Gynecomastia, mainly due to a relative or absolute increase in estrogen, can be seen in physiological states as well as in many diseases. For example, adolescent boys can often have enlarged, hard, painful breasts; testicular lesions, kidney failure, and thyroid can cause this; cirrhosis is the main cause, and gynecomastia is common in patients with cirrhosis; gynecomastia is common in cirrhosis, and the two are not equal, but very closely related. In cirrhosis, liver function decreases, the ability to inactivate estrogen is weakened, and the amount of estrogen in the body is relatively increased; free testosterone in the blood decreases; androstenedione and testosterone precursors in the microcirculation are converted, producing large amounts of estrogen; in alcoholic cirrhosis, there is more estrogen in the body. Estrogen in the blood acts on breast tissue, causing breast hyperplasia and hypertrophy; liver palms and spider nevus appear when capillaries are dilated. Warm tip: Men with breast development, enlargement, hard nodules, liver palms and spider nevus should be alert to cirrhosis and seek timely medical attention.