Hey there! Let’s talk about gynecomastia, a condition where men experience enlargement of their mammary glands. It can happen in two forms: the active form, which involves abnormal growth of cells, and the fibrous form, which is irreversible and involves a cell-poor fibrous struma.

So, how common is gynecomastia? Well, about one-third of men experience asymptomatic physiological gynecomastia, and it tends to increase with age.

Now, what causes it? Physiological gynecomastia can occur during newborn stages, puberty, and adulthood. On the other hand, pathological gynecomastia happens due to changes in the estrogen/testosterone ratio. This could be because of estrogen excess, androgen deficiency, medication, or even smoking marijuana.

What can go wrong if you have gynecomastia? It might be mistaken for breast cancer or even just excess fat. Diagnosis involves a thorough history, physical examination, and tests like ultrasound and mammography.

Treatment depends on the cause. If it’s medication-induced, stopping the meds might help. Surgery might be needed for tumors or significant biological issues. In painful cases, a short-term trial with the anti-estrogen tamoxifen could be considered.

The key is to understand the cause and tailor treatment accordingly. Remember, while physiological gynecomastia might not need treatment, it’s essential to address the underlying issues causing pathological gynecomastia.