Learn the 4 gynecomastia grades, what they look like, how to self-check your severity, and which treatment suits each stage.
July 27, 2026
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While it’s clear that society still places far more pressure on women than men when it comes to conforming to a particular physical image dictated by society, this doesn’t mean there’s no pressure on men.
Issues of concern can include hair loss, excess body fat, problems with weight and one of men’s most dreaded physical issues: a feminine-looking chest, also medically known as gynecomastia.
Gynecomastia, also known as, man boobs
This common breast disorder in men is characterised by enlargement of the male breast tissue. It affects 60 to 70% of the male population, from young to old.
Gynecomastia causes physical discomfort such as breast tenderness, swelling and changes in the chest shape and appearance.
It can also impact a man’s overall physique, regardless of how fit they look in other areas of their body.
Did you know that bodybuilders who abuse anabolic steroids can develop gynecomastia?
They may have defined deltoids, biceps, triceps, trapezius and abdominal muscles, but if they suffer from gynecomastia, their chest may look like a pair of feminine-looking breasts instead.
That’s perhaps why one of the nicknames gynecomastia has earned itself is “man boobs”!
Why and how do men get gynecomastia?
Hormone Changes
Hormonal imbalance as a result of changes and fluctuations in testosterone and estrogen levels is the common cause of gynecomastia.
Men have both testosterone and estrogen hormones in their bodies.
Testosterone, the primary male sex hormone, is vital for the development and maintenance of male reproductive tissues and traits.
Its important functions include promoting:
- sexual development
- sperm production
- sex drive
- muscle growth
- red blood cell production
- mood regulation
Estrogen in the male’s body regulates bone density, cholesterol metabolism and cognitive function in men, among other functions.
When hormones are off-balance, it can lead to various issues such as:
- sexual dysfunction
- Infertility
- Fatigue
- muscle and bone loss
- mood changes
- sleep disturbances
- increased body fat
- gynecomastia (enlargement of the male breast tissue)
Gynecomastia develops when the testosterone level is much lower in relation to estrogen levels.
However, there are cases where higher-than-normal levels of testosterone cause the body to convert this excess male hormone into estrogen through a process known as aromatisation.
This estrogen conversion stimulates breast tissue growth in males, leading to gynecomastia.
Apart from hormonal imbalance, various other factors also play a role in its development, including synthetic drug use like anabolic steroids, ageing, secondary hormonal causes, medical conditions such as tumours, testicular disorder, pituitary disorder, liver problems and so on.
Medications
Some medications are reported to be possible causes of gynecomastia. These include antibiotics like ketoconazole. Additionally, antiulcer medications like cimetidine, ranitidine, omeprazole and growth hormones have also been reported to cause the condition [1].
Alcohol intakes
Consuming alcohol in excess can lead to alcoholism. This in turn may cause liver cirrhosis, which can lead to gynecomastia [2].
Health Conditions
It has been found that gynecomastia in adult males is commonly a result of another condition.
Some examples are liver or lung cancer, cirrhosis of the liver and overactive thyroid. Hormone problems, such as cancer of the pituitary gland, adrenal glands, or testicles, are also known causes of the condition [3].
How gynecomastia can make you look like a woman
Gynecomastia Grade I
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Gynecomastia Grade II
Gynecomastia Grade III
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Gynecomastia Grade IV
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It affects more than your physical appearance
Gynecomastia can cause emotional distress and embarrassment, particularly in social situations where you have to remove your shirt – at a beach party, for example, or by the pool.
“Patients who consult me for gynecomastia generally are very distressed, and they have low self-esteem due to their ‘feminine-looking breasts’,” says Dr Ivan Puah, who had more than 2 decades of gynecomastia surgery experience. “They often have difficulty finding clothes that fit and are wary of wearing light-coloured or fitted T-shirts.”
Gynecomastia is not just an aesthetic issue. It’s a medical issue that needs to be treated, as its effect on men can be extensive – mentally, physically and emotionally.
