Perimenopause breast pain: Causes, relief, and when to worry

Why do breasts hurt in perimenopause?

As women, we’re no strangers to breast pain. Chances are, at one point or another, you’ve experienced sore breasts. But why does that discomfort occur? It’s all tied to our hormones and our menstrual cycle. During your childbearing years, your menstrual cycle is controlled primarily by the hormones estrogen and progesterone. 

Throughout the month, these levels fluctuate, rising and dropping to prepare your body for possible pregnancy. These hormone changes cause a range of symptoms you may be familiar with, like trouble sleeping, mood swings, and, of course, breast tenderness and pain. Hormone fluctuations may also cause breast tissue swelling and fluid retention, which could cause pain. 

As you enter the perimenopausal transition, your hormones are still fluctuating, which is why it’s common to experience breast pain or mastalgia. Mastaglia typically feels like a dull aching pain, but it can also be burning, discomfort, or tightness in the breast tissue. There’s three possible causes of mataglia – cyclic, noncyclical, and extramammary pain.

Cyclical vs. non-cyclical breast pain

Cyclical and non-cyclical breast pain both cause soreness and tenderness in the mammary tissue, but their causes aren’t the same. Cyclical breast pain is connected to normal hormonal fluctuations during the menstrual cycle, and is common during your reproductive years and in early perimenopause. This discomfort ranges from mild to moderate and is generally harmless and follows a consistent pattern with your cycle. Since cyclical breast pain is tied to hormonal patterns, the severity can vary.

Non-cyclical breast pain is unpredictable and constant, commonly occurring in late perimenopause and menopause. However it also happens during the reproductive years. This chest wall pain is not due to hormonal shifts and is random, feeling different than the typical PMS heaviness or achiness. 

There are many possible causes of non-cyclical breast pain, including trauma to the breast tissue, arthritis, and mastitis. For some women, hormone replacement therapy, or HRT, can help relieve breast pain, but for others it may cause breast tenderness. Extramammary pain is due to outside sources like a poorly fitting bra and typically subside once the trigger is removed.

When to worry about breast pain

Breast pain can be alarming, and it’s understandable to feel concerned when it occurs. The good news is that in most cases, breast pain at menopause and perimenopause is benign and due to normal hormonal fluctuations from this natural life-stage shift. During perimenopause, hormone shifts can cause fibrocystic changes in the breast tissue, leading to lumpiness throughout your breasts. 

These changes also happen during the menstrual cycle, and are why your breasts feel painful or swollen before your period. As perimenopause progresses, the breast tissue can become ropy, tender, or lumpy, and cysts may form. Fibrocystic breasts can be uneven or rubbery, and lumps can range in size. They should also be movable when you push on them.

What does cancerous breast pain feel like?

For many women, the main concern when experiencing breast pain is that it’s a sign of breast cancer. However, early-stage breast cancer is usually painless. In cases where pain is present, it can be an unusual sensation that doesn’t necessarily involve tenderness. So it’s important to know what to look for when identifying this disease. Breast cancer symptoms include:

• Skin dimpling
• Nipple discharge and changes
• Persistent, localized pain
• New or thickening lump in the breast or armpit
• Changes in breast shape or size
• Red or flaky skin

It can sometimes be difficult to differentiate between normal generalized breast tenderness from hormones and concerning persistent pain. Screening options include:

• Mammograms
• Breast magnetic resonance imaging
• Clinical breast exams

Mammography is the best method for identifying breast cancer early, giving you the greatest chance for successful treatment. Starting at age 40, all women should undergo annual or bi-annual breast cancer mammography screenings, however in some regions the screening is recommended every three years. 

5 proven ways to relieve breast tenderness

You don’t have to settle for ongoing perimenopause and menopause breast tenderness – there are ways you can relieve the pain. We’ve made a list of five proven ways to combat breast pain and find relief.

1. Wear a properly fitted sports bra

70 to 80% of women are currently wearing the wrong-sized bra, causing pain and discomfort. Choosing a non-wired, supportive bra in the correct size and wearing it for added support when you sleep can help reduce breast tenderness.

2. Reduce caffeine and sodium intake

Caffeine is a vasoconstrictor, narrowing your blood vessels and limiting blood flow. When combined with fluctuating hormones, caffeine consumption can cause breast pain by reducing the amount of blood being sent to the breast tissue. Reducing caffeine intake by switching to alternatives like herbal teas can help you avoid this painful sensation. 

Eating too much sodium can also make your breasts sore or tender by causing fluid retention and swelling. Eating an anti-inflammatory diet that’s rich in foods like flaxseed, green leafy vegetables, nuts, whole grains, and lean protein can also help reduce swelling and inflammation. 

3. Try evening primrose oil

Evening primrose oil, or EPO, and vitamin E are popular supplements for mastalgia. Its effectiveness is due to its gamma-linolenic acid (GLA), which can modulate prostaglandins production, inflammation and ease pain. Although it’s not a quick fix, many women find relief when taken long-term.

4. Apply warm compresses or ice packs

For immediate relief of sore breasts, you can use a warm compress for general aching or ice packs for sharp pain due to swelling. This method is a great way to find relief quickly without the use of medicine.

5. Consider topical relief

Another fast-relief option that’s great for targeted pain is OTC anti-inflammatory gels (NSAIDs). These topical creams reduce pain while letting you avoid systemic side effects. 

How to predict and manage breast pain

While you can’t stop the hormonal fluctuations that cause perimenopause, you can monitor them and predict when breast pain may occur. Symptom tracking lets you identify cycle patterns so you can better understand why you feel the way you do. 

Hormona is the award-winning hormone tracking app that puts control in your hands. With daily logging, the Hormona app accurately predicts symptoms like breast tenderness and identifies irregular cycles, letting you know what to expect before the pain starts. With this advanced warning, you can take preventive measures, like adjusting your diet or wearing a supportive bra. There’s also an upcoming Hormona Testing option that lets you correlate symptoms with your actual hormone levels for unprecedented insights into your hormonal health. 

FAQs

Can perimenopause cause breast tenderness without a period?

Yes, when it comes to breast tenderness, perimenopause can still cause soreness and pain. Even in late perimenopause, when your cycle becomes unpredictable, hormone fluctuations still occur, resulting in breast tenderness. Additionally, breast pain is a possible symptom of HRT for women who take it.

How long will hormonal breast pain last?

Hormonal breast pain typically lasts until perimenopause is complete. The reason is due to hormone changes and medications like HRT.

Do breasts get bigger during perimenopause?

Weight gain during perimenopause can make breasts bigger.