REMEDIES FOR GYNECOMASTIA

What to do

As anticipated, gynecomastia arises for various reasons; in some cases it can be effectively prevented.
For example, pubertal gynecomastia (usually caused by the massive production of testosterone, with conversion to estrogen) visibly worsens with overweight (mixed gynecomastia). Therefore, the most effective remedies are those that oppose the growth of fat mass and optimize the axis of the steroid hormone:

Slimming diet: in the growing subject it must NOT cause a weight reduction; this would lead to excessive nutritional restriction. It is desirable that, while body fat is reduced, the weight remains unchanged and the skeleton, muscle masses etc. increase.
Sports physical activity: of any kind, as long as it affects the caloric balance and significantly promotes development. It is used to reduce or prevent overweight and to exploit hormonal flows in a "more intelligent" way. In fact, true pubertal gynecomastia is caused by the transformation of excess testosterone into female hormones (estrogen). Sports physical activity increases muscle and skeletal receptivity to testosterone, optimizing development and preventing conversion into estrogen.
Wait: Most forms of pubertal gynecomastia resolve spontaneously with development.
If the condition has persisted for more than two years, the doctor will consider using drug therapy.

Obesity can also favor gynecomastia in adults: excess adipose slightly modifies the hormonal axis, increasing estrogen at the expense of androgens.

On the other hand, the congenital forms of gynecomastia (always with hormonal aetiology) cannot be treated definitively with prevention, diet and natural remedies; sometimes, not even drugs are decisive. In these cases it is almost necessary to contact a plastic surgeon.

Fortunately, relatively severe cases of drug-INDUCED gynecomastia can be resolved by discontinuing the responsible molecule and taking other medications necessary for healing (see below). The products most responsible for the onset of gynecomastia are steroid anabolics (converted into estrogens inside the body) and synthetic estrogens. Also in this case, if the gynecomastia is severe, surgery becomes necessary.

There are also forms of gynecomastia caused by chronic intoxication with pesticides and pollutants. Obviously, the therapeutic basis is constituted by the elimination of the poisonous agent (if identified).

Since there is the possibility that some foods can predispose to the onset of gynecomastia (especially in children) it is advisable to drastically reduce their intake or eliminate them from the diet (See What NOT to Eat).

In the most significant cases, it is necessary to intervene early by contacting the doctor: the symptoms are an increase in breast sensitivity, subsequent appearance of painful protuberances, fatty deposits and an increase in the gland.

After a first "palpation" visit, the doctor will prescribe a "chest ultrasound to confirm the diagnosis of gynecomastia and rule out a trivial fat deposit from obesity, breast cancer, etc."

What NOT to do

Follow a diet rich in dubious foods with estrogen-like molecules.

Be sedentary.

Being or becoming obese by following a diet with too many calories, fat and sugar.

Take steroid anabolics without a prescription.

Take estrogen without a prescription.

Do not perform a medical examination and related investigations in the presence of symptoms that may be associated with gynecomastia.

If prescribed, do not take gynecomastia medications.

Refuse surgery when necessary.

What to eat

To treat and prevent false gynecomastia, it is essential to follow a balanced diet. In particular, it can be decisive:

Consume an adequate caloric amount.
Choose foods with a normal metabolic impact, preventing spikes in blood sugar and insulin.
Get a good amount of dietary fiber. It helps to keep blood sugar under control, modulates fat absorption and positively affects estrogen levels.
Keep the fat fraction no more than 25-30% of total calories, preferring the "good" ones (raw vegetable oils and medium-fat blue fish) over the "bad" ones (saturated, hydrogenated, bi-fractionated, etc.).
Keep the fraction of simple carbohydrates no more than 10-16% of total calories (it is sufficient to eliminate all sweet foods, keeping 4-6 servings of fruit and vegetables as well as 1-3 servings of milk and yogurt).

Furthermore, it is advisable to choose foods (both animal and vegetable) paying close attention to the origin and the production disciplinary. As we will see in the next paragraph, some "unwanted" molecules can favor the onset of true gynecomastia.

What NOT to Eat

In case of obesity, it is advisable to reduce weight by decreasing the caloric intake by about 30%, leaving unchanged the (balanced) distribution:

It is advisable to eliminate junk foods and drinks, especially fast food and sweet or savory snacks.
It is also necessary to reduce the frequency of consumption and the portions of: pasta, bread, pizza, potatoes, derivatives, fatty cheeses, fatty meats and fish, cured meats, sausages, sweets, etc.
In adults, it may be crucial to eliminate alcohol.

Eliminate foods containing estrogen-like molecules:

Foods containing pesticides: they are of various types and cannot be summarized in a few lines. These are vegetables, fruits and cereals. Generally it is advisable to prefer vegetables from safe crops.
Foods containing growth promoters for livestock: this is muscle meat obtained from animals raised with the use of hormones. It is necessary to prefer that coming from certified and safe farms, preferably non-EU ones.
Foods containing drugs for veterinary and human use: what has been said for the two categories just described applies.

Pharmacological treatment

The drugs used for the treatment of gynecomastia are:

Tamoxifen (for example Nolvadex): the drug exerts its therapeutic action by interacting with the estrogen receptor.

Raloxifene (for example Evista): the drug can be used for the treatment of pubertal gynecomastia, where the condition has persisted for more than 2 years.

Anastrozole (for example Arimidex): it is an inhibitor of aromatase, an enzyme involved in the conversion of testosterone (the male sex hormone par excellence) into estradiol (the most important human estrogen of all).

Prevention

Avoid or reduce overweight, especially in puberty.

Balanced diet that allows you to improve the ratio between lean mass and fat mass.
Sports physical activity: in this sense it has a positive function on weight loss.

If possible, avoid taking medications that cause breast development. This is the case with steroid anabolics and estrogens.

Avoid the intake of anabolic steroids: some bodybuilding / body building "experts" argue that it is possible to avoid gynecomastia by taking other drugs for preventive purposes. Overall these are ridiculous, inappropriate and absolutely to be avoided.

Avoid the intake of estrogen: used mainly by transgender males to acquire female forms, they can cause the onset of severe and painful gynecomastia.

Limit the intake of meat from farms that use growth promoters (non-EU countries), especially for prepubertal children. If you can't do without it, discard the fat in which toxic substances accumulate.

Maintain optimal fiber consumption.

Medical Treatments

As anticipated, the definitive medical treatment for severe gynecomastia is surgery. The interventions can be:

Liposuction: consists in the "aspiration of excess adipose tissue. It is useful in false gynecomastia.
Breast reduction: consists in the decrease of the mammary mass. It is useful in false gynecomastia.
Removal of the mammary gland. It is useful in case of true gynecomastia and / or breast cancer.