Discussing Sore Breasts During Menopause - Elektra Health

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Sore breasts

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SYMPTOM

Sore breasts

Breast symptoms during menopause can range from pain to soreness and discomfort — the kind of feeling where you’d rather not have anyone touch ‘em, and you definitely don’t want to be doing jumping jacks. Sound familiar? Not to worry, we’ve got you covered.


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    The science

    The official term for breast pain or soreness is “mastalgia,” which comes in two forms: cyclic and non-cyclic.

    Cyclic

    Accounting for ⅔ of all breast pain, cyclic mastalgia is associated with our periods (menstrual cycles = cyclic). Pain begins in the luteal phase, right before your period starts, and reduces during the menstrual phase.

    The cause? Normal hormonal fluctuations in estrogen and progesterone. The two hormones increase both the size and number of ducts/milk glands (aka lobules), which causes breasts to retain water and feel swollen.

    In addition to timing, cyclic mastalgia can be recognized by location of the pain: bilateral, localized in the upper quadrant, and occasionally associated with lumps. And yes, it CAN extend to the armpit and arm, too. Although most common among women in their 20s and 30s (with periods of remission during pregnancy and lactation), cyclical pain may persist into perimenopause due to the erratic surges and drops in hormones that are all-too-common during these years. For the most part, cyclical pain subsides come menopause, with certain exceptions for women using oral contraceptives or hormone therapy.

    Non-cyclic

    Non-cyclic pain can affect anyone, but is particularly common for women in their 40s and 50s. Because it is not linked to menstruation, non-cyclic pain doesn’t follow a predictable pattern. It can be constant or intermittent, affect one breast or both, involve the entire breast or just a small part…in other words, there’s no way to know when or how it’ll pop up.

    Whereas cyclical pain is, more often than not, a sign of expected hormone changes, non-cyclical pain is usually a symptom of a specific condition such as a cyst or benign tumor. Other potential causes include:

    • Trauma/injury
    • Infection (aka mastitis)
    • Strained pectoralis muscle
    • Poor support (aka you need a different bra)
    • Medications (specifically certain cardiovascular, antidepressant, and HRT meds, as well as birth control pills
    • Fibrocystic changes in the breast tissue (thickened tissue with an increased number of cysts)
    • High caffeine intake (how high depends on you, everyone is different, and someone find no effect from caffeine)
    • Smoking
    • Cancer

    Breast pain can be scary and many worry that it’s a sign of something more serious like breast cancer. Before we all get a bit nervous, start convincing ourselves of the worst, and go down a rabbit hole on Google, remember this:

    Breast pain is usually not associated with cancer, and most breast pain isn’t that uncomfortable.

    For women who see their doctor for breast pain, about 85% of women decline any intervention to manage the pain after a negative breast cancer screening – the reassurance of a negative exam is enough. The remaining 15% will require treatment, however, as breast pain negatively impacts physical activity (30%), sexual activity (40%), and/or social activities (10%).

    Wondering when to seek medical advice?

    Elektra’s founding physician, Dr. Anna Barbieri, MD often advises that bilateral (aka happens in both breasts), cyclical discomfort that disappears a few days after the period starts is likely hormonal and benign. However, there are times when you need to see your provider to be evaluated via a clinical exam and maybe even a mammogram and/or ultrasound:

     

    • If breast discomfort crosses the line from dull ache to full-fledged pain
    • If breast pain is one-sided, persistent, and especially if it occurs after menopause
    • If breast pain ever accompanies a noticeable lump/nodule, inverted nipple, skin changes, redness and swelling, or nipple discharge (see this information about signs and symptoms of breast cancer from Susan G. Komen)

    What you can do

    We’re all about equipping you with the know-how to understand your symptoms, and we especially emphasize the specific, tangible ways to manage them. Our goal is to empower YOU to take charge of your menopause journey, starting today.

    A quick note about product recommendations…Elektra Health is not paid to feature any products. We just like them and think you might too, though we can’t guarantee any results.


    Breast Cancer Screening

    Although not a suggestion for managing breast pain, breast cancer screening is an important part of managing breast health.

    It’s complicated, however, because there isn’t consensus about screening recommendations. Here are a few guidelines for women of average risk of breast cancer:

    As we are getting better at understanding risk, breast cancer screening has become increasingly personalized, and there is no longer a one-size-fits all guideline.

    WHEN you should start getting screened, HOW OFTEN you get screened, and HOW you get screened — these are all questions that may have different answers depending on your individual risk and your consideration of the risk vs benefit of screening.

    Your risk depends on several factors, including:
    • Your history of breast cancer or atypical hyperplasia (abnormal cells in the breast that may be a sign of or develop into a breast cancer)
    • Your breast density
    • Your family history of breast and other cancers
    • A known genetic mutation known to increase risk of breast cancer in you or a close family member
    • Any history of chest radiation therapy (for an illness like lymphoma) before age 30

    To determine your risk, talk to your doctor or Elektra to have your risk assessed using a validated tool (this is usually done in breast imaging centers or with your GYN).


    Supplements & Over-the-Counter Solutions

    Over-the-counter solutions and supplements may be effective in easing breast pain…if you choose wisely. We recommend consulting with your healthcare provider first to ensure you’re using something with optimal efficacy and safety (i.e. backed by clinical research) or consulting with Elektra’s providers. Here’s a quick primer from our team on how to go about selecting high-quality supplements.

    Over-the-counter pain medications

    NSAIDs such as ibuprofen (Advil and Motrin) and acetaminophen (Tylenol) can be used for pain as needed. Be sure to take ibuprofen with food since an upset stomach is a potential side effect. And if taking acetaminophen, the maximum daily dose is 3,000 – 4,000 mg.

    Vitex

    Also known as chastetree, monk’s pepper, or Abraham’s balm, Vitex is a peppercorn-sized fruit frequently used as an herbal remedy for those experiencing frequent menstruation. By increasing progesterone, it can help promote ovulation and regulate cycles to reduce the risk of cyclic breast soreness and sensitivity. Our preferred products are Vitex Elixir, Chasteberry Plus, and DIM Vitex.

    Evening Primrose Oil

    Primrose oil, which is derived from the seeds of a wildflower, is an omega-6 essential fatty acid that is hard to come by via diet alone. Because studies surrounding its effect on breast pain are inconclusive, no definitive claims can be made. However, some point to its anti-inflammatory properties as reason to believe that it may affect the balance of fatty acids in our cells which, in turn, may reduce breast pain. Side effects might include nausea, diarrhea, and headaches.

    Chamomile

    Chamomile is one of the oldest medicinal herbs in the world, with impressive anti-inflammatory benefits to boot. It’s for this reason that the herb has been touted as a safe, well-tolerated, and effective treatment for women with moderate mastalgia.

    Vitamin E

    Preliminary studies indicate a potential benefit of vitamin E on cyclic breast pain pre-menopause.

    Omega-3 Fatty Acids

    Fish oil hasn’t been proven effective in rigorous clinical studies, but there is promising anecdotal evidence. In other words, it can’t hurt, but we don’t know yet for certain that it helps.

    Omega-3 supplements are available in prescription and over-the-counter form. And there are tons of natural dietary sources, too! Dark green leafy vegetables, wild fish, flax seeds, walnuts, sesame seeds, etc (we’ve got more on this in our nutrition primer).


    Prescription

    Hormonal

    Hormone replacement therapy (HRT) can be used to balance hormones and reduce fluctuations; however, it’s not the first line of defense against breast pain.


    We’re always keeping an eye out on emerging research and the latest clinical studies. Subscribe to our weekly Elektra Digest for the latest, science-based info direct to your inbox. Something work well for you that’s not listed here? We want to hear it! Shoot us a note at [email protected] (We’re human, promise.)


    Disclaimer: This information is for general educational purposes, and should not be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem.

    As with anything you put into your body, taking dietary supplements can also involve health risks. You should consult a medical professional before taking supplements and inform your doctor about any supplements, as well as any medications you already take, since there may be interactions.

    References

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