Paa_Paw you are correct with the exception of the individual needing Testosterone such as in hypogonadism. For the man with low testosterone, depending on the mechanism, the body often over compensates trying to make enough of the hormone. In this effort too much estrogen can be made causing gynecomastia. In this case, replacing the missing testosterone can actually stop the over production of the breast forming hormones. I have seen quite a few patients stop their breast growth and stabilize once getting to normal levels of Testosterone.
Quite glad you wrote this, doctor. Because I think this is exactly what happened in my case. I am a middle aged man who had sudden (and painful) gynecomastia appear out of nowhere. An endocrinologist found that I was slightly low on T. It was such a slight deficiency that my total T showed to be in the low normal range, while my free T was just barely below the normal range. My primary care doctor didn't think I needed T replacement therapy, but in light of my symptoms, my endocrinologist thought I could benefit from taking a low dosage of the T gel. He thought it could help stabilize my gyne, and hopefully, get rid of the pain. I had been experiencing pain in my left breast for nearly 6 months and I was pretty much ready to try anything.
After starting the T gel, it took less than a month for the pain to go away. I really do believe that, in my case, it was responsible for HELPING my gyne stabilize. It certainly hasn't made it worse. I do still have some increased tissue, which might not go away, but at least the condition has been calmed and I'm no longer in pain. It was really starting to get me down.
Another difference in what people typically believe about the T gel is that my doctor said I wouldn't "necessarily" HAVE to be on it long term. A lot of people believe that once you start using it, you MUST be on it forever. That might be true in some cases, but not ALL cases. I think my doctor just wanted to try it to see if it would help me over a hump and get my hormone levels to be where they needed to be. It appears to have worked. I'll continue to get my T level measured and there is a possibility that I could stop using the gel at some point in time.
I've lost nearly 20 pounds since this all started in an effort to assist my body in bringing my hormone levels back in line naturally. I've still got several more pounds to shed before I'm where I want to be. But every pound I lose "should" help my hormone levels (i.e, bring my T level up and my E level down).
Being overweight and middle aged was likely what knocked my hormone levels out of whack and caused my gyne. So losing weight and exercising can increase the likelihood of my body naturally increasing T, while decreasing estrogen. At least that's the way I understand it. Please correct me if the way I'm phrasing it isn't correct.
I'm thinking a lot of overweight, middle aged males may experience this and not be aware of it. I think my slightly low T caused my hormone levels to get out of whack enough that I developed gyne. But I'm sure there are many men who have the same situation that may NEVER develop gyne, and therefore, never know about their T deficiency. The only reason I had my hormones checked was BECAUSE of my gyne. I wasn't feeling badly and had no other symptoms of low T.
So, ironically, my gyne was essentially an an alarm going off to tell me that I needed to lose weight and exercise a bit. The body really is a wondrous thing.