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Gynecomastia, the enlargement of the male breast that can come with a variety of related symptoms, is a surprisingly common condition in males at three stages of life:

  • Baby boys often have enlarged breasts. This is due to the high-estrogen environment of the womb, and it goes away in a few months. Up to 90 percent of baby boys have enlarged breasts. We really don't know if they have nipple pain. 
  • Adolescent boys are also prone to developing enlarged breasts during their growth spurt. This happens in up to 70 percent of males who have just passed puberty. Gynecomastia in teenage males can be accompanied by nipple irritation or pain, but it's mostly an embarrassment. It also usually goes away on its own.
  • Older men, over 60, often develop enlarged breasts when they get prostate problems. Prostate cancer treatment with feminizing drugs, of course, can cause breast tenderness and swelling.

At other stages of a man's life, enlarged breasts and tender nipples are due to a process called aromatization. This doesn't really have anything to do with a man's aroma. It's about the chemical process of transforming testosterone into estrogen. This hormonal transformation is also responsible in a condition called "beer drinker's droop" (you can imagine which body part doesn't rise to the occasion) in which consuming huge amounts of phytoestrogens from the hops in beer accelerates this process.

Aromazitation takes place in body fat, especially in body fat. To put it bluntly, if you don't get off your fat butt and exercise in midlife, you are at added risk of developing man boobs. But sometimes men who pay attention to fitness also have this problem because of an abnormality in which their bodies manage the production of the small amounts of estrogen a man's body needs. 

It can help to lose weight if you're overweight. But there's a more important piece of advice I have to give you:

If you have breast pain, nipple pain, or breast enlargement, guys, see your doctor now.

That's because these changes in your breast can become permanent. 

The experts will tell you that the breast generates fibrous tissue that makes nipples permanently irritated or breasts permanently enlarged in about twelve months. After that point, there is help for you, but it's surgical. However, you won't really need if you could get drug treatment that works or you have to have surgery until after you see your doctor. It could be that your breast changes aren't so far along that treatment isn't relatively easy.

What would that treatment be?

  • If the doctor determines that the problem is too much estrogen production, then the prescription may be an anti-estrogen. Tamoxifen keeps your breast tissue from responding to the extra estrogen your body is making. It works about 80 percent of the time, but it's only used if the problem has only started recently. Another drug used to treat the problem is clomiphene. It only works about 50 percent of the time, and it can cause vision problems, nausea, and rashes, but it is what will work if the condition has bee around for a while.
  • Some men go for testosterone injections to counteract breast enlargement. This actually can make the problem worse, since fat cells "aromatize" testosterone into estrogen.
  • Surgical treatment includes subcutaneous mastectomy, removal of breast tissue without removing the skin and nipples. 

Keep this problem simple. Go to your doctor now. There also conditions such as dermoid cysts, lymphangiomas (unusual growths of the lymph glands), and hypognoadism (deterioration of the testicles due to underlying disease) that in especially rare cases cause these symptoms. They need prompt treatment, too. The sooner you see your doctor the more likely you are to achieve a lasting cure.

 

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