For over 20 years, I’ve seen and treated a wide range of patients with gynecomastia due to various etiologies, or what we call causative factors
The most critical factor that causes gynecomastia in a particular group of patients is due to anabolic steroids or the intake of hormones. These patients are often bodybuilders, athletes, models, or men who take supplements or medications to build muscle or reshape their bodies.
One of the side effects or complications of the intake of steroids is hormonal imbalance, leading to gynecomastia.
Anabolic steroids: How they affect our hormones
Anabolic steroids are man-made hormones that mimic the male sex hormones. The intake of anabolic steroids will raise the level of testosterone in the body and indirectly cause an imbalance of hormones.
The interesting part is that testosterone itself doesn’t directly cause gynecomastia. It is the imbalance of hormones. When estrogen levels become too high relative to testosterone, it leads to breast tissue growth.
How does the intake of testosterone lead to an increase in estrogen levels? Well, this can happen when testosterone is converted to estrogen by an enzyme called aromatase.
When the level of testosterone is increased, your body will actively convert the excess testosterone to estrogen, leading to an increased level of estrogen, which will stimulate the growth of breast tissue.
Any increase in testosterone, whether a synthetic oral intake or due to organic, physiological, or even medical illness, will lead to a conversion by our body to estrogen and eventually lead to gynecomastia.
Side effects of anabolic steroids in men and women
The effects of anabolic steroids will not only lead to an enlargement of breast glands, but they also have various side effects and complications, such as:
- mood swings
- sleep disorders
- irritability
- aggression
- acne
- testicular atrophy
- infertility
- erectile dysfunction
- prostate issues
- balding
Women who use anabolic steroids may experience:
- amenorrhea
- irregular menstrual cycles
- breast atrophy
- a voice change
- growth of excess hair
- abnormal enlargement of the clitoris
Prolonged use of anabolic steroids comes with permanent side effects
For bodybuilders and those who regularly use anabolic steroids for muscle building and body shaping, the prolonged use of anabolic steroids can lead to reduced drug efficacy and potentially cause the body to completely cease its own testosterone production, which leads to testicular atrophy, erectile dysfunction, etc.
The side effects and complications of prolonged or sustained use of anabolic steroids such as testicular atrophy, gynecomastia, or organ damage are irreversible. When I see patients with gynecomastia due to steroid usage, they may have stopped using the steroids for years, and the condition will persist.
So often, I tell the patients that the only solution for them is to have a corrective procedure like gynecomastia surgery.
