Associated symptoms
The increased breast development can occur on one or both sides and can be pronounced to varying degrees. The accompanying symptoms of breast swelling in adolescence can include a feeling of tension in the breasts, breast pain and sometimes discharge from the mammary glands. In puberty gynecomastia, however, in addition to the physical symptoms, the psychological consequences play an important role.
Puberty is, for boys and girls alike, a very important phase in the development of their own adult identity, in which self-confidence also plays a decisive role. Enlargement of the boy’s breasts, especially in this phase, is something that those affected find very embarrassing. Especially at this age, it can also be something to which the peers react in a correspondingly devaluing way. There is the danger of social withdrawal.
Pain
In the beginning, breast growth in both girls and boys can be accompanied by an unpleasant feeling of tension or even pain in the area of the breasts.
Treatment options
Pubertal gynecomastia does not need to be treated in most cases. In a majority of cases, the increased mammary gland tissue completely recedes. Nevertheless, this takes a while and the phase until the breasts have receded can be very stressful for the adolescents.
In this respect, it should be considered whether it is helpful to consult a psychologist who, in conversations with the adolescent, tries to take away some of the shame and fear and thus to prevent social withdrawal and avoidance strategies as far as possible. In some cases, the excessive breast tissue does not fully recover. Then it must be considered – together with the young person – how disturbing the findings are and whether surgical removal is an option.
The procedure is performed under general anesthesia.The aim is to restore a normal male breast contour without large, disturbing scars. Surgery can also be considered at an early stage in boys in whom pubertal gynecomastia is very painful. As a rule, the mammary gland tissue of most boys has completely regressed by the age of 20.
Drug treatment for puberty gynecomastia is not yet firmly established. There are indications that the active ingredient Tamoxifen is intended to suppress the growth of the mammary glands. However, it has been tested mainly in gynecomastia independent of puberty and also only with a few patients. Whether a therapy trial with Tamoxifen is appropriate should be decided by the treating physician in each individual case.
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