: Breast enlargement in adolescent boys usually
normal
DEAR DR.PAUL: My 13 year-old son is embarrassed to go swimming
because his breasts are enlarged and sometimes painful. Aside
from the effect on him emotionally, I am concerned about this.
Is breast enlargement normal in boys?
DR.PAUL ANSWERS: Breast enlargement or "physiologic
pubertal gynecomastia", develops in up to 65% of normal boys.
All children who enter puberty produce both female hormones,
called estrogens, and male hormones known as androgens.
Androgens cause the development of the male secondary sex characteristics
such as pubic hair, genital growth and a deeper voice. Estrogens
are responsible for the development of female sex characteristics
such as breast enlargement.
This complex process of pubertal hormone production is controlled
by the brain and results in temporary high levels of both androgens
and estrogens. During this period, the high estrogen levels
may stimulate breast enlargement in some boys. It is not uncommon
for one breast to be enlarged and not the other. In some cases,
both breasts are affected. Frequently, the breasts may be tender
or painful. Very rarely, breast enlargement, especially in younger
boys, may be caused by a more serious problem. However, a thorough
physical examination is usually enough to confirm the diagnosis
of pubertal breast enlargement in teenage boys, which usually
resolves on its own within in one to two years.
Knowing this fact is quite reassuring to most boys and their
parents. However, the social effect on the boy's self image
needs to be evaluated. Adolescent boys are quite sensitive to
being picked on, and of course, enlarged breasts can be a source
of embarrassment in public.
While recognizing this is a potential source of stress and shame,
I do not think the answer is to completely withdraw the boy
from swimming and other sporting activities. At the pool or
beach, or even during outdoor summer sporting events, wearing
a T-shirt under the guise of "sun sensitivity" for example,
may do the trick.
On the other hand, this situation can be dealt with if a boy
understands that it is just a normal part of growing up and
is mature enough to be able to explain this to his friends,
teammates and schoolmates. Again, the extent to which a boy's
lifestyle is affected depends on the degree of shame or embarrassment
he feels or experiences. Happily, most adolescent boys can get
through this period very well by having supportive parents and
a clear understanding of the normal and temporary nature of
enlarged breasts during puberty
Since I am on the topic of the effect of hormones on breast
tissue, it is not uncommon for newborn baby girls and boys to
have engorged and slightly enlarged breasts at birth. This breast
enlargement is caused by estrogens passed from the mother to
the baby during the pregnancy. At birth, this hormone transfer
stops and the breasts return to normal size within a week or
two.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
