Glandular tissue recedes or disappears after puberty. Why?

[Monkey83]

I have poured over the internet looking for answers to this and was hoping a doctor could answer this. Why does the glandular tissue recede or disappear after puberty, and what is the actual science behind it? Furthermore, if there is a legitimate reason for it doing so, why couldn't that be triggered by medication in those that it didn't?

[Monkey83]

It doesn't seem as though there is any real evidence to suggest that the glandular tissue actually disappears after puberty. I would like to know for sure though. 

[Litlriki]

I'm not sure if any of the surgeons on this forum are able to answer this question in the manner you would like, but I will offer a few thoughts.  The hormonal stimuli, which wax and wane through the course of breast development in men and women are sex-specific, and estrogens dominate the picture in women leading to female breast development, while in men, testosterone is dominant, thereby leading to a male breast contour with minimal fat and glandular tissue.  If estrogens are high during the process in men, a more female contour results, and this is the situation in cases of gynecomastia.  But the estrogenic stimulation is short lived, and in most cases, full glandular development doesn't occur, and once testosterone is restored to its dominant role, the estrogen-stimulated tissue involutes.  Changes of this sort in breast tissue occur in women as well, for example in pregnancy, where the breasts are stimulated to proliferate glandular tissue in order to make milk.  After the stimulus is withdrawn, many women experience similar involutional changes that result in smaller, saggier breasts with a more fatty consistency.  

Obviously, treatment of gynecomastia with medication would be a very desirable option, and one which pharmaceutical companies would find potential financial benefit, considering the high number of young men who experience the problem--even transiently.  The fact that there is no good medical treatment for idiopathic gynecomastia is testimony to the fact that development is complex and resolution is complex, and creating similar conditions without upsetting other aspects of hormonal balance is a challenging task indeed, as yet unsolved.  

Rick Silverman

[Monkey83]

Thank you for replying Dr. Silverman. Your response is actually the first explanation I have read in terms of how that tissue changes once testosterone reaches normal levels. I appreciate the information.

[DrPensler]

I spent a lot of times years ago looking into the question you pose. During the initial stages of puberty there are substantial hormone fluxes while new hormones are initially produced then regulated.The findings of increased sub areolar tissue during this time are typical in the overwhelming majority of adolescent patients.It has not been established which hormone or combination of hormones in the initial stages of puberty are responsible for the above.We looked at several hormone levels ,the number hormone receptors on the cell walls of glandular tissue and the binding capacity of various hormones to their receptors. Its incredibly complicated subject and in a nutshell we do not have all of the answers.