Interpersonal Neurobiology: A Systems-Thinking Approach to Optimal Health – Dr. Dan Siegel #587

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• Gynecomastia is what happens when a man’s mammary glands grow to the point that you end up with noticeable breast enlargement
• Man boobs can result from being overweight, taking anabolic steroids, genetics, or exposure to excess estrogen
• Keep reading to find out what’s causing your man boobs and how to get rid of them for good.

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When I was fat, I had man boobs, like a lot of overweight men do. I didn’t notice them as much then — I was big all over. After I figured out how to lose the weight, the breast tissue stuck around, which made me super self-conscious. They were even more noticeable once I was at my goal weight and my chest was disproportionately large — and not in the Superman sense.

When I started working with doctors and healers, I found out that I carry a lot of estrogen in my body, and when I had my testosterone tested, I found out that it was lower than my mother’s. I had my suspicions that genetics were another factor, because a lot of men in my family have the same tendency to carry weight in the chest area.

You might feel vain for even caring about your shape, but you’re not. I can totally relate — it’s uncomfortable and I remember hiding behind T-shirts when I would have much rather been soaking up the sun.

A lot of the time, when something like that doesn’t seem right, it’s a signal from your body that there’s a bigger problem, and it’s up to you to sleuth out what’s wrong. For most people, it’s a hormone thing, and getting your hormones in working order will help you operate at max power in work and life. Keep reading to find out what’s causing your man boobs and how to get rid of them for good.

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What is gynecomastia?

Both men and women have breast tissue, or mammary glands — the glands that are best known for their ability to produce milk after a mother births a baby. Men’s mammary glands do not mature to the point that they can produce milk, but they’re there, under the skin, for life.

Gynecomastia is what happens when a man’s mammary glands grow to the point that you end up with noticeable breast enlargement.[ref url=”https://www.nejm.org/doi/full/10.1056/NEJM199302183280708″]

As far as appearance goes, they can look slightly swollen, or they can take on the shape of a woman’s breasts. Instead of the rounded pectorals that male bodybuilders are after, gynecomastia produces the softer teardrop shape. They may or may not feel sore.

What causes man boobs?

There are a lot of reasons why man boobs grow.

You’re overweight

There’s a chance that you don’t have gynecomastia at all — you might have something called pseudogynecomastia,[ref url=”https://www.sciencedirect.com/science/article/abs/pii/S002561961160671X”] which is just a fat deposit without the extra breast tissue. If you’re carrying excess weight, your body stores fat wherever it wants to, including in the breast area. Since there’s no breast tissue, this is the easiest type to deal with. Once you lose the weight, you’ll lose the extra chest fat. I thought this was what I was up against, but it was more complicated than that.

You have low testosterone

Low testosterone makes you feel terrible, day in and day out. It’s one of those things that’s tough to pinpoint why. If you go to the doctor because you’re tired, your knees hurt, and you’re carrying extra weight, the doc will probably tell you to go to bed earlier, eat less, and that all of this is a normal part of aging. Low testosterone might not even cross her mind. Symptoms include:

• Weight gain
• Gynecomastia
• Bedroom problems (performance and desire)
• Fertility problems
• Fatigue
• Concentration and attention problems
• Mood disorders

The list goes on. If low testosterone goes unaddressed, you can end up with bone density issues, cardiovascular disease risk, mood disorders and more.[ref url=”https://jamanetwork.com/journals/jama/article-abstract/1764051″] It’s nothing to mess around with. Insist on testing, or insist on a new doctor.

To get the full picture of low testosterone, read this.

You have high estrogen

If your testosterone levels are low, chances are your estrogen is going haywire. You can also have adequate testosterone and high estrogen — it’s highly individual. Symptoms of excess estrogen in men include:

• Gynecomastia
• Bedroom problems
• Urinary tract infections
• Belly fat
• Loss of muscle
• Fatigue
• Diabetes

There are lots of reasons you could have too much estrogen. I have a gene that makes me convert free testosterone (the testosterone available for your body to use) into estrogen quickly. You also live in a world full of xenoestrogens, which are chemicals all around you that mimic estrogen in the body.

Here’s how men and women can balance their estrogen naturally.

RELATED: The Ultimate Guide to Hormones

You have through-the-roof testosterone

It’s not likely that your testosterone will climb off the charts spontaneously. You’re more likely to experience this if you’re using anabolic steroids to build muscle or for athletic performance. Bodybuilding communities call gynecomastia “gyno” when they talk about it.

Taking high doses of testosterone causes a few problems. One, it throws the rest of your hormones out of whack. Second, you could be converting the excess to estrogen, which causes you problems.

How to get rid of man boobs — gynecomastia treatment options

Liposuction for gynecomastia

If you have legitimate gynecomastia from a hormonal imbalance, liposuction won’t work. It’s a band-aid for a larger issue, and your man boobs will come back shortly after your procedure.[ref url=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146708/”] That’s because liposuction targets fat, and fat isn’t necessarily the problem. It’s the breast tissue that you’re up against.

Even if the fat is gone, the hormone imbalance is still there, along with all of the problems it causes throughout your body. When you have too much estrogen, you might find that you carry extra abdominal weight, or you’ve developed problems below the belt.

When liposuction works for man boobs

There is one instance when liposuction does get rid of man boobs: when you don’t actually have gynecomastia. When you have pseudogynecomastia, you don’t actually have hormonal problems and resulting breast tissue — you just have fat deposits in the chest area. So in that case, liposuction will work.

Excision or surgery for gynecomastia

Men who have gynecomastia can often feel a mammary gland cluster behind the nipple. Doctors often recommend having the glands surgically removed to resolve the issue.

That doesn’t work for the same reason that liposuction doesn’t work. First, if the enlarged gland isn’t the only gland in the chest area, the surrounding glands can swell and you end up right where you started. A better strategy is to treat the hormonal problems that are causing the breast tissue to enlarge in the first place.

Does exercise get rid of man boobs?

To get rid of man boobs, you may be tempted to add a few extra sets of push-ups and bench presses to your regimen to work your pecs. While resistance training is always a good idea for a million reasons, doubling down on chest day shouldn’t be your only strategy for getting rid of man boobs.

Muscle is muscle, and fat is fat. Working certain muscle groups doesn’t do a thing for the fat cells in that area. What adding muscle will do is ramp up your metabolism and make it easier for you to burn fat all over. So, while you’re doing your extra chest presses and dumbbell flyes, knock out a few sets of triceps dips, squats, deadlifts, and pull-ups, which will all work together to melt fat.

Long-term solutions for gynecomastia

Reduce your inflammation

Inflammation makes you hold onto body fat and retain water, which doesn’t address breast tissue under the skin, but does directly affect how soft your chest looks. The best thing you can do is to eat a low inflammation diet. Here are other ways to reduce inflammation naturally.

Diindolylmethane (DIM)

Diindolylmethane is the compound in vegetables like broccoli and cabbage that makes them protective against breast cancer. Too much testosterone can lead to an excess of estrogen, which comes with all of the problems that excess estrogen causes. Diindolylmethane (aka DIM) inhibits the enzyme that converts testosterone to estrogen, so that more testosterone is free in your system for your body to use. Some members of the bodybuilding community swear by it.

Anastrazole (Arimidex)

Arimidex works on the same principle as DIM, but at the prescription level. I’ve had success with Arimidex, and it’s a non-negotiable when I’m taking replacement levels of testosterone.

Calcium d-glucarate

Your liver breaks down estrogen. When you’re producing proper amounts of estrogen and your liver is working well, you break down the amount that you need to break down and you don’t have excess estrogen. A common scenario is that you’re exposed to too much estrogen, and your liver gets burdened. In that case, you don’t break down estrogen efficiently.

Calcium d-glucarate helps the glucaraic acid pathway, the primary mechanism that breaks down estrogen in the liver, work more efficiently. Read more about calcium d-glucarate here. 

Lose weight

Man boobs aren’t just a body fat issue — you need to address your hormones, too. But losing weight will reduce the size of your chest line. Plus, a portion of your estrogen is made in your fat cells, so you’ll make less if you have less body fat available.[ref url=”https://www.tandfonline.com/doi/abs/10.1080/tam.5.2.98.102″] Losing weight will be easier if you get your hormones in balance.

There are a million different body types, and the most attractive people feel comfortable in their skin no matter how they look. But believe me, I understand how uncomfortable it can feel to have man boobs, and there’s nothing wrong with you if you want to do some detective work and find out what’s causing it. You’ll find that once you address the root cause, you’ll see improvement in lots of areas of your health.