‘Man boobs’ linked to heightened risk of death

Those with a pre-existing risk factor most vulnerable, research suggests.

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‘Man boobs,’ also known as enlarged breast tissue or gynecomastia, is a common concern in males. Recent evidence suggests that gynecomastia may be linked to long-term health issues. Still, there is a lack of information on the association with mortality and causes of death in males with gynecomastia.

A new study aims to assess the risk of death in men diagnosed with gynaecomastia and determine whether this risk is dependent on the underlying causes of gynaecomastia. This first study of its kind suggests that men with enlarged breast tissue, not caused by excess weight, may be at heightened risk of early death before the age of 75.

The study indicates that individuals with pre-existing risk factors, such as cancer or conditions affecting the circulatory, lung, and gastrointestinal systems before the diagnosis of gynecomastia, appear to be more vulnerable to associated health risks.

Gynaecomastia can develop at any age, with three distinct peaks during the neonatal period, puberty, and older ages due to changes in sex hormone levels. It is most common in older ages, often accompanied by declining testosterone levels and weight gain, which can exacerbate the condition.

Previous research has suggested a connection between gynaecomastia and increased risk of past and future ill health, but its association with the risk of death has not been well-established. To explore this, researchers analyzed data from Danish national health and population registries involving 23,429 men diagnosed with gynecomastia between January 1, 1995, and June 30, 2021.

The study divided men with gynaecomastia into two groups: those with idiopathic (unknown cause) gynaecomastia and those with a known pre-existing condition or taking medication associated with gynaecomastia. The monitoring period extended from the date of study entry to death or the end of June 2021. During this period, 12,676 men (9%) died.

Among those with gynecomastia, nearly 7% of those with idiopathic gynecomastia and 21% of those with a pre-existing risk factor died, compared to 9% deaths among men without gynecomastia. This indicates a 37% higher risk of early death from any cause among those with gynecomastia compared to those without the condition.

When stratified by group, the risk of death was highest in those with a known pre-existing condition, with odds 75% higher than those with idiopathic gynaecomastia, where the odds were only 5% higher.

Pre-existing cancers were associated with a 74% heightened risk of early death in men with gynecomastia, while circulatory diseases carried a 61% heightened risk. Lung diseases were linked to a doubled risk, while gut diseases were associated with a five-fold heightened risk. However, neurological diseases were associated with a 29% lower risk.

Among individual cancers, those affecting the digestive tract carried a 39% heightened risk, while genital cancers were associated with a three-fold greater risk, and lymph system cancers doubled the risk.

Gut diseases, specifically those of the liver and disorders of the gallbladder, biliary tract, and pancreas, were associated with the greatest risks, with 12-fold and 14-fold heightened risks, respectively.

Men with idiopathic gynecomastia generally weren’t at greater risk of early death than men in the reference group, except for a cause-specific two-fold heightened risk of death from liver disease.

The study is observational, so it can’t establish causal factors, and the researchers note that they couldn’t account for potentially influential factors like obesity, exposure to endocrine-disrupting chemicals, and steroid use.

Researchers noted, “Gynaecomastia is strongly intertwined with later health risks, and quite possibly, the drugs used to treat them.”

“Males diagnosed with gynaecomastia are at a 37% higher risk of death, observed mainly in males with a known pre-existing gynaecomastia risk factor and not in males with idiopathic gynaecomastia. These results should therefore prompt thorough clinical examination to identify the underlying risk factors.”

Journal Reference:

  1. Elvira V Brauner, Cecilie Uldbjerg et al. Is male gynecomastia associated with an increased risk of death? A nationwide register-based cohort study. BMJ Open. DOI: 10.1136/bmjopen-2023-076608

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