News — 14 January 2025 10:00

Bodybuilder Gynecomastia: Why and how it happens

Updated on June 17, 2026

Anabolic steroids are man-made hormones that mimic the male sex hormone, testosterone^[1].

They are designed to facilitate muscle growth and repair^[2].

Anabolic steroids have some valid medical applications, and doctors prescribe them to manage issues such as delayed puberty in males or muscle loss linked to conditions such as cancer or HIV^[3].

However, they are frequently abused to enhance lean muscle mass, reduce fat and accelerate post-injury recovery ^[4].

Depending on the type of steroid used, they come in various forms, such as tablets, capsules or injectable liquids.

Illegitimate use of anabolic steroids is most prevalent among men in their 30s ^[5].

Other groups who use them include:

Professional athletes and bodybuilders.
Young adults and men keen on their body image aspire to build a muscular physique to enhance body confidence.

Bodybuilder gynecomastia: Side Effects of Anabolic Steroid Abuse

The effects of anabolic steroid use can vary among individuals.

Potential side effects include:

bodybuilder gynecomastia (anabolic-induced male breast enlargement)^[6]
fluid retention^[6]
sleep disturbance^[6]
sleeping difficulties^[6]
nerve damage (from steroid injections)^[6]
mood swings^[6]
irritability^[6]
aggression^[6]
depression^[6]
acne^[6]
increased susceptibility to colds^[6]

Men may experience:

testicular and penile shrinkage^[7]
decreased sperm count^[7]
erectile dysfunction or impotence^[7]
prostate issues^[7]
gynecomastia^[7]
balding^[7]

Women may experience:

Amenorrhea ^[8]
irregular menstrual cycles ^[8]
breast shrinkage ^[8]
deepened voice ^[8]
Hirsutism ^[8]
abnormal enlargement of the clitoris ^[9]

Prolonged use of anabolic steroids can lead to reduced drug efficacy, potentially causing the body to cease its own testosterone production completely ^[10].

Bodybuilders tend to adopt "steroid cycling", where the drugs are used for a set duration, discontinued and then reintroduced again ^[10].

Another prevalent strategy used within the bodybuilding community involves the combination of multiple steroid types to enhance their overall effectiveness, known as steroid stacking^[11].

Bodybuilder gynecomastia

The continued anabolic steroid usage is recognised as the primary factor in the development of enlarged male breasts; thus, the phrase "bodybuilder gynecomastia" was coined ^[12].

Whether taken orally or via injection, anabolic steroids send signals to the endocrine system, indicating "an adequate supply of testosterone in the body".

Consequently, this prompts a decrease in natural testosterone production.

Now, once the steroid cycle is discontinued, the body will need to restore normal testosterone levels, and this transitional phase often results in elevated estrogen levels (female hormone).

Such hormonal imbalance heightens oestrogen levels, triggering the growth of breast glandular tissue, potentially leading to gynecomastia.

Notably, while testosterone and oestrogen levels gradually rebalance over time, the glandular tissue within the breast has already developed, and it rarely regresses without surgical intervention.

It is important to note that enlarged male breasts will persist even if steroid consumption is discontinued.

Currently, the U.S. FDA has not approved any official medication for the treatment of gynecomastia.

Pharmaceutical interventions are generally not recommended for the management of gynecomastia ^[13].

For those seeking a permanent solution to bodybuilder gynecomastia, gynecomastia surgery is the solution^[14].

Bodybuilder gynecomastia: You are not alone; even celebrities are not spared

Dwayne "The Rock" Johnson has openly admitted to using steroids on several occasions.

He revealed that he used steroids when he was around 18 or 19 years old while playing football for the University of Miami, "I tried it.

My buddies and I tried it back in the day when I was 18 or 19. We didn't know what we were doing."

During his stint in World Wrestling Entertainment, Johnson felt insecure about his enlarged male breasts.

Because of his profession, Johnson wanted his body to appear picture-perfect.

In 2005, it was reported that he underwent gyno surgery to address his bodybuilder gynecomastia.

He explained, "It was an aesthetic thing. I went in and showed the doctor, and he said, 'Are you crazy?' I was walking around with my shirt off all the time, so I had it done."

Other celebrities who have also been reported to suffer from gynecomastia include Simon Cowell, John Travolta, and Arnold Schwarzenegger.

Read more about the relationship between gynecomastia and bodybuilders:

Gynecomastia Surgery to Address Bodybuilder Gynecomastia

Gynecomastia surgery, performed by Dr Ivan Puah, typically involves the removal of enlarged male breast glands, which is often combined with liposuction of the chest.

During the surgery, the patient will be under twilight sedation and cared for by a team of experienced surgical personnel and anesthesiologist.

Dr Ivan Puah will use his proprietary 360° GTD^®️ technique to remove glandular tissue and the MDC-Sculpt^®️ Lipo technique to remove excess fat and contour the chest into a masculine-looking, sculpted shape.

Muscle up without steroids

Taking anabolic steroids to build muscles, knowing there is a high probability of getting gynecomastia, is certainly not an option.

Instead, there are other ways to achieve your goals.

These include:

Proper nutrition and dietary habits
Custom-tailored (gym) training programmes
Getting enough rest

Regardless of gender, a beautiful or more defined physique is arguably a common goal.

If bodybuilding is your hobby, by all means, pile those muscles on.

But do it the right way and do it the safe way to avoid bodybuilder gynecomastia!

Reference

[1] Sathaye, A. A., Joshi, D. D., & Arote, N. D. (2025). STEROIDAL HUMAN PERFORMANCE-ENHANCING AGENTS. Indian Drugs, 62(2).

[2] Bhasin, S., Wang, C., Chandra, M. S., Gagliano-Jucá, T., & Jasuja, R. (2026). Mechanisms of testosterone's anabolic effects on muscle and function: controversies and new insights. Endocrine reviews, 47(2), 280-300.

[3] Goldman, A. L., Pope Jr, H. G., & Bhasin, S. (2019). The health threat posed by the hidden epidemic of anabolic steroid use and body image disorders among young men. The Journal of Clinical Endocrinology & Metabolism, 104(4), 1069-1074.

[4] de Velasco, L. M. C., Flores, J. E. G., Cervera, A. A., Arteaga, J. L. M., & Casas, M. J. O. (2026). Testosterone replacement therapy in athletes: implications for injury recovery and musculoskeletal performance. Cureus, 18(2).

[5] Parmar P, Aslam SP, Gokarakonda SB, et al. Anabolic Steroid Use Disorder. [Updated 2026 Mar 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538174/

[6] Albano, G. D., Amico, F., Cocimano, G., Liberto, A., Maglietta, F., Esposito, M., ... & Montana, A. (2021, January). Adverse effects of anabolic-androgenic steroids: a literature review. In Healthcare (Vol. 9, No. 1, p. 97). MDPI.

[7] de Souza, G. L., & Hallak, J. (2011). Anabolic steroids and male infertility: a comprehensive review. BJU international, 108(11), 1860-1865.

[8] Burns, A. D., Taylor, N. F., Taylor, D. R., Bhake, R. C., & Rahman, F. (2020). A curious case of primary amenorrhea. Clinical Chemistry, 66(9), 1150-1154.

[9] Alizadeh Pahlavani, H., & Veisi, A. (2025). Possible consequences of the abuse of anabolic steroids on different organs of athletes. Archives of Physiology and Biochemistry, 131(3), 393-409.

[10] NIDA. 2024, July 11. Anabolic Steroids and Other Appearance and Performance Enhancing Drugs (APEDs). Retrieved from https://nida.nih.gov/research-... on 2026, June 10

[11] Kimergård, A., & McVeigh, J. (2014). Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study. Harm Reduction Journal, 11(1), 19.

[12] El Wakeel, H., Abou Arab, M. H., & Kholosy, H. M. (2021). Bodybuilder gynecomastia: Etiology, characteristics, and management. The Egyptian Journal of Plastic and Reconstructive Surgery, 45(3), 133-139.

[13] Berger, O., Landau, Z., & Talisman, R. (2022). Gynecomastia: a systematic review of pharmacological treatments. Frontiers in Pediatrics, 10, 978311.

[14] Vojvodic, M., Xu, F. Z., Cai, R., Roy, M., & Fielding, J. C. (2019). Anabolic-androgenic steroid use among gynecomastia patients: prevalence and relevance to surgical management. Annals of Plastic Surgery, 83(3), 258-263.