Gyno and Bodybuilding: How to Handle Excess Breast Tissue

Gynecomastia is the development of breast tissue in males. It can lead to a puffy, swollen, and breast-like appearance in the chest and nipple area. The condition is usually harmless, although it can cause psychological and social distress among those who have it.

According to published research, gynecomastia is primarily caused by an increased circulating estrogen to androgen ratio (1).

Depending on the progression of the condition, gynecomastia may be reversed in the early stages. However, if the condition persists, the development of nonfat breast tissue around the nipple area requires surgery to remove or will otherwise be permanent.

It’s worth mentioning that gynecomastia specifically refers to the development of glandular tissue around your nipple area, although it may be confused with fat storage in the chest area.

While gynecomastia may be accompanied by body fat around the chest area, it isn’t a result of excess fatty tissue. It’s a specific condition that can affect men of all fitness and body fat levels.

Summary

Gynecomastia is the physically harmless development of breast tissue in males. If persistent, it becomes permanent, and surgery is required to remove it.

Clinical studies list the symptoms of gynecomastia as enlargement of breast tissue around the pectoral and nipple area, with the presence of a firm, symmetrical rubbery mass that extends concentrically from the nipple.

This development is accompanied by the benign proliferation of glandular breast tissue (2).

As mentioned, gynecomastia can be accompanied by body fat deposition in the same area. However, this is not a determining symptom of the condition.

Summary

Gynecomastia symptoms include rubbery breast tissue in the nipple area and growth of glandular breast tissue.

Although it’s difficult to know exactly how commonly gynecomastia occurs in bodybuilders, it’s far from an isolated phenomenon.

One study on gynecomastia in bodybuilders claims that between 1980 and 2013 in the United States, 1,574 bodybuilders received surgical treatment for the condition (3).

According to additional research, an estimated 30–40% of males in the general population experience the condition (2).

Overall, it’s safe to say that gynecomastia is not an isolated phenomenon and likely experienced by many male bodybuilders, particularly those who use anabolic steroids.

Summary

Gynecomastia commonly affects bodybuilders, although the exact rate of occurrence is difficult to pinpoint.

Studies suggest that there are many causes of gynecomastia, including multiple different prescription drugs (4).

As mentioned, when gynecomastia appears in bodybuilders, it’s typically caused by the use of anabolic steroids, such as exogenous testosterone derivatives. Gynecomastia occurs due to the body’s attempt to remove circulating testosterone in response.

One of the byproducts of testosterone breakdown is estradiol, a type of estrogen hormone that results in the development of female secondary sex characteristics.

In the case of males with high estradiol, the result includes the development and enlargement of breast tissue.

Gynecomastia can also be caused by certain drugs and over-the-counter supplements. However, not all individuals experience these side effects.

Summary

Gynecomastia in bodybuilders is primarily a side effect of anabolic steroid use.

Exercise is sometimes used to address gynecomastia. However, this approach is largely ineffective if you’re experiencing gynecomastia caused by glandular tissue growth, which is common when the condition is a side effect of anabolic steroid use.

Clinical gynecomastia involves the development of glandular tissue, which cannot be reduced through diet or exercise and must be addressed by medical intervention.

Gynecomastia is primarily a medical condition and not an indicator of being out of shape or deconditioned, so exercise is not typically recommended as a specific treatment, although there are many other benefits to exercise.

Note that excess fat tissue in the chest area can result in the appearance of gynecomastia even if you don’t have clinical gynecomastia.

In this instance, reducing overall body fat through a calorie deficit may be an effective approach. Exercise can help increase calorie expenditure and support weight loss in conjunction with nutritional interventions.

On a related note, performing chest exercises can increase the mass of the pectoral muscles, which can help develop a more chiseled chest appearance provided your body fat levels are sufficiently low.

However, most bodybuilders with gynecomastia already perform chest exercises and have substantial amounts of pectoral muscle.

Summary

Exercise is not an effective treatment for clinical gynecomastia.

Many over-the-counter supplements are marketed as useful for reducing gynecomastia. The purported primary mechanisms are increased estrogen processing, meaning preventing gynecomastia in the first place.

These supplements include:

• indole-3-carbinol
• white button mushroom extract
• mucuna pruriens
• choline
• vitamin E

To date, there’s little peer-reviewed research on the efficacy of these supplements for treating steroid-induced gynecomastia.

Additionally, in the United States, the Food and Drug Administration (FDA) doesn’t regulate supplements in the same way as it regulates prescription drugs, and most claims on supplement efficacy are not supported by evidence.

Always consult your healthcare provider before taking any supplement, particularly if your goal is to address a medical condition.

Summary

There are no FDA-approved supplements for the treatment of gynecomastia.

The treatment of gynecomastia varies depending on the underlying cause and level of breast development.

For gynecomastia caused by anabolic steroid use, research supports the use of anti-estrogen drugs like tamoxifen to reduce the amount of estradiol caused by the breakdown of the anabolic steroid (1).

Nevertheless, once gynecomastia is established, only the surgical removal of breast tissue will result in the complete reversal of the condition.

This treatment must be conducted by a qualified surgeon and involves the removal of glandular tissue and liposuction of additional fatty tissues, if needed.

Overall, the surgical treatment of gynecomastia in bodybuilders is usually successful, with research showing that 98% of patients were pleased with the aesthetic result of the surgery (5).

Given that gynecomastia from anabolic steroid use is not a life threatening condition, the main goal is patient satisfaction with the final appearance of the treatment.

Note that gynecomastia is just one side effect of anabolic steroid use, and other side effects from steroids may be more concerning for physical health.

Summary

Early stage gynecomastia can be treated with certain prescription drugs. Surgical removal is the only effective treatment for fully developed gynecomastia.

Gynecomastia can cause substantial psychological discomfort, particularly for athletes with a focus on physique.

Fortunately, the previously discussed surgical interventions have high success rates.

Furthermore, a few notable bodybuilders with gynecomastia have reached the pinnacle of the sport.

For example, Lee Haney, the 1987 Mr. Olympia, had notable gynecomastia yet was immensely successful in the sport.

Also, Franco Columbu, the 1981 Mr. Olympia, dealt with some substantial gynecomastia during his career.

More recently, Ronnie Coleman, one of the most successful bodybuilders in the history of the sport, had substantial gynecomastia that was very noticeable around his left nipple when zoomed in during his posing.

Note that when bodybuilders reach the low levels of body fat required for competition, gynecomastia primarily appears as swollen nipples as opposed to pronounced breast growth.

Regardless, given the effectiveness of surgical treatments for bodybuilders with gynecomastia, there’s no reason the condition will prevent success in the sport of bodybuilding.

Summary

Multiple successful bodybuilders have had noticeable cases of gynecomastia.

Gynecomastia is a medical condition that affects many men. When bodybuilders are affected, it’s typically a side effect of anabolic steroid use.

Although this type of gynecomastia is not life threatening, it can cause substantial psychological and emotional distress, particularly in a sport so focused on aesthetics.

Fully developed clinical gynecomastia requires surgical treatment to remove glandular and fatty tissues. These surgeries have a high rate of success, and most patients report satisfaction with the results.

While the condition is inconvenient and potentially distressing, it doesn’t preclude success in the sport of bodybuilding, with many notable famous bodybuilders having dealt with the condition and competed at the highest levels in the sport.

If you’re concerned about gynecomastia, consult a healthcare professional. Rest assured, the condition is quite common and completely treatable.