breasts enlarged by weight gain but not reduced by weight loss

web.med/breasts enlarged by weight gain but not reduced by weight loss:
. a postmenopausal woman became obese after using Evista,
(an estrogen agonist or antagonist for bone density)
and it was discontinued after a few years .
. the breasts had gotten larger as she became obese,
but they didn't downsize with the rest of her body
when she lost weight;
perhaps she has poor circulation in breasts
so the fat there is the last to be used?
or, perhaps taking estrogen agonists/antagonists
caused the breast tissue to grow ?

Evista is rarely associated with breast enlargement .
--[ but how many women would complain about that ?
esp'ly if it was part of obesity;
so, even a rare occurrence may be a significant association .]

Raloxifene (Evista)
Raloxifene is approved for the prevention and treatment of
osteoporosis in postmenopausal women.
It is in a class of drugs called estrogen agonists/antagonists
Raloxifene used to be called a
selective estrogen receptor modulator (SERM).
Raloxifene increases bone density
and reduces the risk of spine fractures.
There are no data showing that raloxifene
reduces the risk of hip and other non-spine fractures.
Raloxifene appears to decrease the risk of
estrogen-dependent breast cancer
by 65 percent over eight years.
. Side Effects include hot flashes,
leg cramps [a sign of endothelial dysfunction,
from carb intolerance or insulin resistance?]
and deep vein thrombosis (blood clots).
Blood clots are also associated with estrogen therapy.
Other side effects include swelling and temporary flu-like symptoms.
Raloxifene should not be given to women at increased risk for stroke.
This includes women who have had previous strokes,
transient ischemic attacks (TIAs),
atrial fibrillation (a type of serious irregular heart beat)
or uncontrolled hypertension (high blood pressure).

reasons for breast enlargement (in men):
Absolute overproduction of estrogen,
from increased aromatization of testosterone-to-estrogen
as seen in obesity's and aromatase excess syndrome;
-- or rarely from a testicular or an adrenal tumor,
or a human chorionic gonadotropin-producing tumor
Absolute deficiency of testosterone,
as is found in certain hypogonadal states and patients
treated with hormone deprivation therapy for prostate cancer.
An unresponsive androgen receptor will have the same effect.
Increased SHBG (sex hormone-binding globulin) levels,
with rising SHBG preferably binding testosterone,
thus decreasing the free testosterone to estrogen ratio
-- this process is thought to be at the heart of
gynecomastia due to aging as well as due to thyrotoxicosis.
Chronic renal and liver disease
(probably related to hypogonadism and elimination of estrogen).

aging causes enlarged breasts:
36% of adult young men in the United States
have at least mild gynecomastia;
in older adult men, that rate increases to 57% .
. this is consistent with a rise of SHBG with age:
. the steady rise in SHBG with aging is directly correlated with
bone loss and osteoporosis in both men and women
(Hofle 2004, Lormeau 2004).
As a general rule the higher the SHBG level,
the less estrogen and testosterone is available
to contribute favorably to bone health.
this is also consistent with aging's increased obesity .