Male breast enlargement
Am I normal?
Many teenage boys notice that their breasts enlarge and become tender during early adolescence. This is quite normal and does not mean there is something wrong with their sexual development. It happens to approximately 50% of teenage boys.
How does it happen?
Both boys and girls have breast tissue. Breast tissue forms in the early weeks of foetal development. The structure of the breast tissue in boys and girls is similar up to the time of puberty. During puberty the levels of sex hormones begin to rise.
The male sex hormone is called testosterone and it is produced in the testicles. The female sex hormone is produced in the ovaries and is called oestrogen. However boys also have small amounts of oestrogen in their bodies and girls have small amounts of testosterone.
In the early stages of puberty the levels of testosterone can fluctuate allowing the influence of oestrogen to predominate. This results in stimulation of the male breast tissue to increase in size. As the levels of testosterone rise and eventually stabilise the influence of oestrogen begins to decline. This prevents further development of breast tissue. In particular it prevents the development of glandular tissue within the breast. The essential difference between the male and female breast post puberty is that the male breast lacks the gland and tubular system illustrated in the diagram.
Do I need treatment?
Sometimes the breast is enlarged because of fat. Fat can be distinguished from actual breast tissue by self-examination. If you feel the nipple between thumb and fingers, breast tissue will feel like a small rubbery lump, which is stuck to the back of the nipple. The area is usually tender. Fatty tissue does not have the same feel to it and is formless and non tender.
Some teenage boys will have persistent swelling until they are about 15 years old. At this stage the influence of testosterone is dominant and the oestrogen effect on the breast tissue declines. In these cases no treatment is needed.
Very rarely breast enlargement can persist. This is usually because the individual concerned is extremely sensitive to tiny amounts of oestrogen. The GP could check oestrogen levels with a simple blood test. If the levels are normal then the enlarged breast tissue could be easily removed. This procedure rarely needs to be performed since the breast tissue usually shrinks in the vast majority of cases.
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