Gynecomastia is a very common symptom of an underlying hormonal imbalance in men. In addition to the three age peaks, a number of pathological conditions can also lead to an increase in the ratio of estrogen to androgen in the male, and thus provoke gynecomastia. While it is not necessary to carry out a thorough diagnostic investigation in every case of gynecomastia, the presence of an underlying tumor needs to be excluded. Should appropriate treatment of associated or causal pathology fail to resolve the problem, drug treatment or surgical options are available.