Gynecomastia in Bodybuilders: Causes & Treatment

As a bodybuilder, you would agree that the process of bodybuilding requires you to stay committed to your fitness goals with discipline and thoroughly understand your body. During this process, you might have to face several hurdles, and a major one among them is gynecomastia. Even though you ensure the body fat levels are low and undergo rigorous training, some of you might have to deal with an enlarged chest. It becomes highly visible with puffiness or fullness in the chest area, especially near the nipples. As a bodybuilder, gynecomastia is not just a cosmetic issue, but can disrupt the symmetrical look and erase muscle definition. Enlarged breasts will also make your gymming efforts a waste, as achieving a chiselled look becomes impossible. Unfortunately, bodybuilder gynecomastia caused by enlarged glandular tissue in the breast will not fade away with a low-fat diet, supplements, or extreme training[1]. If you are noticing chest puffiness even with a lean physique, it’s time to learn more about bodybuilder gynecomastia and ways to rectify it.

Why Bodybuilders Get Gynecomastia More Often Than Others

Bodybuilder gynecomastia is one of the most frustrating conditions featuring man boobs that can ruin your overall body appearance despite being dedicated during gym hours. Bodybuilders have to spend endless hours on specific workouts, consume a low-fat diet, and take several supplements along with performance enhancers. However, such performance-enhancing drugs and supplements with steroids might induce alterations in hormone levels, resulting in enlarged glandular breast tissue.

If you were under the idea that your breast shape would be restored as soon as you stop consuming performance enhancers, you might have to rethink that. These pills contain anabolic steroids to improve muscle mass and help with muscle development and growth. However, such steroids supplement your body with various forms of testosterone, a natural male hormone. This, in turn, disrupts blood testosterone levels in your body and raises oestradiol, a female estrogen hormone in the body. High levels of oestradiol cause overgrowth of male glandular tissue in the breasts, leading to gynecomastia in bodybuilders.

Steroids, Supplements & Hormones: The Real Culprits

Role of Steroids in Gynecomastia

Gynecomastia is a common side effect faced by bodybuilding professionals using anabolic steroids[2]. As these steroids help with better performance and improved muscle growth, it’s hard to resist their usage. Such anabolic-androgenic steroids contain substances that have testosterone-like traits to promote muscle growth. However, this hormone is converted into estrogen during aromatization. Mostly used AAS or Anabolic-androgenic Steroids like methandrostenolone, nandrolone, and testosterone will induce gynecomastia among bodybuilders[3]. Such steroids will elevate estrogen levels and will cause abnormal growth of your breast tissue.

Role of Supplements in Gynecomastia

Some performance-enhancing supplements are responsible for gynecomastia among bodybuilders. You might find a lot of low-quality supplements labelled as testosterone boosters or fat burners, which are laced with prohormones or anabolic steroids. Some supplements contain MK-677 or RAD-140 compounds that can cause a surge in your hormone levels and lead to gynecomastia[4]. Taking supplements that contain specific herbal ingredients like tea tree oil, lavender, and Tribulus terrestris[5]. will also cause gynecomastia.

Role of Hormones in Gynecomastia

Taking performance enhancers, prohormones, and testosterone-boosting supplements will cause fluctuations in the testosterone and estrogen levels. Any disruption in the hormone fluctuations will trigger the growth of your glandular breast tissue. These exogenous hormones in anabolic steroids are responsible for creating hormonal fluctuations. It occurs when the aromatase process converts anabolic steroids into estrogen with enzyme activity. When the levels of estrogen increase, it kindles the growth of glandular tissue in males, causing gynecomastia. The chances of enlarged breast tissue will be higher among bodybuilders who are genetically predisposed and have a hormone imbalance.

Puffy Nipples vs Fat Chest – How to Spot the Difference

Can Gynecomastia Be Reversed Without Surgery?

Non-surgical treatment options will be effective for bodybuilders who have fatty gynecomastia or pseudogynecomastia. It occurs due to excess chest fat and can be corrected with non-surgical treatment options along with weight loss, lifestyle modifications, and fat loss procedures. However, bodybuilders with glandular gynecomastia will have dense tissue in the breast, which cannot be corrected with non-surgical options. Bodybuilding professionals with mild to moderate pseudogynecomastia and who maintain a healthy body weight can opt for these non-surgical procedures to improve their overall physique without any downtime.

Medical Treatments That Actually Work

• Radiofrequency/Ultrasound Treatment: These non-surgical procedures are energy-based and performed by heating the fat and skin layers for the production of collagen and support breakdown of fat cells. The special devices powered with radiofrequency and ultrasound tighten the skin and cut down excess fat deposits in the breasts.
• Cryolipolysis: This CoolSculpting procedure is based on controlled cooling energy to remove fat tissues by freezing action. It is useful for men facing pseudogynecomastia and helps you achieve a sculpted chest by eliminating fat cells naturally.
• TRT/ Testosterone Replacement Therapy: This treatment will be helpful for restoring the hormone balance by regulating testosterone levels. This therapy will help in lowering the chances of breast tissue enlargement when combined with hormone replacement therapy.

Gynecomastia Surgery for Bodybuilders – What to Expect

The gynecomastia procedure for bodybuilders is much different from that for common people in terms of approach. As bodybuilders have very little body fat and more glandular tissue, removing it can be challenging. Even a tiny imperfection can be visible on their lean chest muscles. Also, removing the vascular glandular tissue in the chest by making a tiny incision along the areola’s outline will require an expert surgeon.

1st Week: Initial Healing

This initial week after your breast reduction procedure should be dedicated to resting and protection. Tightness, bruising, and swelling in the breast area are normal, and you should not misunderstand them as complications. It can be averted by wearing compression garments.

2nd & 3rd Week: Gradual Healing

During these weeks, you will begin to feel better, and there will be improvement in swelling and bruising. The incisions would have healed, and you can perform light activities.

4th – 6th Week: Visible Differences

After a month of gynecomastia, you will begin to notice a contoured look in the chest area. There would be less tightness and swelling, and you can get back to your work. After the 4th week, you can perform mild cardio sessions, and you can begin scar management.

6th – 8th Week: Resume All Activities

After 6 weeks of your gynecomastia, you need not miss your physical activity, sports, or gym sessions as you can resume them. Your chest will have a naturally looking, flatter chest with better confidence levels.

3rd – 6th Months: Refined Results

During this period, the outcome of the gynecomastia procedure will begin to take shape. The chest contour will be visible along with skin tightening. Scars will also become almost invisible.

Prevention Tips So Your Chest Stays “Bro” Not “Bra”

• Maintain your ideal body weight to prevent excess fat from accumulating on your chest and other areas. Too much fat might raise the estrogen hormone levels in your body, which would lead to glandular tissue growth.
• Indulge in strength training workouts that would build chest muscles and cut down chest fat. Performing cardio workouts will help burn unwanted breast fat and maintain a healthy weight.
• It is essential to understand that eating a hormone-balanced diet with healthy fats, protein, nuts, seafood, beans, and low-fat meat will help in regulating hormone levels.
• Use performance boosters or supplements only after consulting your doctor for bodybuilding without facing gynecomastia.
• Avoid consuming alcohol, as it can affect liver health, as it may elevate estrogen hormone levels.
• As high stress levels can lead to hormonal imbalance, stay stress-free and get at least 8 hours of sleep.

If you are into bodybuilding and looking for a safe and effective way to get rid of gynecomastia, consult an expert at Akruti now!

Reference Links:

1. El wakeel et al., 2021;Gikas & Mokbel, 2007;Johnson & Murad, 2009;Vojvodic et al., 2019 – https://www.researchgate.net/publication/353538249_Bodybuilder_Gynecomastia_Etiology_Characteristics_and_Management.
2. Briely, 1987;Brower et al., 1991;Friedl et al., 1989;Haupt et al., 1984 – https://www.researchgate.net/publication/262911042_Self-Treatment_of_Gynecomastia_in_Bodybuilders_Who_Use_Anabolic_Steroids
3. Beniwal M, Singh K, Singh P, Sharma A, Beniwal S. The Burden of Anabolic Androgenic Steroid-Induced Gynecomastia. Indian J Plast Surg. 2023 Jul 28;56(4):338-343. doi: 10.1055/s-0043-1771293. PMID: 37705825; PMCID: PMC10497340. – https://pmc.ncbi.nlm.nih.gov/articles/PMC10497340/
4. Chong S, Woolnough CA, Koyyalamudi SR, Perera NJ. Reversible Gynecomastia and Hypogonadism Due to Usage of Commercial Performance-Enhancing Supplement Use. JCEM Case Rep. 2024 Aug 14;2(8):luae148. doi: 10.1210/jcemcr/luae148. PMID: 39145153; PMCID: PMC11321837. – https://pmc.ncbi.nlm.nih.gov/articles/PMC11321837/
5. 2012, American Family Physician – https://www.sciencedirect.com/science/article/abs/pii/S0960977603002509