Can I shrink my large nipples?

Dear Awful Chest,

While people of all genders may have nipples of varying shapes and sizes, they can be a point of insecurity for many. There's no "perfect" nipple, just as there is no "perfect" body. Unfortunately, that's not typically the message relayed in magazines, movies, and other media, though there are many ways to increase body image and self-confidence that can get you back to the beach in no time. That said, it's not uncommon for those assigned male at birth to experience breast tissue growth, especially in the first few years following puberty. This growth, called gynecomastia usually disappears within 12 to 18 months. Only a medical provider could know for sure if your particular protrusion is gynecomastia, the result of another medical condition, or just plain ol' insecurity, but for more information, continue on! 

First, gynecomastia is a condition caused primarily by hormonal changes, which is why it usually occurs following puberty. In particular, it happens when the amount of testosterone in the body decreases compared to the amount of estrogen. In addition to hormones, certain medications, drugs or even alcohol can upset this testosterone balance, causing gynecomastia. Liver or kidney damage can also cause this condition, in some cases. For many with gynecomastia, the extra tissue will go away on its own in about a year, without any medical intervention. If the condition is causing discomfort, physically or emotionally, it may help to speak with a health care provider, who may be able to explain potential medical solutions, including medication or surgery, for long-term gynecomastia. 

It may also reassure you to learn what the "average" nipple looks like for someone assigned male at birth, as a general comparison. Some studies have recruited large groups of people, varying in age and other characteristics, and actually measured the size of different nipple features, with one finding that the average male nipple is about 5 to 6.9 millimeters wide, with about 22 centimeters between them. As with any human feature, from nose length to ear shape, there's natural variation from person to person that may not be related to any sort of condition. 

There's plenty of pressure from media, peers, and even society as a whole to conform to an unattainable illusion of perfection, which can be damaging to self-esteem and even cause depression. While the impacts of these pressures are more often highlighted in those who identify as women and girls, people of any gender can feel negatively about their body, and recent studies have shown that men aren't immune to these feelings either. There may be some strategies that you can use to feel more confident about your body, including:

• Using positive language to talk about your body and others 
• Decreasing internet use 
• Staying physically active in ways that make you feel good
• Surrounding yourself with positive people who affirm you

Hopefully these methods can keep your reservations about your nipples at bay. Of course, if you're concerned about your nipples, whether due to pain, discomfort, changes in size, shape or color, or even emotional distress, speaking with a medical provider may provide some guidance and reassurance. Only they can say for certain what the cause, if any, may be. 

Best of luck on your journey to body confidence!