Q. My breasts have become large and I'm embarrassed. What can I do?

This question came from a man in his 60s. Breast enlargement in males is common. About 30 percent of older men have this condition, which can be caused by hormonal changes or simple weight gain. It can occur in one or both breasts.When the usual balance of the female hormone estrogen and the male hormone testosterone in a man shifts, he can get "gynecomastia."Males normally produce small quantities of estrogen to regulate bone density, sperm production and mood. Natural hormonal changes that lead to gynecomastia occur not only in old age but also during infancy and adolescence.Gynecomastia can be caused by a health problem such as liver, kidney or thyroid diseases. This condition can also result from drinking alcohol or taking drugs.There are medications that can cause gynecomastia, too, including: anti-androgensthat are used to treat prostate cancer; AIDS medications; anti-anxiety medications; tricyclic antidepressants; antibiotics; ulcer medications; chemotherapy drugs; heart medicationand calcium channel-blockers.Some other symptoms of gynecomastia include tenderness, swelling and nipple discharge.If you have enlarged breasts, see your doctor for a checkup. Enlarged breasts can be a symptom of breast cancer or a testicular tumor.There is a condition called "pseudogynecomastia." This occurs when a male just has a lot of chest fat that enlarges his breasts. You can tell the difference between false gynecomastia and the real thing by examining the breasts.In the examination, a health care professional spreads a thumb and forefinger and places themon the circumference of the breast. The fingers are then squeezed gently toward the nipple. Gynecomastia is diagnosed if there is enlarged glandular tissue that feels like a rubbery disk and can be moved around.Gynecomastia usually will go away without treatment. This condition is often treated with drugs. Medications used to treat breast cancer and other conditions may be helpful for some men with gynecomastia.Two types of surgery are used to treat gynecomastia: liposuction and mastectomy.The Times News Inc. and affiliates do not endorse or recommend any medical products, processes, or services or provide medical advice. The views of the author do not necessarily state or reflect those of the Times News. The article content is not intended as a substitute for professional medical advice, diagnosis or treatment.