Man beats his breasts over ARV effects
It is a wonderful thing when a young girl develops breasts, but for a 42-year-old Mpumalanga man, it has become a harrowing experience.
Sabelo Maepa - not his real name - of Sakhile township in Standerton is in need of urgent medical treatment because his breasts grow bigger by the day.
"Having female-like breasts when you are not female can be a source of shame and embarrassment," said Maepa.
"I am forced to remain indoors because whenever I take a stroll on the streets, people stare at me and some even laugh uncontrollably when they see my big boobs," he said.
Maepa was diagnosed HIV-positive in April this year and he said his breasts started to grow a month after he took antiretroviral (ARV) drugs.
Maepa said his doctor said the problem might have been caused by his stopping his ARV intake.
He said he realised four weeks after being given ARVs that his breast started developing and informed doctors and nurses at the TB hospital in Standerton where he was admitted.
"But the doctors did not take me seriously when I said the type of ARVs that I was recommended were not suitable for me," said Maepa.
"I then decided to stop taking them and later when my breasts grew bigger, a private doctor who said the period that I have been not taking ARVs was to blame for my condition," he said.
ARVs are medication for the treatment of infection by retroviruses, primarily HIV.
Different classes of antiretroviral drugs act at different stages of the HIV life cycle.
But two medical experts concurred that a condition like that of Maepa is common and has to do with hormonal imbalance.
"The problem could be that female sexual hormones dominate in Maepa's body and this contributed to the enlargement of his breasts," said Mopedi Mohale, a gynaecologist in Standerton, Mpumalanga.
"His illness can be treated medically and the patient can get better depending on the magnitude of damage suffered."
But Roger Mixter, a certified plastic surgeon who has practiced cosmetic surgery in Wisconsin in the US for over twenty years, described Maepa's ailment as gynaecomastia, or "man boobs".
He shares Mohale's view that the condition is a common problem.
"All men have at least a small amount of mammary gland tissue beneath their nipples and this tissue is usually small and inconsequential. In man boobs, this breast tissue starts to enlarge," said Mixter.
Mixter is a Clinical Associate Professor of Surgery at both the University of Wisconsin and Marquette University.
He said breasts that develop on a man can be made up of mammary gland tissue, fat or, most commonly, a combination of both.
"Gynaecomastia can happen just after birth, at puberty, or with age as is the case with Maepa."
It is usually caused by an imbalance in the two sex hormones, oestrogen and testosterone.
He said all men and women have both oestrogen and testosterone naturally in different amounts in their bodies.
"Hormonal imbalances can be caused by conditions ranging from pituitary problems to liver disease. Any man who develops gynaecomastia or man boobs must be evaluated to determine if there is an underlying cause, and have that cause treated if possible.
"Frequently, correcting the underlying problem can reverse the breast development. But many cases of gynaecomastia are called idiopathic, which means there is no known cause," said Mixter