Menopausal breast pain
Breast pain is a common symptom of the menopause - in fact, the majority of women will experience some breast discomfort at one time or another. It is most common between the ages of 30-50. This may be because our breast tissue has estrogen and progesteron receptors, meaning that they will be sensitive to the decline in your hormones during your menopausal years.
It is, however, very important that you get medical advice with any new breast pain, especially if pain is associated with the development of lumps on your breast or a change in your breast shape and texture. Most breast pain and breast lumps are not due to breast cancer, but we urge you to seek medical help to be sure of this.
It is a good idea to be breast aware - know what your breasts feel like, and make sure to check them regularly.
Breast pain can be classified as:
1. Cyclical - this pain relates to your menstrual cycle (periods). It may vary in intensity, and usually starts a few days before your period, and will often improve after your period. It may affect both breasts and is often felt most in the upper and outer parts of your breasts. This breast pain is generally not associated with discrete lumps.
2. Non Cyclical - this pain is unrelated to your periods. You will most likely feel this on one side of your breast, however, can also be felt on both sides. A few causes of this type of breast pain include:
- Hormonal medication including the oral contraceptive pills, and HRT.
- Antidepressants (including sertraline, venlafaxine and mirtazapine) and strong psychiatric medications such as antipsychotics (including haloperidol).
- Drugs for your heart - (including digoxin and spironolactone).
- Antibiotics (including metronidazole) and antifungals (including ketoconazole).
- Breast cysts - sometimes you can feel a discrete lump
- Fibrocystic disease - generalised feeling of a lumpy breast
- Pregnancy - in early pregnancy the breasts can become tender.
- After giving Birth - mastitis describes inflammation or infection in the breast causing pain, often with redness of the skin.
3. Chest wall pain - this pain is not in the breast tissue, but is actually beneath the breasts in the chest wall. It may be painful or uncomfortable to move or breathe, or you may even have tender spots on your chest when touching it. This can be due to trauma (e.g. rib fracture, shoulder or back sprain), muscle pain (fibromyalgia) or a range of other diseases in which cause you should discuss with your doctor.
So what can I do about breast pain during menopause?
Most breast pain will resolve itself, however, pain levels differ for everyone, and you may find that your's is unbearable at times. Menopausal breast pain specifically should resolve once your periods have stopped for a year, so any new pain after that should always be discussed with a doctor.
Cyclical breast pain:
- A soft comfortable bra and simple pain killers
- Topical anti inflammatory gel (diclofenac) can be applied straight on the skin and may provide some relief
- Evening primrose capsules have a suggested role in relieving pain - the evidence for them is mixed.
- This often resolves on its own if not due to an underlying structural problem such as a cyst. Breast Pain on starting HRT is a common side effect and will usually settle after a few weeks, or occasionally needs a change of HRT dose or formulation.
- Acupuncture has shown promising results in providing some relief.
- A support bra, soft sleep bra and oral or topical anti- inflammatory medications may be helpful