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Blog. Idiopathic Gynecomastia: What Does it Mean?

If you have enlarged male breasts, like thousands of guys we’ve treated for man boobs over the years, you’ve probably learned some new words. “Gynecomastia” is one, the medical term for your condition.

Another new word you might be interested to know is “idiopathic.” Merriam-Webster defines it this way: arising spontaneously or from an obscure or unknown cause.

Why are we telling you this? Because fully 25% of gynecomastia cases are thought to be idiopathic. So says an article by Dr. Gretchen Dickinson in American Family Physician. Even though the piece is written for doctors and contains its share of medical jargon, it’s worth a read if you’re interested in learning more about causes of gynecomastia.
Given that gynecomastia can be so distressing for a guy, we find that many of our man boob patients are desperate to find out exactly why they grew breasts. While we disagree with a few points Dickinson makes, generally her article does a fine job explaining the various causes of gynecomastia. She divides causes into two main groups: physiologic and nonphysiologic.

Physiologic Causes of Gynecomastia

Physiologic causes relate to hormone fluctuations. That’s why males tend to have enlarged breasts at birth, due to estrogen from the mother, at puberty when testosterone and estrogen can be out of balance, and in middle to old age when testosterone production naturally decreases. According to Dickinson, about a quarter of the cases of persistent gynecomastia can be traced to a physiologic cause.

It’s worth noting that enlarged breasts in newborns almost always resolve within a few weeks of birth. On the other hand, men around 50 years of age or older who get man boobs usually have them for the rest of their lives unless they elect male breast reduction. Adolescents fall somewhere in between. Many cases of teen moobs fade away in two years or less, many don’t.

Nonphysiologic Triggers

Included in the category of nonphysiologic causes of gynecomastia are medications (including street drugs), substances like steroids and medical conditions such as liver damage and tumors. This catch-all category accounts for as much as about 40% of cases of gynecomastia.

Medications and substances linked to gynecomastia are too numerous to mention here. You can read the American Family Physician article to see if something you use is listed. Dickinson also details exactly how each medication and substance triggers breast growth.

Idiopathic Gynecomastia

Treating gynecomastia is one of the specialties of our plastic surgery practice. Man boob patients usually want to discuss what may have caused their enlarged breasts, and we’re happy to have this conversation as it can help ease a guy’s worries.

We are careful to rule out possible conditions that warrant a second look, including breast cancer and cysts. With a detailed health history, discussion of symptoms (if any) and careful examination, most patients can be diagnosed with simple gynecomastia.

Some guys we see have taken steroids, street drugs or prescription medication that can be identified as a likely trigger. Others developed man boobs in adolescence and the unwanted breast tissue did not resolve on its own.
As for the rest? Frustrating though it can be, oftentimes there’s no apparent cause. If this is the case for you, you can take comfort in knowing:

1) You are far from alone. We treat as many as 250 or more patients with man boobs annually, and in many cases we can’t point to a definitive cause.

2) Gynecomastia is most often a benign condition. If you are not overly bothered by enlarged breasts, and there’s no reason to suspect an underlying medical problem, you can choose to simply live with them.

3) If your man boobs cause you distress, male breast reduction surgery is an effective, permanent solution. Just select a board certified plastic surgeon who has hundreds of successful operations under his or her belt, and your gynecomastia will be a thing of the past.

We’re here to help you if you’re interested. If you live in or near greater Miami, schedule an appointment and we’ll be glad to share our expertise. If you live elsewhere and would like to discuss your condition and options with us, we can arrange an online consultation. Fill out our short email form to get started.


Dr. Elliot William Jacobs is a board-certified aesthetic plastic surgeon who specializes in FTM top surgery, gynecomastia surgery, revision gynecomastia surgery and male breast reduction. He is a native of New York and has over 40 years of experience in his field. Dr. Jacobs is a highly respected and sought-after surgeon who is known for his skill, experience, and compassion. Whether you are interested in gynecomastia for the first time, or are looking to correct a gynecomastia you aren’t happy with, Dr. Jacobs can deliver amazing results.


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