Why Men Develop Gynecomastia With Age and What You Can Do About It

Posted on January 29, 2026 by root

If you have noticed your chest looking fuller or puffier as you have gotten older, you are certainly not alone. Many Los Angeles men are surprised and often embarrassed by changes in their chest appearance, wondering if something is seriously wrong. The medical term for this condition is gynecomastia, and in most cases, it is common, benign, and completely explainable.

Dr. Justin Houman, a board-certified urologist and fellowship-trained men’s health specialist in Los Angeles, sees this condition frequently in his practice. Understanding why gynecomastia happens and what options are available can help men across the greater Los Angeles area take control of their health and regain their confidence.

Understanding Gynecomastia: More Than Just Chest Fat

Gynecomastia is the growth of actual breast gland tissue in men, not simply an accumulation of fat. It typically presents as a firm or rubbery disc located directly under the nipple. This distinguishes it from pseudogynecomastia, which is caused by excess fat deposits in the chest area. Many men experience a combination of both conditions, making accurate diagnosis essential for effective treatment.

The distinction matters because treatment approaches differ significantly. While pseudogynecomastia often responds well to diet and exercise, true gynecomastia involves glandular tissue that requires a different approach. A proper evaluation from a men’s health specialist can determine exactly what is causing your symptoms.

The Hormonal Shift: Why Age Plays a Major Role

Men do not suddenly start producing high levels of estrogen as they age. What actually happens is far more subtle and much more common. The body’s hormonal balance gradually shifts over time, creating conditions that allow breast tissue to develop.

As men age, testosterone levels slowly decline while estrogen levels remain relatively stable or even increase slightly. This changing ratio is the key factor. Your body responds more dramatically to the balance between testosterone and estrogen than to the absolute levels of either hormone. When testosterone decreases without a corresponding drop in estrogen, breast tissue can begin to grow.

Four Key Factors Behind Age-Related Gynecomastia

Natural Testosterone Decline

After approximately age 30 to 40, testosterone drops gradually each year. Even if your levels fall within the technically normal range, they may be low for you personally. This is especially true for free testosterone, the active form your body actually uses. Lower testosterone means estrogen faces less opposition, allowing breast tissue development to occur.

Increased Body Fat and Estrogen Conversion

Fat tissue contains an enzyme called aromatase, which actively converts testosterone into estrogen. As belly fat increases with age, this conversion accelerates. The result is a double impact: testosterone levels drop while estrogen levels rise. This combination makes gynecomastia significantly more likely, which is why the condition is more prevalent among men who are overweight or insulin resistant.

Medications and Their Hidden Effects

Many commonly prescribed medications can contribute to gynecomastia development. Men throughout Los Angeles and Beverly Hills may not realize their prescriptions are affecting their hormone balance. Common culprits include:

• Hair Loss Medications: drugs like finasteride affect hormone metabolism
• Blood Pressure Medications: certain classes can disrupt hormonal balance
• Antidepressants: some varieties influence hormone levels
• Opioid Pain Medications: known to suppress testosterone production
• Prostate Medications: several options affect hormone pathways

This does not mean you should stop any medication without consulting your physician. However, it does mean a comprehensive medication review is often worthwhile when addressing gynecomastia.

Reduced Hormone Clearance

As men age, the liver and kidneys may not clear estrogen from the body as efficiently as they once did. Even mild changes in organ function can tilt the hormonal balance toward estrogen dominance, contributing to breast tissue growth over time.

When to Seek Medical Evaluation

In the vast majority of cases, gynecomastia is not dangerous. However, certain symptoms warrant prompt evaluation by a men’s health specialist. You should schedule an appointment if you notice:

• Rapid Growth: breast tissue that develops or enlarges quickly
• Pain or Tenderness: persistent discomfort in the chest area
• Asymmetric Changes: enlargement affecting only one side
• Nipple Discharge: any fluid coming from the nipple
• Testicular Changes: new lumps or changes in the testicles

These situations are uncommon but important to rule out with proper testing and examination.

Can Gynecomastia Be Reversed?

The answer depends largely on timing and the underlying cause. Early-stage gynecomastia, typically within the first year of development, may improve with conservative approaches. Effective strategies for early intervention include weight loss to reduce aromatase activity, addressing underlying hormone imbalances through proper testing and treatment, and adjusting medications when appropriate under physician guidance.

Long-standing gynecomastia that has been present for 12 to 18 months or longer often becomes fibrotic, meaning the tissue hardens and typically does not regress on its own. At that point, surgical treatment may be the most effective option if the condition is affecting your quality of life, confidence, or physical comfort.

Common Questions About Gynecomastia

• Does testosterone therapy cause gynecomastia? It can in some cases, but it does not have to. Testosterone can convert to estrogen in certain men. Proper dosing, regular monitoring, and individualized care from a specialist like Dr. Houman significantly reduce this risk.
• How can I tell if this is fat or true gynecomastia? True gynecomastia feels firmer and is more centralized directly under the nipple. Fat deposits feel softer and are distributed more diffusely across the chest. A physical examination can provide definitive answers.
• Is gynecomastia always a sign of low testosterone? Often, but not always. The condition results from hormonal imbalance rather than simply low testosterone. This is why proper lab testing is essential for accurate diagnosis and effective treatment planning.

Taking the Next Step

Gynecomastia in aging men is common, usually hormonal in origin, often manageable, and not something you need to simply accept. Modern men’s health care offers multiple pathways for evaluation and treatment, from hormone optimization to surgical intervention when appropriate.

If chest changes are affecting your confidence, comfort, or quality of life, a proper evaluation can clarify exactly what is happening and outline your real options. Many men in Los Angeles, Beverly Hills, Santa Monica, and throughout Southern California have found answers and effective solutions.

Schedule Your Consultation With Dr. Justin Houman in Los Angeles

Dr. Justin Houman is a board-certified urologist and fellowship-trained men’s sexual and reproductive health specialist serving the greater Los Angeles area. With extensive training from UCLA Medical Center and Cedars-Sinai, Dr. Houman brings expert-level care to hormone management, sexual health, and the full spectrum of men’s health concerns.

If you are experiencing gynecomastia or other changes that concern you, comprehensive evaluation and personalized treatment options are available. Contact the office at (310) 854-9898 to schedule your consultation and take the first step toward understanding your health and exploring your options.