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Tuesday, February 13, 2007

Lavender and Unwanted Breast Tissue in Boys and Men
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A recent article in the New England Journal of Medicine noted that there may be a connection between the development of breast tissue on male children and the use of lavender and/or tea tree oils on them. The researchers found that the oils had both estrogenic and antiandrogenic properties. This means that the oils fostered estrogen (a primarily female hormone) and suppressed androgens (a primarily male hormone).

The researchers speculated that these hormonal effects may have led to the development of the unwanted breast tissue and they cautioned parents to be on the lookout for these products in products such as diaper wipes. In the three children who had the gynecomastia, once the use of these oils stopped, the extra breast tissue did go away.

How else does gynecomastia develop? When a male's estradiol blood level is high enough, the glut in this female hormone can cause him to have breast enlargement. Males may notice this breast development during their teen years. The sudden surge in adolescent testosterone and its spillover that converts to estradiol seem to overwhelm the body at first.

The temporary glut of estradiol changes the hormonal balance and alters the teenager's testosterone/estradiol (T/E) ratio. For a brief period of time, the relative excess of female hormones in the teenager's bloodstream stimulates his breasts to start growing. Gradually the T/E ratio tilts in favor of the testosterone. Then, as estradiol levels dwindle, the stimulus to further breast development slows down and eventually ceases. Innovative hormone treatments with dihydrotestosterone (DHT) may provide a nonsurgical alternative for treatment.

I have treated several men in my practice who have had gynecomastia and had one friend who also had it. From my small sample alone, I can say that this can occur regardless of sexual orientation. No matter what zone of the world a male inhabits, gynecomastia can be a challenge to live with.

Young boys tend to resort to loose fitting clothes and the avoidance of public swimming. For some, it is so upsetting that they try to distract themselves with unhealthy habits like overeating (which can inadvertently add breast tissue) and self-numbing with substances as teens and later. The seeming feminization of the male body can lead to confusion about gender identity and/or orientation -- among other types of psychological discomfort.

In the gay male culture, where there may be a strong emphasis on physical appearance, gynecomastia can place additional burdens on a man who may already be struggling to figure out where he fits in. Only men who are interested in transvestism and transsexualism seem to find gynecomastia a "blessing." No matter their sexual orientation, some men do turn to liposuction surgery to remove the extra tissue -- an option with some risks (as with any surgery), but not an unreasonable one. I look forward to a time in which differences are noticed but not made a source of humiliation or embarrassment. I hope I live that long.

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Posted by: Louanne Cole Weston, PhD at 2:10 PM

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