Gynecomastia incidence is greatest among which groups?

• A. Adolescents
• B. Men older than 50 years
• C. Adolescents and men older than 50 years
• D. Adults aged 30-40 years

Answer: (C)

Gynecomastia happens when breast tissue in men is exposed to more estrogenic effect relative to androgens. This balance shifts during two life stages, making the condition most common in adolescents and in older men. In puberty, hormonal surges cause transient increases in estrogen effects on breast tissue as the reproductive axis matures, so many teens develop temporary breast enlargement. Later in life, testosterone levels decline and fat tissue—where aromatase converts androgens to estrogens—becomes more prominent, tipping the balance toward estrogen and promoting gynecomastia in men over fifty. In adults around thirty to forty, this hormonal tipping is less common, so the overall incidence is lower than in the other two groups.