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Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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In general, gynecomastia results from a hormonal imbalance in the body. All normal humans have both male and female hormones to a certain extent. Gynecomastia occurs when male hormones (androgens) are relatively low compared to the level of female hormones (estrogens) in the body. This can transiently occur during normal development of boys, resulting in gynecomastia in infants or during puberty. In these cases, gynecomastia usually resolves on its own as hormone levels return to normal.

In other cases, medical conditions or medical treatments can create the hormonal environment in the body that allows gynecomastia to develop. Examples of conditions that may be associated with gynecomastia include:

• cirrhosis of the liver,
  
  
• malnutrition,
  
  
• chronic kidney failure,
  
  
• disorders of the testes (male sex organs) including infection, trauma, or inborn disorders,
  
  
• aging,
  
  
• testicular cancer,
  
  
• anti-androgen treatments for prostate cancer, and
  
  
• hyperthyroidism.

A wide range of medications have also been associated with the development of gynecomastia. Examples include the diuretic spironolactone (Aldactone), some calcium channel blockers and ACE inhibitor drugs used to treat hypertension (high blood pressure), some antibiotics, anti-ulcer drugs, and highly active anti-retroviral therapy (HAART) for HIV disease, which may cause fat redistribution leading to pseudogynecomastia or, in some cases, true gynecomastia.

Finally, drugs of abuse (for example, alcohol, marijuana, and heroin) are known causes of gynecomastia. Lavender oil and tea tree oil, when used in skin-care products, have also been associated with gynecomastia.

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