QUESTION

Since reaching menopause this year, my breasts are frequently tender and sometimes swollen. What could be causing this, and what should I do? Should I worry?

ANSWER

Discomfort, even pain, is fairly common for women in one or both breasts. Most of the reasons are not dangerous but, of course, it's important to find out the cause, and when something is hurting, you'll want to find a solution as soon as you can. The breasts are extremely sensitive to the hormones estrogen and progesterone. In the months leading up to menopause and in the year or two after, hormones are still being produced, though at lower levels, and levels are quite unbalanced. These suboptimal fluctuations of estrogen and occasionally progesterone can influence the breasts and cause them to feel tender or swollen or feel as if the skin is stretched tightly. You may even feel sharp, stabbing pain. You didn't mention whether you are on hormone therapy, but if you are, the reintroduction of higher hormone levels can cause one or both breasts to feel quite sensitive and to enlarge—and the increased size can lead to discomfort. As your body gets used to the steady dosage of hormones, your breast pain symptoms should subside.

SLEUTHING OUT BREAST PAIN

The first step to dealing with breast discomfort is to make sure there isn’t something else going on besides normal hormonal fluctuations. There could be a physical cause. For example, if you rarely or never wear a bra and your breasts are bouncing around a lot, you may have stretched a ligament (the fibrous connective tissue that supports your breast), and that would definitely cause discomfort. Similarly, if you’ve recently bruised a rib, it may feel like your breast hurts when in fact it’s the bone underneath. It's also possible to have strained the muscles that cover the ribs and lie beneath and surrounding the breasts, which often happens to women who lift heavy objects, rake, shovel or do weight training. Breasts can also become inflamed, a condition called mastitis. Often there is warmth associated with this. There could also be a cyst in the breast causing pain. Caffeine can also bring on breast pain in some women. I'm sure a more disturbing scenario has already crossed your mind as well—breast cancer. Breast pain can be a symptom of cancer, though typically pain isn't an early symptom. Because breast pain is so frightening for most women and because of the potential serious nature of breast pain, I recommend making an appointment to see your health-care provider soon. A simple exam will provide answers in many instances. Some testing, such as a breast ultrasound, a mammogram or other testing, may be ordered to confirm a diagnosis. The good news is that more times than not, the answer to, What is causing my breast pain? is going to be something other than cancer. In the short term, wear a well-fitted and supportive bra...wear a sports bra during exercise...limit caffeine...try an anti-inflammatory such as ibuprofen...and apply cold packs.

Related Articles