Gynecomastia: What are Your Options?

Overview

What is gynecomastia? Gynecomastia is the clinical name given to ‘man boobs’ that are caused by overdeveloped glandular tissue in the male breast. Pseudogynecomastia refers to a condition that can appear much the same but is in fact caused by fat deposits. While the symptoms of the two types of ‘man boobs’ can be identical, the two different underlying causes require very different treatments. So it’s important that your first step in sorting out your own man boob problem is to figure out exactly what’s causing your unique case.

The reasons that you developed gynecomastia will determine your options for treating it. Your options may be further limited by your medical history and some lifestyle factors. To determine the cause in your case, and the health factors and lifestyle habits that could be contributing to your ongoing condition, the first step is to see your GP.

If your GP isn’t sure what’s causing your gynecomastia, or are not 100% convinced it’s benign, your GP will schedule further tests. These tests are no cause for alarm: they’ll be simple things such as saliva, urine or blood tests to check the levels and overall ratio of hormones in your body; and possibly a chest x-ray (mammogram) to rule out malignant growths.

Once you and your GP have figured out the root cause of the gynecomastia, you’ll be offered a set of possible solutions. And treatment plan is going to include a recommendation for a healthy diet and sufficient exercise, regardless of whether you’re in a healthy weight range. Beyond that, your options include three main treatments, which may be recommended separately, in combination, or sequentially (as in, ‘try this first, and if it doesn’t work we’ll then try plan b’). The three approaches are: covering up the symptoms on a day to day basis, seeking to stop, slow or reverse the enlargement of your glandular tissue through medication, and/or gynecomastia surgery. Every option has pros and cons, every option will take some degree of effort and time, and every option will require you to spend some money, although your insurance plan may cover some or all of the costs. It’s important to stay open to all of the options your GP puts in front of you.

Also remember that although there are dozens of treatment options described below, not all of them are suitable for your condition. Ultimately, your personal GP will decide which treatments are suitable options in your case. Ignoring that advice could be counter-productive if not dangerous.

When browsing the following options, consider what restrictions you face and what you really value. Do you have limited funds for treatment costs? Are you currently taking medication which could preclude hormone therapy? Is it important that you try to get results naturally before you’re willing to try less natural approaches? And exactly what results are you looking for?

With all that in mind, here is a list of the four main options for treating gynecomastia:

Surgical Treatment

‘Gynecomastia excision,’ literally cutting out your man boobs, is the most instant and long-term effective method of removing your unwanted chest tissue and ensuring that it can’t return.

Pros of gynecomastia surgery:

If surgery is advisable for you, the pros definitely seem to outweigh the cons:

It is the single treatment that guarantees a permanent reversal for gynecomastia
Even taking recovery into consideration, you get the quickest permanent results
You have a much better idea of what results you can expect, and the results are almost certain to be better than the results achievable with non-invasive medical therapies
While you’re under the knife, your surgeon can dramatically improve the shape and contours of your chest, so you won’t end up with persistently loose skin (as you would with weight loss and hormonal therapies)
After surgery, you’ll be immediately fitted with a compression vest to help you heal safely, and to help your muscles and other tissues restore as tightly and evenly as possible.

Cons of gynecomastia surgery:

There is essentially just the one drawback: the cost. Your existing health cover may extend to gynecomastia. If you’re wondering how to find out, read our article on health insurance coverage and gynecomastia surgery.
Surgery has complications but they are actually a little easier to anticipate and treat than the huge and subtle range of complications that can occur as a result of hormone therapies. Complications from hormone therapy can take months to present and continue to have domino effects in your system for a long time after you cease taking the medication.
You will need absolute bed rest for three days followed by four to six weeks of very limited activity, possibly even driving restrictions. But overall, you’ll be able to return to your pre-gynecomastia lifestyle much quicker than with non-surgical medical treatments, so the brevity of treatment and the length of your recovery period probably cancel each other out.

If you can afford the surgery and the holiday you’ll need to take afterwards, there’s no reason not to go straight for the quickest and most effective treatment option available to you.

Liposuction

Liposuction involves inserting a needle under the armpit and using this to draw fat out of the breast area.

Pros of liposuction:

It’s cheaper than excision surgery
Liposuction doesn’t cause scarring
The liposuction Sydney patients can get is quick, and recovery is quicker than for excision surgery

Cons of liposuction:

Liposuction still needs some downtime while the swelling and bruising abates
Depending on the severity of the case, you may have baggy or sagging skin, at least temporarily
Liposuction is recommended against in patients who are at risk for serious complications such as blood clotting, haemophilia, pulmonary problems, heart problems, and obesity
Liposuction can only work on fat deposits, not enlarged glands. This means that you may still have abnormally large masses under your breasts, and that these might keep growing or reach the same size again

Medical treatments for gynecomastia, including hormone therapy:

Medicated treatment for gynecomastia is another option. The most popular brands for treating gynecomastia are Danazol Oral, Letrozole, Nolvadex, Raloxifene, and Tamoxifen. These medications are primarily marketed as oestrogen blockers and/or to treat breast cancer.

Pros of medical treatments:

Approved as safe by the Therapeutic Goods Administration (TGA). Based on scientific studies, you can be sure that a statistically significant amount of users have had results in using these drugs to treat gynecomastia.
Your GP, pharmacist or specialist should be familiar with these medications, so they can give you personalised advice that is tailored to your medical history.
If you achieve results, then the appearance of your gynecomastia will be improved more than just temporarily – i.e. visible improvement even if you’re shirtless at the beach, and without the discomfort and warmth of a compression shirt
Results may be permanent and persist after you cease treatment

Cons of medical treatments:

These medications weren’t actually formulated with gynecomastia in mind, so it is difficult even for doctors to estimate their effectiveness – how long it will take, how well it will work, and how long the effect will last.
Some medications cannot be taken by people with liver problems
Some medications may interfere with a medication you are already taking
All medications have potential side effects

Hormone Replacement Therapy (HRT)

The primary hormone replacement therapy treatment for gynecomastia involves applying a topical gel called Adractim to your affected area.

Pros of HRT:

A non-invasive alternative to surgery, and won’t cause pain or scars
Easy to apply yourself at home
Initial results may be visible in as little as ten days
A course of HRT costs around AUD$200, which is cheaper than six months of Gynexin pills, herbal supplements or prescription refills, and much more affordable than surgery

Cons of HRT:

Effects may be temporary if an underlying hormonal imbalance persists
Ingredients of the gel can cause an allergic reaction in individuals with sensitive skin
You may only use HRT for two to three month – extended use of Adractim has not yet approved

Gynecomastia Pills

Specifically-designed supplement for treating gynecomastia are probably the second most effective method for reducing enlarged breast tissue in men. The two most popular brands are Gynexin Alpha Formula and UltimateGynemax.

Pros of gynecomastia pills:

Much more affordable than liposuction or excision surgery
The manufacturers of Gynexin claim that the pills are 95% effective. Reviews of the product indicate that results are visible within a few months of use
No time off work and no scars
If the pills manage to restore natural hormonal balances, results may persist after you stop taking the pills

Cons of gynecomastia pills:

These pill still aren’t cheap, at about AUD$93.50 for one month’s supply
Natural supplements take longer to work, so it’s difficult to estimate total costs
Not suitable for patients with a caffeine intolerance
Potentially unsuitable for patients with other concurrent medical conditions

A more thorough look at the efficacy of gynecomastia reduction supplements, including popular brands and average reviews, can be found here.

Herbal Supplements

Turmeric frequently comes up on health forums as a DIY natural treatment for man boobs. The recommended method is to drink water that’s being boiled with fresh turmeric. Fresh turmeric added to food is also beneficial, especially when combined with black pepper. But how does it work?

Primarily, turmeric is an anti-inflammatory. It works relatively quickly, if temporarily, to reduce puffiness and inflammation throughout the body. Several online sources claim that it curbs excess oestrogen as well, thereby treating the cause as well as mitigating part of the symptom. Turmeric is known to improve liver function – excellent news for anyone suffering gynecomastia as a result of liver disease. At least one study has linked turmeric to an increase in testosterone levels among insulin-resistant patients.

Pros of herbal supplements:

Turmeric is very cheap, readily available and does not require professional consultation or a prescription
Eating or drinking turmeric is easy, and it can be incorporated into your diet in several ways
Turmeric is linked to a range of other health benefits, especially for cardio health, liver and blood health, immune health and stress reduction

Cons of herbal supplements:

Persistently effective at a low level but results seem to be mild and long-acting rather than dramatic
If you love the taste of turmeric you’re in luck, but if you hate it you’re in trouble

Compression garments

Compression shirts, garments, or vests considered to be effective at improving the appearance of man boobs as seen through another layer of clothing, but the results disappear as soon as you take the compression garment off.

Pros of compression garments:

Wearing your compression shirt or vest can instantly help and – depending on the severity of your case – remove all traces of excess fat or sagging shapes
More than that, they can give your whole torso a more tones appearance
Compression shirts are far cheaper than any other treatment options, ranging from AU$20 to $100
Non invasive and have no side effects
There is a range of styles, materials and colours to choose from, and you can stop wearing them whenever you want
No interactions with diet or medication
No recovery time from surgery
Although compression garments wont prevent the action of whatever is causing your man boobs to grown, it can prevent skin from sagging over time, in the same way that bras keep breasts higher and tighter for longer

Cons of compression garments:

They won’t change the cause of your gynecomastia or prevent it from continuing
The effect disappears as soon as you take your compression garment off
Not ideal for hot weather, swimming, or anytime you want to take your shirt off

You can read more about how to choose and buy gynecomastia compression garments here.

Summary

Use this table to easily compare results, pros and cons for each treatment option at glance:

Always speak to your GP about your health concerns and your plans for self-treatment. Undergo any recommended tests to confirm your theories and rule out other possibilities.

Gynecomastia, although it describes the enlargement of glandular tissue, also involves excessive growth in adipose (fat) tissues around the nipple and breast area. So whatever treatment option you choose to treat the cause of your gynecomastia, ensuring that the ‘man boob’ effect really goes away and stays away will require hard work on your part, including a healthy diet and plenty of enjoyable exercise.