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Many images of the last four hereditary pharaohs of the Eighteenth Egyptian Dynasty (1559 BC to 1319 BC), Amenophis III, Amenophis IV (also known as Akhenaten), Smenkhkare, and Tutankhamun, show them with gynecomastia. Amenophis III was most probably the sire of the last three. The feminine physique and other abnormalities of Amenophis IV have been extensively commented on as indicative of some sort of pathological condition, but the gynecomastia of the others, including Tutankhamun, has been glossed over or considered an artistic mannerism of the El Amarna period. An alternative theory, that the gynecomastia was actually representational and indicative of a familial abnormality in two or three generations, is suggested.

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