Men with enlarged breast tissue not due to excess weight, a condition formally known as gynecomastia, may be at increased risk of premature death before age 75, according to a study published in the open access journal BMJ Open. .

Enlarged breast tissue in men is usually caused by hormonal imbalance and affects about one-third of men, depending on age. It differs from the bloat associated with excess weight and is called pseudogynecomastia. Gynecomastia can develop at any age, but it has three distinct peaks during men’s lives, caused by sharp changes in sex hormone levels: During the neonatal period, during adolescence, and in older ages. However, it is more common in older ages, as testosterone levels decrease and weight gain often occurs, which in turn can make it worse.

In the present research the scientific team relied on data from the Danish national health and population registers. Between January 1, 1995 and June 30, 2021, 23,429 men were diagnosed with gynecomastia. Just over 44% were aged 19-40 at diagnosis. Each of these men was matched by age and date of diagnosis to five randomly selected men without the condition, resulting in a total of 140,574 individuals.

Men with gynecomastia were further divided into two groups, those with unknown cause (idiopathic) gynecomastia and those with a known pre-existing condition or taking medication associated with gynecomastia.

All participants were followed from the date of entry into the study until their death or until the end of June 2021. A total of 9% of the men died during the follow-up period.

The researchers found that men with gynecomastia had a 37% higher risk of premature death from any cause than men without the condition. When stratified by group, the risk of death was found to be higher in those with a known pre-existing condition: The odds were 75% greater than those with gynecomastia of unknown cause. Pre-existing cancers, circulatory, lung and bowel diseases were associated with the greatest risks. Also, among individual cancers, cancers of the digestive system, genital organs, and lymphatic system were associated with a higher risk. In contrast, men with idiopathic gynecomastia had no greater risk of premature death than men in the reference group, except for a specifically two-fold increased risk of death from liver disease.

The researchers note, however, that this is an observational study that cannot determine causal factors, and they acknowledge that they were unable to account for potentially influencing factors such as obesity, exposure to endocrine-disrupting chemicals system, and the use of steroids.

However, as an explanation for their findings, they suggest that gynecomastia is closely related to later health risks and very likely to the drugs used to treat them.

The scientific publication