Developing gynecomastia *after* hormone therapy for prostate cancer?

[redwing57]

In the last month or so I became aware of tenderness in my breasts, and some visible enlargement.  It's embarrassing enough I avoided swimming this summer at a couple of friend's events.
I was on hormone therapy, Lupron and Casodex, for 3 years, with an undetectable testosterone level.  That ended in March, over 6 months ago.  My testosterone has recovered already almost to the bottom of the normal range.
During the HT period, I never noticed any kind of sensitivity or tenderness in my breasts.  They got a little bigger due to weight gain, but nothing I haven't always dealt with.  
Now that I'm off of HT, with a recovering testosterone level, I'm puzzled why I'd be developing breast enlargement now.  I know testosterone can be converted into estrogen, but why on earth would this be happening?
Any ideas?

[Dr. Schuster]

Prostate medications decrease the production and/or the ability of testosterone to work. Therefore the relative ration of estrogen increases. the increased effect of estrogen can effect the breast and cause gynecomastia. If the increase is primarily due to increased fat content, it may respond to weight loss through dieting. More often there is actually an increase in the glandular portion of the breast tissue. In this case there is a limit to how much improvement you will see after weight loss. Fortunately surgical correction is very successful. I would make sure that you are finished with your prostate treatment before you have the surgery.

[redwing57]

Thanks for the response.  I was aware of the hormone balance issue *during* hormone therapy.  My confusion is because nothing really happened *during* hormone therapy.  I'm off of it for 6 months, and only *now* do they show symptoms, tenderness, palpable glandular tissue under the areolas. 

It's like the return of testosterone has triggered this for some reason. 

[Dr. Schuster]

Don't forget that testosterone is converted to estrogen. So if your testosterone level is rising, so might your absolute amount of estrogen. An endocrinologist might be able to give you better advise.

[Litlriki]

Lupron and other medications used to treat prostate cancer can readily cause gynecomastia, but the timing can be variable as to onset and ongoing development. The axis governing this is very complex, so Dr. Schuster's recommendation to get an endocrinologist involved is a wise one.  Once you've determined that everything is stable in terms of hormones, consideration of correction makes more sense.  RTS