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Gynaecomastia (enlarged breasts) is a common condition in newborn children, adolescents, and elderly males. The prevalence of gynaecomastia is 60%-90% in neonates, 50%-60% in adolescents, and up to 70% in men aged 50 to 69 years  .
Gynaecomastia is usually caused by an increase in oestrogen activity, a decrease in testosterone activity, or the use of certain medications. This often results in anxiety among patients with gynaecomastia.
Let's get into the details of what causes gynaecomastiaand how it's diagnosed and treated.
What Causes Gynaecomastia
All males and females have both the hormones: oestrogen and testosterone, but usually testosterone is higher in males and oestrogen is higher in females. The female hormone oestrogen is responsible for the growth of breast tissues, while the male hormone testosterone stops oestrogen from making the breast tissues grow. When there is an increase in the hormone oestrogen and a decrease in the hormone testosterone, gynaecomastia occurs  .
Gynaecomastia can affect one or both the breasts in men. It isn't a serious condition, but many men can't cope with it because they feel embarrassed.
Other medical conditions that cause gynaecomastia are liver cirrhosis, hyperthyroidism, chronic renal failure, testicular tumours, obesity, lack of nutrition, hypoandrogenism, and hypogonadism.
Certain drugs that cause gynaecomastia include oestrogens, anabolic steroids, diazepam, finasteride, spironolactone, cimetidine, ketoconazole, and metronidazole  .
It is estimated that 10%-20% of gynaecomastia cases are caused due to the use of medications  .
Symptoms Of Gynaecomastia 
- Swollen breasts
- Breast tenderness
- Breast discharge
Risk Factors Of Gynaecomastia 
- Kidney or liver disease
- Thyroid disease
- Klinefelter syndrome
- Use of anabolic steroids or androgens
Complications Of Gynaecomastia
Gynaecomastia has few physical complications, but it can cause psychological problems such as depression, anxiety, body dissatisfaction, eating disorder, and low self-esteem  .
When To See A Doctor
Consult a doctor when you experience swelling or tenderness in the breasts and nipple discharge in one or both breasts.
Diagnosis Of Gynaecomastia 
The doctor will first ask about your medical and drug history, then ask about your symptoms and physically examine you. If the breasts are abnormally large, tender, and having a nipple discharge, blood tests and mammograms are conducted. Based on these test results, CT scans, MRI scans, testicular ultrasounds, and tissues biopsies are performed.
Treatment Of Gynaecomastia
Medications such as tamoxifen and anastrozole can aid in the treatment of gynaecomastia. Tamoxifen is a medicine that blocks the activity of oestrogen in the body and reduces breast enlargement in men.
Aromatase inhibitors such as anastrozole can help in the treatment and prevention of gynaecomastia in males.
Surgery is another treatment option, which include the following:
- Liposuction - This surgery is performed to remove the excess breast fat and glandular tissue. It is carried out using one or two small incisions on each side of the chest. This is followed by draining of the fat from either one of the incisions  .
- Mastectomy - This type of surgery involves removing the breast gland tissues from the breast therefore leaving the skin, nipple and areola intact  .
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