Life is full of contraries. Something which is a boon for one situation becomes a bane for the others. Breasts are the same if they start growing in a male it becomes a never ending tyranny. Then starts the flurry of suggestions and the series of consultations. The story of breast enlargement in males is triphasic i.e Neonatal, Prepubertal (adolescence) and the Elderly. Most of the times it is the growth of local breast tissue under the influence of female hormones in the male body. Anything which leads to less production of male hormones or trauma to testicles or removal of the testis, itself leads to increase in the levels of female hormones in the body this leads to increase in the breast size. The common causes  of the breast enlargement in males are-

Neonatal

During the early phase of life i.e, the first year of birth can have mini puberty. During this period, the sex hormone axis from the brain to gonads is active and leads to more of conversion of hormones to female hormone leading to breast enlargement in some newborns. This condition subsides with time on its own .

Pubertal 

The same axis is again activated when we achieve puberty i.e around 12 to 14 years in boys. This  is the commonest form of breast enlargement in boys. The breast starts growing mostly both and sometimes they are painful. This is called as Pubertal Gynecomastia. This is a normal physiological phenomenon which subsides on its own after 6 to 18 months roughly. Most of them are relieved on their own. Some 25% still persists and sometimes needs cosmetic corrections. Pubertal Gynecomastia needs only counseling and family and peer support.

Obesity

Sometimes the child is chubby, overweight and scores high in the percentile for weight for normal children and has breast which looks like gynecomastia but is actually all fat no breast tissue. This is lipomastia , i.e more fat in the breast area. This seen in overweight children and adults who are obese.

Liver and Kidney disease

Sometimes patients have liver or kidney problem which leads to a metabolic mismatch in clearance of female hormones in males leading to breast enlargement. Kidney patients on dialysis and alcoholics with the liver problem can have breast enlargement.

Story of popping pills

We have a tendency of popping pills for acidity and some of the medicines are available over the counter. It starts with immediate relief later follows every time and most of the times we take it without medical advice and there is disharmony of the  two corners of the male and the female hormone in the body . The breasts grow this time because of medication without advice.

Side effect of a drug prescribed

This is a side  effect of a  medicine prescribed by your doctor for  controlling your blood pressure, cooling of your mind or  for the treatment of the underline cancer.

Unilateral gynecomastia

Sometimes you get one of your breasts get enlarged and  on examination, there is a culprit in your testicle or abdomen i.e a tumor forming more of female hormones.

Cosmetics fancy husbands

Sometimes husbands are very casual about the use of  cosmetics , soaps, shampoos made for their better half. Use of female cosmetics which have lavender oil, plant oils, and many natural plant estrogens leads to an increase in female estrogens in a male body. Unknowingly you end up like your wives.

Andropause 

The story of male menopause is still not supported by data till date . There is a condition in elderly where the levels of male hormones go down and leads to increase in the size of breast tissue.

Thyroid problem 

There are patients who have an enlarged thyroid gland and have high levels of thyroid hormones and there is  disbalance of the protein which carries the male hormone in our blood leading to enlargement of the breast.

Tumor of the master gland

 Sometimes there is a tumor in the master gland pituitary causing the imbalance leading to  breast enlargement in men.

Wiring  defect of chromosomes 

Sometimes there is an extra X  or Y chromosome in the male patient which leads to enlarged breasts a condition called Klinefelter's syndrome . There can be a condition where there is resistance for the male hormones at its receptors and the males have enlarged breast.

There are many causes of breast enlargement. We need to handle it carefully . Treatment needs a qualified hormone doctor i.e an Endocrinologist. Most of the time treatment starts with achieving the normal body weight and some medicines and the cosmetic correction surgically if required.