Understanding Gynecomastia: Supporting Breast Tissue in Men

Image courtesy of Gynecoma.com, a great resource for men with gynecomastia

I have written hundreds of blogs about breast and bra related issues for women. This week is the first time I'm writing about a male breast issue. In the last month I have been corresponding with two men who both have gynecomastia. Gynecomastia is a condition that causes excessive breast tissue growth in men. It is far more common than we realize largely because there are still huge social barriers for men to talk about vulnerabilities or concerns, especially one that is so female-centric, so many men don't know it is a common condition. The first email I received about gynecomastia explained that there is very little information and support out there for men with gynecomastia so would I consider writing a blog with helpful information that could be a resource. I am very pleased to be able to help.

What Causes Gynecomastia?
The growth of excess breast tissue in men is caused by a hormonal imbalance. This imbalance can be caused by a number of things: puberty, illness, medications, aging and environmental factors. Gynecomastia is not of itself a harmful condition but you should always consult your doctor if you have sudden or prolonged breast tissue growth to check your overall health. There are 4 levels of severity in breast tissue enlargement:

Image courtesy of Gynecoma.com

For a huge number of men gynecomastia is a temporary condition that rights itself as the body restores the hormonal balance. For others though, especially those whose gynecomastia has been triggered by ongoing medications, the condition is prolonged and or permanent.

How Do You Treat Gynecomastia?
Once your doctor confirms a diagnosis of gynecomastia they will be in the best position to assess whether it's likely a temporary condition that will pass with improved health or at the end of a course of medication. If the gynecomastia is more permanent then there is no physical need to have the breast tissue removed (unless, in some cases, if the condition is accompanied by pain in the breast tissue). There is some pharmaceutical treatment available, however, it's not recommended in each case and the success rates are not guaranteed.

You may elect to have surgery to remove the tissue but it's worth bearing in mind that this is not covered by medical insurance as it is considered a cosmetic procedure. There are also risks associated with surgery that should be considered: loss of sensation, asymmetry, infection, hematoma and scarring. Elective surgery has become increasingly common with over 10,000 elective surgeries being performed each year in the US alone so your doctor will be able to give you more information about the surgery options where you live.

If there's no medical reason to have surgery and you don't elect to have it then you can live perfectly healthily with gynecomastia.

How Do You Support Breast Tissue?
Lots of men choose not to use any support garments for their gynecomastia but this can be painful. A lot of women will tell you that going braless isn't an option for them because the movement impact is too painful, this can happen for men too as the physiology is largely the same.

Finding a bra that will not only support you but give you the shape you want can be hard enough for women; for men there is an extra layer of social ignorance about the condition that can make it really tough. There are some compression garments designed for men (mostly post surgical but they can also be worn for daily wear) but these aren't readily available and can be expensive. As one of the men I've been consulting with explained to me, getting bra fit help can be hard. He shared with me his experiences of trying to get fitting help from a mainstream lingerie store and it was heartbreaking.

"In my early 60s my testosterone levels took a very sudden dive and over 6 months I developed significant breast tissue. I had to get some support because the pulling on my chest was really painful. My wife came with me to a local lingerie store and I nervously began to explain that I was in need of support . It wasn't said but the assistant treated me like my inquiry about bra support was sordid or perverted. She was dismissive and wouldn't give me a fitting. My wife was so upset which made me mad and we both left feeling humiliated. Gynecomastia made me feel really alone so to find out I couldn't ask for help with dignity made me feel worse. I found advice on reddit from other men in exactly the same boat; in need of bras for support, not for fashion or fetish purposes. Ultimately the online bra community gave me support, answers and advice about how to find a bra that fits."

I have always said that everyone deserves to be fitted with dignity and respect and this extends to every sex and gender. With that in mind I have been educating myself as much as possible in the last month about bra fit for men with gynecomastia. I will be completely honest and say that I don't have anywhere near as much experience with bra fit for men as I do for full busted women but I hope these fit points will be helpful for those men trying to find support.

Bra Fit Tips for Men with Gynecomastia
There are a couple of generalized physiological points to bear in mind when fitting a bra for the male body (please note that these are very general points just worth bearing in mind, the male body is as diverse in shape and size as the female body).

* A lot of men have more muscular chests because higher testosterone levels in men builds more muscle in men than in women.  The additional muscle can make the chest broader so bras with wide wires are more comfortable if you have a wide chest and breast root.

* While male and female skeletons are incredibly similar, male bones grow for longer which can make them wider and more angular. This can change the shape of the ribcage to be more triangular or flared. Flared ribcages can be tricky to fit because the band needs to be smaller at the bottom and wider at the top. This post about torso shape can help you if you have a flared ribcage.

* Wire free bras can be a great option for men with gynecomastia, especially if the breast root is very wide and a wide enough wire cannot be easily found. Lots of men appear to have had success with wire free sports bras because the support level is good and the coverage is wide and tall.

* A more angular ribcage can mean a more protruding sternum so men with gynecomastia can find a more comfortable fit in bras with a lower gore (the centre part of the bra between the cups).

* The distribution of breast tissue tends to be wide in men (I've tried to find any physiological reason for this but as of yet, no answers). When you wear a bra with a supportive side panel (a vertical panel that forces the breast tissue forward) wide breast tissue becomes narrower with more projection. This shape will work for some men and not others.

* Bras with a horizontal seam straight across the nipple will give less projection and follow the shape of wide breast tissue. This gives lift and stability without projection. Here are some examples of bras with horizontal seams.

* One of the men I was consulting with said he has always been self conscious about wearing a bra and it is very important to him that the bras are not obvious under clothing. Compression garments and compression sports bras are a good solution for those men who want discreet support as these can look like a regular under vest.

While this is in no way a comprehensive guide to gynecomastia, I hope it adds to the helpful information available to men navigating this condition. If you have experience of either having gynecomasita or fitting men with gynecomastia then we would love to read your comments. Thank you to the two men who were generous with their time and brave with their candour. xx