During puberty, boys' hormone levels vary. If the level of testosterone drops, oestrogen can cause breast tissue to grow. Many teenage boys have some degree of breast enlargement. Gynaecomastia at puberty usually clears up as boys get older and their hormone levels become more stable.
The early minor changes in breast growth can cause mild pain or tenderness just as you describe in your son. He may feel a small lump or cyst behind one or both nipples or notice some breast enlargement. Reassure your son that all these result from changes in his sex hormones which are normal at this stage in puberty.
Here is a brief overview of the changes that happen: In girls, the first puberty change is the development of breast buds. These are small mounds that form under the nipple as the breast and nipple become slightly raised. The areola (the circle of different colored skin around the nipple) gets larger at this time.
Breast development during puberty
2.1 Stage 1 This stage begins at about 8-12 years old, the nipples just begin to pop up, pink circle appears.
Puberty — Gynecomastia that occurs during puberty usually resolves without treatment within six months to two years. The condition sometimes develops between ages 10 and 12 years and most commonly occurs between ages 13 and 14 years. The condition persists beyond age 17 years in up to 20 percent of individuals.
Gynecomastia usually goes away without medical treatment. The breasts flatten out within a few months to a couple of years. If gynecomastia is very severe, there is medicine that can help. And if gynecomastia lasts past puberty, surgery can reduce the size of the breasts.
Gynecomastia in teenagers usually goes away by the late teen years. The excess breast tissue growth seen during puberty is a result of hormonal changes in the body affecting both androgens and estrogens. Within a period of 6 months to 2 years teenage gynecomastia should go away without any intervention.
Hormonal Changes
Estrogen controls the growth of the ducts, which is why the areolas and nipples tend to get firmer and the ducts more prominent during the middle stages of the menstrual cycle (when estrogen levels are at their highest).
Falling oestrogen levels at the menopause make breast tissue dehydrated and less elastic, so breasts can lose their rounded shape and begin to sag. The change in shape can leave you with nipples that point downwards.
It's common for nipples to become smaller, and the area around them, called the areola, almost vanishes. Lumps. Older breasts may be more prone to lumps or bumps.
Pubertal gynaecomastia is a common finding in boys: seen in 38 % of boys aged 10-16 years; reaching a peak of 65% in 14-year-olds (1) the gynaecomastia is generally transitory - pubertal gynaecomastia resolves in 73% of boys after 2 years and 92% after 3 years (1)
The simple answer is hormones. During puberty a lot of hormones are at play and this causes the “puffiness” of nipples, even in young men at times. It is perfectly natural and normal. Some women have puffier nipples into adulthood or during pregnancy and that is also totally normal.
In boys, puberty usually begins between ages 10 and 16. Once it begins, it lasts about 2 to 5 years. But every child is different. And there is a wide range of what is normal.
In most cases, inverted nipples in men are caused by the same issue as inverted nipples in women. The milk ducts (yes, men have these too!), are shorter and tighter than normal. This creates an imbalance between the strong inward pull of the milk ducts and the relatively weaker outward pull of the muscle in the nipple.
Puberty hormones are the culprit for this breast tissue growth, and it is a very normal – though seemingly little discussed – aspect of puberty in boys.
When puberty starts there's a rise in the levels of the hormones oestrogen and testosterone. Oestrogen stimulates the breast to grow and testosterone stops breast growth. As well as the other changes associated with puberty, boys may notice that their breasts are tender or are growing.
When they are stimulated either by touch, cold temperatures or sexual arousal, they harden (actually become erect) and part of that response is for the brown part (the areola) to shrink and wrinkle. It is kind of like a muscle contraction.
You can expect your nipples to return to their original size and color (likely lighter and smaller than when you were breastfeeding) and extra veins should disappear, says Kasper. All those stretch marks, however, are yours to keep, she adds.
This is a result of the hormone progesterone. In addition, the dark areas of skin around the nipples (the areolas) begin to swell. This is followed by the rapid swelling of the breasts themselves.
Grade 1 – Very Mild
The breast typically has a localized area of tissue behind the areola. Frequently referred to as “puffy nipple.” Skin quality is generally very good. In most cases, only excess glandular tissue is present.
Gynecomastia can be seen as a button-sized growth underneath the nipple. You may be able to see this as a breast lump or feel it when you press on the area. The lump may move easily within the breast tissue and may be tender to touch. Breast lumps and breast enlargement may occur in one or both breasts.
Answer: Gynecomastia — enlarged male breast tissue — may slightly increase your risk of breast cancer. But even with gynecomastia, your risk of developing male breast cancer is very small. In most cases, gynecomastia resolves on its own with minimal treatment and little risk of long-term complications.
Grade I: Small enlargement without skin excess. Grade IIa: Moderate enlargement without skin excess. Grade IIb: Moderate enlargement with minor skin excess. Grade III: Marked enlargement with excess skin, mimicking female breast ptosis.