Autoimmune disturbances, ejaculation disturbances and anatomic abnormalities are much less common causes. Proposed mechanisms for this disorder involve an imbalance between estrogen and androgen concentration or an abberation in response at the mammary gland level. Chronic gynecomastia is usually asymptomatic. Acute gynecomastia often presents with nipple or breast pain and tenderness, enlarged breasts and sometimes a discharge. Patients may be more at risk for breast cancer .
Treatment is by removing the underlying cause or drug.
Antiestrogens are useful for relieving pain and reversing gynecomastia in some patients. For cosmetic reasons, surgical reduction may be considered. Pubertal gynecomastia usually spontaneously regressess over 1-2 years. Drug-induced breast enlargement is easily corrected by removal of the causitive agent in the early stages of the disorder. After 6 months to a year very little regression takes place.