What Causes Gynecomastia in Men?

February 19, 2026 | Gynecomastia
6 minute read

Gynecomastia causes enlarged breasts in men, but what causes gynecomastia? This blog discusses the various causes of gynecomastia, provides helpful at-home tips for reducing risks, and lists next steps for getting treatment.

How Do I Know If I Have Gynecomastia?

Gynecomastia is a condition in which glandular tissue, or breast tissue, grows in men. It can occur in men of all ages and is a primary side effect of hormonal imbalances. Pseudogynecomastia, on the other hand, is categorized as an increase of fat that appears like male breasts—not glandular tissue.

You can test to see if you have true gynecomastia with the following: 

• If your breasts are firmer to the touch, it is glandular tissue
• If your breasts are softer to the touch, it is fat
• If your breasts are sensitive, it is likely glandular tissue

Gynecomastia vs. Pseudogynecomastia: What Are the Causes?

Pseudogynecomastia is caused by simple weight gain and can be treated with diet and exercise. In some cases, if weight loss doesn’t help that particular area, focused liposuction can help smooth and contour the chest for a more masculine appearance. 

True gynecomastia is a little different. It is caused by an imbalance in estrogen, the hormone for female reproduction, and testosterone, the hormone for male reproduction. Everyone has some balance of the two hormones, but when one begins to overpower the other, physiological changes occur, including gynecomastia.

But hormones fluctuate all the time, as part of natural life cycles and due to controllable factors like medication or diet. Below, we’ll discuss the most common causes of gynecomastia and how they affect the body.

Normal Hormone Fluctuations

As we age, the body goes through normal fluctuations in hormone levels. For example, a common demographic who experiences gynecomastia is boys going through puberty. In these cases, the condition usually resolves on its own. Another group that experiences hormone fluctuations is older men going through andropause, which is the natural regression of testosterone. Older men can help balance hormones through hormone replacement therapy.

Medications

Gynecomastia can be caused by medications that affect testosterone levels or block its effects. Others can affect estrogen levels. Some common medications that can cause gynecomastia include: 

• Anti-androgens that treat conditions like enlarged prostates and prostate cancer.
• Antiretroviral medications, which contain estrogen-like properties, can cause hormone imbalances.
• ADHD medications that contain amphetamines, anti-anxiety medications, and tricyclic antidepressants
• Some antibiotics
• Opioids

Anabolic Steroids

Anabolic steroids are a common cause of gynecomastia in men. Anabolic steroids, or anabolic-androgenic steroids (AAS), are synthetic variations of testosterone, used by people who want to gain a large amount of muscle mass quickly. But because these steroids raise testosterone levels rapidly, the body converts the excess into estrogen, which accounts for imbalanced hormones and an increase in breast tissue, among other health concerns.

Recreational Drugs & Alcohol

Amphetamines, marijuana, heroin, and methadone are also known to disrupt hormone levels. Each has different effects, but most interfere with the endocrine system (hormones), either stimulating estrogen-like activity or blocking normal hormone production.

Alcohol, too, can cause enlarged breasts in men. Chronic alcohol consumption damages the liver, which impairs its ability to metabolize estrogen, resulting in more of it in the body. Ethanol, or the intoxicating ingredient in alcoholic beverages, suppresses testosterone synthesis.

Health Conditions

Certain medical conditions can cause gynecomastia by disrupting hormones, including: 

• Hyperthyroidism
• Kidney failure
• Hypogonadism

How to Treat Gynecomastia

Clearly, there are many causes of gynecomastia. If you suspect that you have true gynecomastia, consider whether any of the above conditions or lifestyle choices resonate with you. While it’s always best to consult your doctor, learning about the causes of this condition can help you understand why it’s happening and better prepare you for treatment. 

Your doctor will likely review your medical history with you and help you determine what might be the underlying cause. To start, there are some things you can do to improve your overall health and balance your hormones. 

1. Stop taking anabolic steroids, recreational drugs, and drinking alcohol. 

For this step, try to eliminate common causes of gynecomastia. Starting with clean living is a great way to get your health back on track, too.

2. Review your medications with your doctor. While it’s not always possible, your doctor might be able to adjust certain medications to help balance your hormone levels. For example, some patients may be able to swap their ADHD medication for a non-stimulant dose.

3. Discuss your health conditions with your doctor. If you have one of the above conditions, there may not be much you can do about your gynecomastia symptoms for now. But communicating with your primary care doctor that you are developing gynecomastia may lead to adjustments to your medications or an assurance that, once your condition improves, so will your gynecomastia.

4. Schedule a consultation with a board-certified plastic surgeon. While you work on treating the causes of gynecomastia, you can meet with a plastic surgeon to discuss next steps for improving the aesthetics of your male breasts.

How Gynecomastia Surgery Works

Once you have your medical conditions, medications, and lifestyle factors under control, a plastic surgeon can treat the aesthetic part of your gynecomastia. While balancing hormones can stop the increase in breast tissue, most patients will need surgery to remove the tissue that is already present. 

During gynecomastia surgery, an experienced surgeon makes small incisions around the affected breasts and removes glandular tissue via excision. Some patients also benefit from liposuction to remove fat pockets and further contour the chest.

Gynecomastia surgery is the best way to reshape the chest and achieve a natural-looking, masculine chest contour.

Want to Learn More About Gynecomastia Surgery in Long Island?

Let the experts at Greenberg Cosmetic Surgery and Dermatology help you through the last part of your gynecomastia process: Contouring the chest with gynecomastia surgery. Our board-certified plastic surgeons are experts at creating natural-looking, masculine results for our gynecomastia surgery patients. Call Greenberg Cosmetic Surgery and Dermatology today at (888) 680-2090 or complete the contact form to request a consultation and learn more about your options.