For men who like smoking pot, there may be a single issue with which they struggle: a lurking suspicion that marijuana might cause man boobs. After all, that's what their girlfriends keep saying. Referred to by doctors as “gynecomastia,” the condition is sometimes inherited, but more often it is caused by a simple hormone imbalance. When testosterone levels fall, estrogen is proportionally increased and excessive breast tissue is the result. In fewer cases, the imbalance begins with a rise in estrogen levels. So could pot really cause this kind of hormonal disturbance?

Let’s go to the source — — and take heed of some ancient weed wisdom: “Doobies Make Boobies.” (Unfortunately, women seem to be immune to these boob-making effects.) For those who require more science behind their opinions, animal studies provide evidence that exposure to delta-9-tetrahydrocannabinol (THC), the active ingredient in marijuana, can decrease testosterone levels while also generally affecting the endocrine system. These findings only apply to the animals under observation and human studies are not at all conclusive, often presenting conflicting reports of marijuana’s effects. That said, the staid and just Mayo Clinic lists cannabis, along with alcohol, amphetamines, heroin, and methadone, as a potential cause of gynecomastia. It also identifies medications, herbal products, aging, tumors, and kidney failure, among other conditions, as potential causes. And Dr. Anthony Youn, a plastic surgeon, gives an answer of “probably” after posing the question of a link between weed and man boobs in his article published in CNN.

It is interesting to note that although the condition affects approximately 33 to 41 percent of men between 25 and 45, higher rates bookend this central age range; gynecomastia affects 60 percent of 14-year-old boys and nearly the same percentage of men over 50. Most cases of gynecomastia resolve spontaneously within a few months to a few years, according to Dr. Youn. In particular, among the individuals who develop the condition during adolescence, 80 percent show a regression before the age of 18. Unfortunately, those cases which do not follow this pattern of regression are typically the most severe.

Two dominant types of gynecomastia exist, true gynecomastia and psuedogynecomastia, and most cases are a mixture of both. The American Society of Plastic Surgeons (ASPS) characterizes true gynecomastia by enlarged glandular tissue in comparison to psuedogynecomastia, which is typically defined as excess adipose tissue. Medications, including Gynexin, Gynexerol, and Gynemax, may be used to address the condition, though adherence to the regimen may be difficult — some forms must be taken three times a day — and they may produce side effects, such as stomach ache.

Perhaps for these reasons, in 2012 nearly 23,000 men underwent surgery to correct the condition, which is a somewhat startling increase of five percent over the previous year. True gynecomastia is treated using surgical excision of the gland, whereas psuedogynecomastia may require liposuction. According to ASPS, the recurrence rate is somewhere between 10 and 35 percent in cases using only liposuction. In cases using only excision, recurrence is about 10 percent. Many surgeons use both techniques, and it typically takes about six weeks before a patient is able to return to all normal activities.

Because gynecomastia does not usually cause pain or other physical symptoms, most people do not consider it a serious health problem. On the other hand, some men believe it erodes their self-confidence. Because the link between man boobs and marijuana seems highly probable, ultimately only one question remains for the guy who likes to light up: Are moobs worth the high?