Gynecomastia is a benign enlargement of the male breast that is caused by an imbalance in the ratio of circulating male hormone (testosterone) to female hormone (estrogen). Gynecomastia occurs with normal hormonal changes during puberty or aging, but is also associated with other conditions or drugs that alter the hormonal ratio. Gynecomastia is characterized by the growth of glandular tissue within the breast, the growth of glandular tissue and fatty tissue deposits, or by an accumulation of fatty tissue alone. The condition is often associated with pain or tenderness that warrants medical intervention, and patients also seek treatment due to social concerns and embarrassment. Certain drugs may alleviate gynecomastia but when these are not effective, surgery might be needed.