Gynecomastia and me

February 11, 2010 11:58 AM

I've been diagnosed with Gynecomastia. Now what?

I am male, just turned 40. Last year, I noticed that one of my breasts was much more tender than the other one, and noticeably larger. Feeling around, it seemed like there was a hard mass at the center of an expanded squishy zone. After x-rays and ultrasounds, the doctor said that it's gynecomastia, likely caused by pot smoking. So, now what?

If I stop smoking, the breast won't go away, right? I'd have to get surgery to remove the tissue. If I do get it removed surgically, and still smoke, will it just regrow back? Is it likely that the other breast will start to grow as well, regardless of surgery to the existing expanded breast?

If I keep the breast, do I need to start doing breast self exams and getting mammograms?

posted by No1UKnow to health & fitness (14 answers total)

Can this doctor point you to any medical studies or textbooks that actually link marijuana smoking with this disease that weren't done in the 70's? ianad but my quick googling tells me that noone could reproduce the links found in these early studies at any time subsequent to them.

sounds like reefer madness to me.
posted by judge.mentok.the.mindtaker at 12:12 PM on February 11, 2010

Are you on any meds for high blood pressure, by any chance? The reason I ask is that certain potassium-sparing diuretics (spironolactone, for one) can cause gynecomastia, but it's been my experience that not all general doctors are aware of this.
posted by chez shoes at 12:28 PM on February 11, 2010

Respectfully, wouldn't these questions be better asked of a medical professional, rather than, you know, us?
posted by bicyclefish at 12:36 PM on February 11, 2010

IANAD, but gynecomastia is when men have visible women-like breasts. This often happens in puberty, to fat men, or to men who are just unusually sensitive to the normal amounts of female hormone going around their bodies (If they were women, I'd supppose they'd be Russ Meyer's fantasies). Gynecomastia *can* affect only one breast.

But if at 40, one breast becomes tender and noticably larger, well even if it is gynecomastia, (and IANAD) that is pretty messed up to just start happening at 40. Pot smoking or not. And what caused that to happen now? Look at how many regular pot smokers there are! How many have boobs? How many have one boob that grows at 40?

Not to scare you but men can and do get breast cancer. Or other things. Get of Askme, get thee to another doctor stat.
posted by xetere at 12:51 PM on February 11, 2010

I'd get a second opinion. If he thinks pot caused your breasts to grow, he might be a nutter. As for BSE and mammograms: I would. Men can get breast cancer too, even without breast development. It's very rare but it does happen. Clearly you've got unusual things going on so precaution seems like a good idea.

IANAD.
posted by chairface at 12:52 PM on February 11, 2010 [1 favorite]

likely caused by pot smoking

No. Your doctor is a quack. Gynecomastia is caused by a hormone imbalance. You need a different doctor.

I had gynecomastia as an adolescent for many, many years, and I eventually had the surgery. I wrote a lot about it in a related AskMe. Please feel free to MeMail as you deal with this. It sucks.
posted by Lutoslawski at 1:03 PM on February 11, 2010 [1 favorite]

If he thinks pot caused your breasts to grow, he might be a nutter.

Its comments like this which illustrate why you should be asking a doctor this, not a random group of nerds. Yes, pot causes this:

Most Common Causes of Gynecomastia:

* Puberty (hormonal growth and changes during adolescence)
* Estrogen exposure (female hormone present in the body and the environment)
* Androgen exposure (body-building hormones)
* Marijuana use
* Medication side effects
posted by damn dirty ape at 1:04 PM on February 11, 2010

Another vote for your doc's a quack. Get a second opinion, and soon.
posted by Koko at 1:06 PM on February 11, 2010

get thee to another doctor stat.

This. It's possible for gynecomastia to effect only one breast, but not all that common.
posted by coolguymichael at 1:21 PM on February 11, 2010

After a cursory review of the medical literature, I was able to find exactly one mention of marijuana use contributing to gynecomastia (I'll MeFi Mail you the full text if you're interested; it's got more clinical notes about the condition). When I clicked through to the cited source, the only thing mentioned is that steroid users (who are at risk for developing gynecomastia) are more likely to use marijuana. In other words, unless you're taking steroids, your doctor was wrong about that.
posted by sciencemandan at 1:39 PM on February 11, 2010

Damn dirty ape, I really hope you aren't a doctor.

Saying that "yes, pot causes this" because you can find one online reference for it (which is later explained by sciencemandan, more accurately) is absolutely worse than someone else saying "it is doubtful pot causes gynecomastia in one breast at your age, get another doctor".

About.com is not a peer reviewed medical journal, but thanks for playing askme diagnosis filter!
posted by shownomercy at 1:43 PM on February 11, 2010

As for BSE and mammograms: I would. Men can get breast cancer too, even without breast development. It's very rare but it does happen. Clearly you've got unusual things going on so precaution seems like a good idea.

IANAD.

IAAD, and following this advice may potentially lead to considerable harm. Breast cancer in men is very rare (100 times less common than in women), and though having gynecomastia may increase your risk of cancer (one study suggests about a 5 fold increase in risk), it still remains quite small (my back of the envelope estimate is 0.5% lifetime risk). When the prevalence of a disease is so low, using a screening test considerably increases the chance of a false-positive result, which could lead to all manner of things you might not want. BSE and mammograms are not well tested techniques in men. Whether to pursue these sorts of tests depends on your personal values and goals of care, and a more personalized estimation of your risk of disease that also depends on lots of other information (risk factors like family history, age, etc.) that we don't know, but you and your doctor would. So talk to them about it.

The evidence supporting marijuana's association with gynecomastia is indeed quite limited but it has been published, so your doctor isn't completely out there for suggesting the possibility. That said, if your doctor didn't do some blood tests to look at your hormone levels and check for any testicular, liver, kidney, or thyroid problems, I'd get a second opinion, possibly from a reproductive endocrinologist if you have access to one.

As to whether it will grow back after surgery if you smoke, or regress if you stop smoking, again, I don't think anyone can really answer that because noone could say for sure that marijuana was causal in the first place. I certainly don't think it would hurt to at least try cutting back and see what happens.
posted by drpynchon at 1:50 PM on February 11, 2010 [2 favorites]

Are you on any meds for high blood pressure, by any chance?

nope, just the weed, and moderate recreational alcohol.

get thee to another doctor stat.

I went thru 2 GPs, 2 radiologists, 1 ultrasoundist (sp?), and 1 breast cancer specialist who coordinated. All of them agreed it was definitely not cancer. They work at Seattle's cancer specialty hospital, in the breast cancer division.

wouldn't these questions be better asked of a medical professional, rather than, you know, us?

There are medical professionals that answer askme's sometimes, often with useful advice.

comments like this which illustrate why you should be asking a doctor this, not a random group of nerds.

The questions didn't occur to me back then because I was more focused on the whole is it cancer bit.

if your doctor didn't do some blood tests to look at your hormone levels

they did do blood work.
posted by No1UKnow at 1:58 PM on February 11, 2010

Man, people get in a tizzy over their favorite thing

Marijuana has been associated with the development
of gynecomastia in an early case series,
but a case control study showed no association.
Given the effects of marijuana on the HPG
axis in males and the possibility that noncannabinoid
components of marijuana smoke have affinity to the es-
trogen receptor, an association with gynecomastia is
plausible but has not been convincingly demonstrated.

Personally, I would wait on the surgery and I would cut out anything that could possibly contribute to the problem: weed, soy, etc.. I would probably look for supplements or maybe ask about drugs before I went through surgery, but that's my take. If the problem did (hopefully) go away I would add back in what I wanted and keep a close eye for any problems that may crop back up.
posted by P.o.B. at 8:40 PM on February 11, 2010