Malnutrition
Malnutrition has been reported to be associated with testicular atrophy, and liver dysfunction. Both of these associations alter the hormonal balance of estrogen and testosterone. There may be other health factors that are disrupted in a way that leads to breast enlargement and sagging. In some cases, rapid refeeding has been shown to do more harm than good. The proposed mechanism for this phenomena is that the underlying cause i.e. hormonal imbalance, remains untreated. A study investigates the association of gynecomastia in severely malnourished, war-torn males. This study proposes a number of factors that can lead to hormonal derangement, but is unable to pinpoint a single mechanism responsible for gynecomastia.