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Why Do I Have Man Boobs?

You're not top-heavy and you're not alone.

Enlarged breasts in men, a condition known as gynecomastia, is very common among newborn and adolescent boys, as well as men ages 50 and older. It is caused by a hormonal imbalance, typically resulting from decreased testosterone, increased estrogen, or some combination of the two. New fathers experiencing a decline in testosterone might be especially concerned about this, despite the fact that it has no impact on physical health. Because it sure impacts mental health.

“Gynecomastia can negatively impact every aspect of a man’s life, particularly intimate relationships,” explains board-certified plastic surgeon Dr. Joseph Cruise. “Some men feel so helpless they give up taking care of themselves, while others turn to excessively exercising and dieting to try and get rid of their enlarged breasts.”

Gynecomastia is a surprisingly widespread issue, occurring in up to 60 percent of adolescent boys, 70 percent of men over the age of 50, and 90 percent of newborn boys, research shows. (It’s especially common among babies because of estrogen exposure in the womb, and goes away within a few weeks after birth). Rarely cause for concern, male breasts become enlarged due to excess breast tissue that grows under the nipple and is firmer to the touch than breast fat.

In some cases, the hormonal imbalances that cause man boobs can be triggered by alcohol, marijuana, and other drug use, as well as some medications. Occasionally, medications like androgens and antiandrogens can be prescribed to treat hormonal imbalances. In rare instances, gynecomastia may be a result of an underlying medical issue, such as hyperthyroidism, adrenal cancer and testicular cancer. So it’s always important to see a doctor to be sure.

“The vast majority of gynecomastia is not a medical concern, rather an aesthetic one,” Cruise adds. “However it is always recommended to first be evaluated by your primary care doctor to ensure there isn’t a serious underlying medical problem such as breast cancer.”

But more often than not, enlarged breasts in men are a result of a combination of aging and genetic disposition, and there’s not much you can do about that besides getting plastic surgery, taking anti-androgens, or embracing your newfound bust. The good news is that fatherhood itself probably won’t give you man boobs—that shouldn’t happen until you’re about 50.

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“Gynecomastia isn’t necessarily common among fathers, rather it is common in older men as testosterone levels drop,” Cruise explains. So for men who are not worried about it now, just give it a minute.