Growing up is hard to do. Your thoughts, feelings and hormones are all out of whack and your body undergoes many changes – regardless of gender. You may start your period, grow facial hair and even develop breasts.
While it’s expected that teen girls and people assigned female at birth (AFAB) will develop breasts, for teen boys and people assigned male at birth (AMAB) who develop breasts, adolescence can be especially difficult — even embarrassing.
This condition is called gynecomastia and is quite common and nothing to be ashamed of.
“Gynecomastia, by definition, is a problem that occurs in a male child around puberty where there is a significant increase in the size of breast tissue that can be seen and felt,” said Ravindra Vegunta, MD, a pediatric surgeon with Banner Children’s in Mesa, AZ. “Almost 70% of boys will show some growth in breast tissue around puberty (ages 11 to 13), but how much will vary.”
It’s natural for teens with gynecomastia to want to get rid of what is stereotypically known as “man boobs” or “moobs” ASAP. And if you’re a parent, you may wonder what the best path is to help guide them.
Dr. Vegunta shared four important things to know about gynecomastia and what you can do as a parent to help your teen.
What causes gynecomastia in puberty?
Puberty is the main cause of breast enlargement. During this time, the hormones estrogen and testosterone are both at work helping with growth and development.
Typically, in the development of male adolescents, testosterone plays a major role. It’s what helps the growth of facial hair, a deeper voice and the growth of the testes, scrotum and penis. Sometimes, however, there is an imbalance, and testosterone takes a backseat to estrogen.
“Rising estrogen levels during puberty can lead to a growth of breast tissue or breast buds,” Dr. Vegunta said. “Physiologically, male infants, boys during puberty and older men can have more estrogen than testosterone.”
In rare cases, gynecomastia in teens can also be caused by certain medications, diseases or medical conditions.
Adults can have gynecomastia as well. It is caused by hormone imbalances as well as by certain medical conditions, including thyroid problems or cancer, or from alcohol use and recreational drug use like marijuana.
Is obesity a cause of gynecomastia?
No. Children who are overweight or obese can develop fat tissue in the chest, but it isn’t the cause of gynecomastia. This extra fat is called pseudogynecomastia (or fake gynecomastia).
Your teen’s health care provider can examine them and determine whether the extra tissue is caused by gynecomastia or pseudogynecomastia.
Gynecomastia sometimes feels like a small, firm rubbery lump under the nipple and can happen in one or both breasts. Whereas pseudogynecomastia feels soft and squishy.
How is gynecomastia treated?
“Most teens (roughly 90%) with peri-pubertal breast enlargement (growth of breast tissue that happens around puberty) will grow out of the condition within one to two years,” Dr. Vegunta said.
That said, if this condition is affecting your teen’s emotional and mental health, there are other options you and your teen can discuss with their provider.
For severe cases, your provider may recommend a short course of medications, such as tamoxifen or raloxifene. If gynecomastia lasts past puberty, a mastectomy for gynecomastia, or the removal of breast tissue, may be an option.
How can I help my teen?
Gynecomastia is often a temporary condition, but some teens may feel very self-conscious or ashamed. They may wear loose-fitting shirts and refrain from participating in activities where they may have to be shirtless, such as at the pool or beach.
This can be hard to watch as a parent. You may not know what to do or say to help them. Dr. Vegunta said it’s important to listen and show your support for what they are experiencing.
“Identify and acknowledge the problem early on and refrain from teasing and reassure them,” he said. “Treating this condition earlier in life can help your teen feel more confident in their body and avoid social issues during those critical teen years.”
Treatment may include making changes to their clothing to help them feel more confident during this period, talking to a behavioral health specialist or speaking with their provider about surgery if the gynecomastia does not go away after puberty.
Gynecomastia is a common cause of breast development in adolescent males that occurs during puberty. Most often this condition gets better within one to two years. However, if gynecomastia continues after puberty, you may want to consider breast reduction surgery.
Need help treating gynecomastia?
Schedule an appointment with a pediatrician near you.
Schedule an appointment with a pediatric surgeon.