasts, or there may be more in one breast than the other.

As testosterone levels drop in older men, gynecomastia may develop and persist unless it’s treated. Gynecomastia affects about 1 in 4 men between the ages of 50 and 80, according to the Mayo Clinic. The condition usually isn’t harmful or serious. It can be embarrassing for men at any age. In some cases, it can result in sore breast tissue.

Causes of low T and gynecomastia

Low T is most often simply the result of aging. Underlying health conditions can also be the cause. Talk to your doctor about whether your low T might be the result of an underlying condition, such as:

  • damage to cells in the testes that produce testosterone
  • an accident
  • inflammation (swelling)
  • testicular cancer
  • cancer treatment, including radiation and chemotherapy
  • diseases that affect parts of the brain, such as the hypothalamus and the pituitary gland

Additionally, if you take anabolic steroids, you may also be damaging your body’s ability to manufacture testosterone.

Treatment

A variety of treatments are available for both gynecomastia and low T.

Gynecomastia

Gynecomastia may be treated with medications such as raloxifene (Evista) and tamoxifen (Soltamox). These are drugs usually prescribed to treat breast cancer. The U.S. Food and Drug Administration (FDA) has approved those medications to treat breast cancer, but not gynecomastia. The use of drugs to treat a condition for which they are not FDA-approved is known as an “off-label” use. Off-label treatments may be safe, but you should talk about the use of these medications with your doctor before starting treatment.

There are surgical options, too. You may have heard about liposuction, which removes excess fat from the belly. It can be used to remove fat in the breasts, too. Liposuction doesn’t affect the breast gland, however. A mastectomy is the surgical removal of breast gland tissue. It can be done with a small incision and a relatively short recovery period. These treatments may include corrective or cosmetic surgery to provide you the shape and look you want.

Low T

In addition to treating gynecomastia, you may want to treat low T. Testosterone levels in men tend to decline as they age. That’s why many older men try testosterone replacement therapy. Treatments are available in a variety of forms:

  • skin gels
  • patches
  • injections

Men who receive testosterone replacement therapy usually have noticeable results. They often experience improvement in:

  • energy
  • sex drive
  • erections
  • sleep
  • muscle mass

They may also see a positive change in their outlook and mood.

Side effects of treatment

There are potential side effects to testosterone replacement therapy. Men who may have breast cancer or prostate cancer should not undergo testosterone replacement therapy. There has been some controversy about whether the treatment may increase the risk of developing prostate cancer. In addition, it may increase your risk for cardiovascular events, obstructive sleep apnea, and excess red blood cell production. It’s worth having a conversation with your doctor about the latest research, as well as the risks and benefits of testosterone therapy.

Talk with your doctor

You may feel uncomfortable discussing low testosterone and gynecomastia with anyone, including your doctor. But the conditions are not uncommon. According to Boston University School of Medicine, 4 to 5 million men in the United States have low testosterone. Gynecomastia is quite common as well.

The takeaway

Low T and gynecomastia are common conditions among men, especially as they age. Many treatment options are available. Although you may find it uncomfortable at first to talk to your doctor about these conditions, discussing treatment options can help you take charge of your health and body. You may also benefit from talking with a therapist about your concerns. A support group of other men with gynecomastia may provide you some perspective to help cope with the condition as well.

Unlike some conditions that have no real treatment options, low T and gynecomastia can often be treated, and your quality of life can improve.

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