I'm a 25-year-old male and have noticed that no matter how much exercise I do, I cannot develop my pectoral muscles and my chest seems more like a woman. I don’t have big breasts, but small buds, and was wondering why this is and what I could do about my problem?
J.H.

Dear J.H.,
It sounds like you have a mild form of gynaecomastia or male breasts.

BeforeAfterGynaecomastia is a common condition in teenage boys where firm, tender breast tissue grows under the nipples. This is usually caused by an imbalance of hormones during puberty, i.e. the ratio of active male hormones (androgens) to female hormones (oestrogens). Once this ratio falls, breast tissue is stimulated to grow.

In most cases, the hormonal imbalance corrects itself within a couple of years and the breast tissue disappears. However, if the stimulus has been prolonged, the breast tissue can remain and gynaecomastia becomes established.
In rare cases, gynaecomastia can be due to taking anabolic steroids, certain medications or using cannabis. Very occasionally, gynaecomastia is due to tumour or disease. If the condition appears after adolescence, i.e. in adulthood, tests are required to find out the cause of the problem, as it could be due to disease of the pituitary gland, liver, lung, testicles or adrenal glands – treatment of the underlying cause is necessary.

Some men and boys have fat on their chests, which can look like they have breasts. This is ‘false gynaecomastia’ and is helped by losing weight with a combination of healthy eating and regular exercise.

Physiological gynaecomastia, which occurs during puberty, can sometimes be treated by medication to correct the hormonal imbalance, although success rates with medication alone are small. Surgery to remove the breast tissue and liposuction is the most effective way to deal with the problem. Pectoral implants to give the appearance of well-developed chest muscles are sometimes performed at the same time.