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
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.
Causes
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
* Stress
* Alcoholism
* Oral contraceptive use
* Antidepressants
* Mastitis
* 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.
Herbal Remedies
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.
Sources and
Additional Information: