"Bob had bitch tits", or so the movie character famously said. This opening one-liner from Fight Club is perhaps the most mainstream mention of gyno. It introduced a generations of moviegoers to the horror that is male breast tissue growth, although many were already familiar with it.

Gynecomastia is a benign enlargement of the breast tissue in males. It occurs naturally in about 1/3 of those who suffer from it, with the other 2/3 from drug use, usually anabolic steroids. Once it occurs, it is permanent, and can only be removed via surgery. It is caused by sensitivity to estrogen in the body, and is often spurned when stopping a steroid cycle.

Gynecomastia is correctable with surgery and other various conditions. Liposuction, reduction mammoplasty, skin sculpture, and gland excision are all commonly used. Typically, a plastic surgeon will place a small incision at the border of the nipple complex. The glandular tissue is then removed. A vest is worn for several weeks to ensure healing occurs and the shape of the chest remains constant. Many bodybuilders - even the new young pros we see in magazines - opt for this procedure in the off-season during a break.

The surgical solutions above are designed to remove gyno once it has become a major problem. Preventative medicine is always preferable to surgery. Gyno occurs during the weeks following a steroid cycle. Bodybuilders employ a technique known as PCT, or post-cycle therapy, in which two compounds are introduced to the body to correct the estrogen/testosterone imbalance. PCT consists of 1-2 AIs (Aromatase Inhibitors) and 1 SERM (Selective Estrogen Receptor Modulator) used to help correct the balance during that initial imbalance period, until the body begins producing testosterone on its own and the estrogen production slows. The top over-the-counter solution is probably Nolvadex-XT by Gaspari Nutrition. It is very popular with amateur bodybuilders and those without a doctor.

Gynecomastia, like acne or baldness, is a condition that comes with the territory when it comes to using steroids for competitive bodybuilding purposes. The trade-off can be minimized, however, if the user knows beforehand that gyno is indeed an occurring side effect, and takes preventative measures to ensure its impact is minimized. Too many bodybuilders run headfirst into the steroid realm without a true understanding of the side effects. Use of PCT, along with prompt surgery when that fails, ensures that one doesn't end up like our good friend Bob of Fight Club fame.