Breast pain is a common symptom that can develop during the menopausal transition, due to fluctuating levels of estrogen and progesterone. While postmenopausal women can experience breast pain, it is most common in premenopausal and perimenopausal women.
A common complaint among females, breast pain affects as many as 70% of women at some point in their lives. Only a small portion of these women, about 10%, will experience severe breast pain, which can have a significant impact on relationships, work, and daily life. Nevertheless, breast pain can prompt understandable questions and concerns at any intensity.
Becoming more educated about breast pain in menopause is one of the best steps towards understanding and managing this condition. Please read on to learn more about breast pain.
About Breast Pain
Breast pain - known medically as mastalgia, mastodynia, and mammalgia - is the general term used to mean discomfort, tenderness, and/or pain in one or both of the breasts.
Breast pain is categorized as either cyclical or non-cyclical. With the former, breast pain is the result of hormonal changes, making it the most common kind of breast pain in pre- and perimenopausal women. Non-cyclical breast pain, more common in postmenopausal women, is not related to hormonal changes. Extramammary breast pain, which originates outside the breast, is a third type of breast discomfort.
The symptoms of breast pain can vary depending on the type and the individual woman. Generally speaking, symptoms include tenderness, tightness, soreness, burning, swelling, dullness, and/or aching. Symptoms can be consistent or intermittent and may affect one or both breasts.
While some women experience breast pain much later in life, in the majority of cases, breast pain settles down shortly after the menopause or when periods stop.
Types of Breast Pain
Normal or physiological breast pain
* Mild premenstrual breast discomfort lasting for 1 to 4 days can be considered 'normal'.
* In order of decreasing frequency, premenstrual breast symptoms are tenderness, swelling, pain and lumpiness.
Cyclical breast pain
* Women who experience more severe and prolonged pain are considered to have cyclical mastalgia.
* Research studies use methods to measure the severity and duration of pain. Cyclical mastalgia is taken to be more severe pain lasting for more than seven days per month.
* About 10 to 20% of women will meet the criteria for cyclical mastalgia.
* Pain may be present to a lesser degree during the entire cycle (with premenstrual intensification).
* The pain is typically in the upper outer breast area. It often radiates to the upper arm and axilla.
* Most cyclical mastalgia is diffuse and bilateral (may be more severe in one breast).
* Pain is described as 'dull', 'heavy' or 'aching'.
* It is important to ask about medical history and any associated problems. Such problems are common and disruptive. Likely findings include sleep problems, work, school and social disruption.
Non-cyclical breast pain
* It is less common and typically accounts for approximately 31% of women seen in breast pain clinics.
* It tends to be unilateral and localized within a quadrant of the breast.
* Non-cyclical breast pain presents later (in the fourth or fifth decade). Many women are postmenopausal at onset of symptoms.
* Most noncyclical breast pain arises for unknown reasons.
* It is more likely to have an anatomical rather than hormonal cause (with the exception of breast pain associated with medication).
* A minority of non-cyclical breast pain is explained by pregnancy, mastitis, trauma, thrombophlebitis, breast cysts, benign tumors or cancer.
* A wide range of drugs have been associated with breast pain. Between 16% and 32% of women report breast pain with estrogen and combined hormonal therapies. Other drugs associated with breast pain include antidepressants (including venlafaxine and mirtazapine), cardiovascular drugs (including digoxin and spironolactone) and other drugs including metronidazole and cimetidine.
Extramammary pain due to various conditions may present as breast pain. There are many such conditions but most common are costochondritis and other chest wall syndromes.
The most common cause of breast discomfort during menopause is hormonal change. As with all times of hormonal fluctuation (i.e. menstruation and pregnancy), menopause can alter the levels of estrogen and progesterone in the body. As a result, women may develop breast pain.
During the hormonal fluctuations of the perimenopause and menopause, breasts can increase in size. This occurs when the level of the hormone progesterone increases while estrogen decreases. The result can be pain and tenderness.
While hormones are the most common cause of breast pain experienced in menopause, other factors can cause or contribute to breast pain. These rarer causes range from serious health conditions to dietary issues.
Less Common Causes of Breast Pain:
* Breast cysts
* Breast trauma
* Prior breast surgery
* Breast size
* Oral contraceptive use
* Hormone replacement therapy (HRT)
* Cholesterol and heart drugs
Breast Pain Diagnosis
While breast discomfort during menopause is not usually cause for alarm, it is never a bad idea to speak with a doctor about this symptom. Though breast pain is rarely indicant of cancer, speaking with a doctor to rule out breast cancer can greatly help to allay these worries and help a woman determine the best way to manage breast tenderness.
Women who experience prolonged or unexplained breast pain, or additional accompanying symptoms should speak with a doctor to rule out rare, but more serious, causes of breast pain. At a doctor visit, a full physical and clinical exam will be performed. If something more serious is suspected, a doctor may order additional tests.
Breast Pain Treatments
Fortunately, a number of self-care measures and natural treatments can help to relieve breast pain during menopause with little or no side effect risks.
There are certain measures which can help relieve the worrying symptoms of breast pain. It is worth putting some effort into easing the symptom, as this will aid your morale, general health and comfort.
* Smoking can have an adverse effect on your body at the best of times, not least during the menopause. Smoking can prevent the body from adapting to the hormonal changes experienced during the menopause. It also increases the likelihood of breast cancer.
* Diet is important. Food with plenty of vitamins keeps the body healthy, and vitamins B and E particularly can help ease breast pain. Making sure you have enough fiber in your diet will help your body balance out estrogen levels.
* Consuming stimulants such as caffeine can have an unwanted effect on breasts. This is because these dilate (widen) the blood vessels throughout the body, including those in the breasts, leading to swelling and pain.
* Make sure that your bras fit correctly as an ill-fitting one can lead to pain or even breast tissue damage. It is important to get measured regularly as your breast size and shape can change quickly.
While these can help a woman reduce the severity of breast pain, they alone cannot reach the root problem of hormonal imbalance. Natural therapies are safe and effective methods of relieving breast pain symptoms by targeting the root cause of hormonal imbalance. A majority of women find that a combination of self-care and natural therapies is the best way to address breast pain in menopause.
Experts recommend exploring medical options only after these other methods have failed to provide relief, because these are often more invasive and carry greater risks.
A number of herbs have been used traditionally to help with breast pain:
* Agnus castus is usually a remedy for PMS (Pre-menstrual syndrome or tension) but can be particularly effective during the perimenopause. It has a reputation for balancing female hormones.
* Kelp – this is a type of seaweed which contains a high proportion of iodine. Kelp tablets are available as nutritional supplements.
* Milk thistle – this is a plant with a long history of medical usage. It can be found in herbal remedies such as Milk Thistle Complex, which contains a combination of fresh plant extracts.
* Urtica – this is more commonly known as the stinging nettle. It has a high nutritive value, containing vitamin C, iron, calcium, potassium and silica.
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