Symptoms of Gynaecomastia
The symptoms of gynaecomastia can vary from mild breast enlargement to significant swelling and tenderness, affecting one or both breasts. While the physical appearance is the most noticeable feature, the symptoms of gynaecomastia can also include pain, emotional discomfort, and psychological distress—especially in adolescents and adult men.
Gynaecomastia is defined as the benign enlargement of male breast tissue caused by hormonal imbalances, typically involving increased oestrogen activity or decreased androgens. It can affect newborns, adolescents, and older men, and its symptoms may range from barely perceptible to significantly distressing, both physically and emotionally.
Common Physical Symptoms
The physical signs of gynaecomastia are usually the most obvious, and often include:
Firm or rubbery tissue underneath the nipple area
Symmetrical or asymmetrical breast enlargement (one-sided or both)
Tenderness or mild pain in the affected breast
A disc-like mound of tissue beneath the areola (the dark area around the nipple)
In some cases, visible swelling that resembles female breast development
Unlike fat tissue associated with obesity, the glandular tissue in gynaecomastia is firmer and more nodular to the touch. The tissue is usually located centrally under the nipple and does not extend broadly like adipose tissue in pseudogynaecomastia.
Unilateral vs Bilateral Symptoms
Unilateral gynaecomastia (one breast only) occurs in about one-third of cases
Bilateral gynaecomastia (both breasts) is more common and may occur evenly or unevenly
Asymmetry often causes additional anxiety, as men may fear cancer or another underlying disease
While breast cancer in men is rare, any lump that is hard, fixed, or associated with nipple discharge warrants immediate medical evaluation.
Pain and Tenderness
Pain is not always present, but when it occurs, it may include:
A dull ache or sensitivity
Discomfort when pressure is applied, such as when lying on the chest or wearing tight clothing
Tender nipples, which may be irritated by contact with fabrics
Pain is typically more noticeable during the growth phase of gynaecomastia, when hormonal fluctuations are most active.
Emotional and Psychological Effects
The symptoms of gynaecomastia go beyond the physical. Many men and boys experience:
Body image concerns
Shame or embarrassment, particularly during social or intimate situations
Avoidance of activities like swimming or changing in public locker rooms
Low self-esteem, especially during adolescence
Depression or anxiety, in severe or long-standing cases
In teenagers, these psychological symptoms may significantly impact quality of life, school participation, and peer relationships.
Nipple Changes
Although rare, some men notice:
Nipple protrusion or change in shape
Increased pigmentation or sensitivity
In isolated cases, clear or milky discharge, which should be evaluated further
Any bloody or spontaneous nipple discharge must be promptly assessed to rule out malignancy.
Distinguishing Features of True Gynaecomastia
To confirm that symptoms are consistent with true gynaecomastia and not fat-related enlargement (pseudogynaecomastia), key signs include:
A firm mass under the nipple
Tissue that does not change significantly with weight loss
No signs of infection or inflammation
In contrast, pseudogynaecomastia (caused by excess body fat) tends to be soft, evenly distributed, and responsive to changes in diet and exercise.
Progression and Duration of Symptoms
Gynaecomastia can be:
Transient, especially in newborns and teenagers
Persistent, in cases related to medications, liver disease, or ageing
Progressive, if underlying causes are not addressed
Symptoms often resolve spontaneously within 6 to 24 months in adolescents but may persist into adulthood if not evaluated.
When to Seek Medical Advice
It is important to consult a healthcare provider if:
The swelling is rapid or painful
There is nipple discharge or skin dimpling
Only one side is affected
Symptoms cause emotional distress
There is a family history of breast cancer or testicular disease
These features help differentiate benign gynaecomastia from more serious conditions such as tumours or hormonal disorders.
Conclusion | Symptoms of Gynaecomastia
The symptoms of gynaecomastia include not only visible breast enlargement but also tenderness, nipple sensitivity, and psychological discomfort. Understanding the full range of symptoms of gynaecomastia is essential for early recognition, appropriate diagnosis, and compassionate management. For many men, timely reassurance and evaluation can ease physical discomfort and restore confidence.
