A look at Gynecomastia

Who would think an invitation to a beach, lake, or pool party could strike terror in a boy's - or man's - heart? Yet these summer pastimes can seem a fate worse than death for a boy or man with gynecomastia, the development of breast tissue that leads many males to hide in shame and humiliation.

In his new book, Demystifying Gynecomastia: Men With Breasts, psychotherapist Merle Yost reports that up to one-third of males may have to deal with problem gynecomastia at some time. Although adolescent onset is most common, adult-onset gynecomastia is on the rise with men's increased use of prescription drugs - including anti-depressants - and this country's obesity epidemic.

Yost himself has been affected since age 11. "I was a skinny little boy who grew noticeable A-cup breasts," says Yost. "They called me 'tits' in junior high. Girls offered bras; boys twisted and taunted." He suffered through school, hiding his body as best he could.

After breast reduction surgery at age 34, Yost posted a gynecomastia page on his therapy practice website. It got so much traffic that he launched a dedicated site, www.gynecomastia.org, a free information and discussion service that now gets 1.2 million hits per year.

Gynecomastia can be a normal part of adolescence, with a mild form affecting up to 70 percent of boys. Their livers can't keep up with the testosterone raging through their bodies, Yost explains, and what the liver can't process converts to estrogen, causing painful nipples, puffy breasts or both. This usually disappears once the liver adjusts. But for some, breast growth is obvious and permanent, causing emotional harm and life-long body self-consciousness.

Yost says many doctors know little about gynecomastia and assure boys they'll grow out of it. Millions don't, however, instead growing up humiliated and ashamed.

Yost's book is sprinkled with heart-wrenching quotes:

• "I haven't taken my shirt off in public since I was 8."
• "I have back pain because I slump over to try to reduce the effect."
• "I pretend to be a strong, carefree individual, when in fact I hate myself sometimes."

"Gynecomastia itself is benign - it's simply development of a secondary female characteristic," says Yost. "It signals underlying issues that may need treatment, from a pituitary gland tumor or liver dysfunction to weight gain."