Perimenopause Breast Pain: When to Worry and How to Find Relief

Sore, heavy breasts? Burning sensations? Painful nipples? This type of breast pain and more could all be related to perimenopause.

If you have perimenopause breast pain, you’re far from alone! Up to 7 out of 10 women experience breast pain at some point in their lives, including during perimenopause [1].

Perimenopause breast pain can be frustrating and uncomfortable at best, and very painful at worst. Most of the time, though, you don’t need to worry about it (and your hormones probably have something to do with it). 

Read on to find out when perimenopause breast pain is normal, what causes this breast pain, when you should talk to a doctor, and how to get breast pain relief.

Quick Facts About Perimenopause Breast Pain

• Perimenopause breast pain is a common perimenopausal symptom, and rarely cause for concern
• Generally, breast pain is not a sign of cancer, less than 2% of breast cancer cases present with pain as the primary symptom [3]
• Always talk to your doctor if you find any lumps in your breasts or armpits; it might be nothing, but it's better to get checked
• Sometimes a more supportive bra is all it takes to relieve perimenopause breast pain
• Breast pain can occur in one or both breasts during perimenopause
• Most women find breast pain improves after menopause when hormones stabilize

Does Perimenopause Cause Breast Pain?

Yes, perimenopause can cause breast pain (also called “mastalgia” in medical terms). Perimenopause breast pain, or perimenopause mastalgia, is a common symptom that many perimenopausal women experience.

Perimenopause breast pain is typically:

Cyclical: Breast pain that’s related to your menstrual cycle and generally occurs around your period.

Noncyclical: Breast pain that isn’t related to your cycle and may occur at any point.

In women who get breast pain, around 2 out of 3 experience pain that aligns with their cycle, and around 1 out of 3 have pain at more random moments [1].

Perimenopause breast pain typically goes away after perimenopause ends and you’ve officially passed menopause (that is, once you’ve gone 12 consecutive months without a period). In other words, breast pain after menopause tends to be less common [1].

Perimenopause Breast Pain Symptoms

What perimenopause breast pain feels like varies from person to person. Pain severity can range from mild discomfort, to more intense pain that makes it hard to think or do anything. 

Many women describe perimenopause breast pain as:

• Dull ache
• Burning sensation
• Swollen sensation
• Stabbing pain
• Heaviness
• Tightness
• Tenderness
• Nipple sensitivity 
• Nipple pain

You may feel pain in both breasts or just one breast. You could have perimenopause breast pain from time to time, or you may go through entire days of aches and throbs. 

Can Perimenopause Cause Breast Pain in One Breast?

Yes, perimenopause can absolutely cause breast pain in just one breast. While cyclical, hormone-related breast pain typically affects both breasts, noncyclical perimenopause breast pain may occur in only one breast [1].

Unilateral (one-sided) breast pain during perimenopause is usually caused by:

• Fibrocystic breast changes that develop in one breast
• Breast duct ectasia affecting one side
• Previous injury or trauma to one breast
• A poorly fitting bra putting pressure on one side
• Musculoskeletal issues (chest wall or rib pain that feels like breast pain)

Important: While pain in one breast during perimenopause is usually benign, always have your doctor examine any one-sided breast pain, especially if it's persistent or accompanied by a lump. Most breast pain isn't cancer, but breast cancer can occasionally cause pain, particularly if a tumor is pressing on surrounding tissue [3].

When Is Perimenopause Breast Pain Normal?

Most of the time, perimenopause breast pain is normal and doesn't point to a health problem. What's more, the vast majority of breast pain is not linked to cancer [1]. Breast cancer rarely presents with pain as the primary symptom, studies show this occurs in less than 2% of cases [3]. So while breast pain may feel scary, you usually don't have to worry.

Still, it's always a good idea to talk to your doctor if you notice lumps, have persistent pain, or experience unusual breast symptoms.

Perimenopause Breast Pain vs. Breast Cancer: Know the Difference

Understanding what's normal versus concerning can ease anxiety about perimenopause breast pain.

Normal Perimenopause Breast Pain Usually:

• Comes and goes, often in relation to your cycle
• Affects both breasts (though one breast can hurt)
• Feels achy, tender, or burning
• Responds to pain relievers or lifestyle changes
• Improves with breast support (better bra)
• Doesn't come with a hard, fixed lump

Concerning Symptoms That Need Evaluation:

• Hard, immovable lump (feels different from surrounding tissue)
• Pain persistently in one specific spot that doesn't go away
• Bloody or clear nipple discharge (especially from one breast)
• Skin changes: dimpling, puckering, or orange-peel texture
• Nipple retraction or inversion (when it wasn't that way before)
• Persistent redness or scaliness on nipple or breast skin
• Rapid change in breast size or shape (not related to weight change)

When to Call Your Doctor Immediately

Contact your healthcare provider right away if you experience:

• A new, hard lump that doesn't move
• Bloody nipple discharge
• Skin dimpling, puckering, or thickening
• Rapid breast size change in one breast
• Persistent pain in one specific spot lasting more than a few weeks
• Any breast changes that worry you

Remember: Most breast concerns are benign, but early detection saves lives. It's always better to get checked.

What Causes Perimenopause Breast Pain?

Generally speaking, perimenopause breast pain is caused by:

• Hormones: when pain is cyclical, and sometimes when it’s noncyclical

• Other factors: when pain is noncyclical

Perimenopause Breast Pain and Hormones

Have you ever had breast pain around your period? That’s cyclical breast pain, and it’s typically caused by period-related hormone changes. 

The same is true during perimenopause: cyclical perimenopause breast pain, the most common type, is largely caused by hormone changes. Perimenopause is a time of biological shift, when hormones like estrogen and progesterone fluctuate wildly. Jumps in estrogen, in particular, are thought to be a major cause of perimenopause breast pain [1].

Why do estrogen spikes cause breast pain? Estrogen stimulates breast tissue, causing the milk ducts to enlarge and breast tissue to swell with fluid. During perimenopause, estrogen doesn't decline in a steady, predictable way, instead, it can spike dramatically before eventually declining. These surges can cause significant breast tenderness and pain [2,4].

Plus, your periods become increasingly irregular in perimenopause. That means that perimenopause breast pain associated with period hormones may pop up unexpectedly alongside an unexpected period, leaving you with sore breasts at unpredictable moments.

Noncyclical perimenopause breast pain can also be related to hormones. That’s because perimenopause hormone changes impact breast tissue, which can cause general breast tenderness and sensitivity – meaning you might get flashes of hormone-driven breast pain outside your period [2].

Perimenopause Breast Pain and Other Factors

If you have perimenopause breast pain at random moments unrelated to your period, it could also stem from other factors, like [1]:

• Fibrocystic breast changes: Benign cysts that are common during perimenopause and in people taking hormone replacement therapy (HRT).
• Breast duct ectasia: A benign condition, common in perimenopause, that makes breast ducts thicken and widen.
• Medication: Perimenopause medication like hormonal birth control or HRT, as well as certain antidepressants (particularly SSRIs), some antibiotics, and cardiovascular medications can cause breast pain as a side effect [1,4].
• Breast size changes: Weight gain during perimenopause can increase breast size, which may lead to pain from inadequate support or strain on breast ligaments.
• Caffeine and diet: High caffeine intake and diets high in saturated fats have been linked to increased breast pain in some women [4].
• Stress: While not a direct cause, stress can amplify pain perception and may worsen perimenopause symptoms, including breast pain.

Fibrocystic breast changes and breast duct ectasia aren't related to breast cancer, and they don't increase your risk of breast cancer [2]. However, always talk to your doctor about any lumps or changes in your breasts.

How Long Does Perimenopause Breast Pain Last?

The duration of perimenopause breast pain varies significantly from woman to woman, but here's what you can typically expect:

During an episode: Individual episodes of cyclical breast pain usually last 3-7 days, often appearing in the week or two before your period and improving once your period starts or ends.

Throughout perimenopause: Since perimenopause itself typically lasts 4-7 years (though it can be shorter or longer), you may experience intermittent breast pain throughout this transition period [4].

After menopause: Most women find that breast pain significantly improves or resolves completely after menopause, once hormone levels stabilize at lower levels [1]. However, if you take hormone replacement therapy after menopause, you may continue to experience some breast tenderness.

Noncyclical pain: This type of pain may last longer or be more persistent, depending on the underlying cause. Some women have pain that lasts weeks or months, though it often eventually resolves on its own [1].

If your breast pain is severe, persists for more than a few months, or significantly impacts your quality of life, talk to your doctor. There are treatment options available, and persistent pain should always be evaluated to rule out other causes.

How to Tell Whether Your Perimenopause Breast Pain Is Hormonal

When you have perimenopause breast pain in the week or so before your period, it’s typically hormone-related.

Irregular perimenopause periods make it hard to track your cycle, but perimenopause care tools can help. At-home hormone tracking decodes your cycle, so you can tell whether your perimenopause breast pain is related to perimenopause hormone changes. 

The Oova perimenopause kit measures your unique hormones with lab-level precision to reliably track even the most unpredictable perimenopause cycles. That way, you can pinpoint when in your cycle perimenopause symptoms like breast pain occur, and identify the hormone patterns behind them. This data can help you and your doctor guide your perimenopause care plan.

Benefits of tracking hormones for breast pain:

• Identify estrogen spikes that trigger breast tenderness
• Anticipate when breast pain is likely to occur
• Distinguish between hormone-related and other causes of pain
• Share objective data with your doctor for better treatment decisions
• Validate that your symptoms are indeed hormone-related

When to Worry About Breast Pain After Menopause

Talk to your doctor if you have these breast symptoms during perimenopause, or if you have these symptoms alongside breast pain after menopause:

• Lump in your breast or armpit
• Significant change in breast size or shape
• Changes in breast skin color or texture
• Nipple changes (like skin puckering, or nipples that suddenly become inverted)
• Nipple discharge (particularly if bloody or clear, or coming from only one breast)
• Breast pain that persists in one specific spot for more than a few weeks
• Pain that worsens progressively rather than fluctuating
• Breast symptoms accompanied by unexplained weight loss or fatigue

According to the American Cancer Society, while breast cancer is rare in women under 40, risk increases with age, making regular screening important during and after perimenopause [3].

How to Talk to Your Doctor About Perimenopause Breast Pain

It can be helpful to prepare before talking to your doctor about perimenopause breast pain or breast pain after menopause.

A perimenopause symptom journal can help you keep track of what to discuss, including:

• What perimenopause breast pain feels like (throbbing, aching, stabbing, tender breasts, swollen breasts, heavy breasts, etc.)
• Where in your breast you feel pain (surface-level, deeper in the tissue, behind your nipples, in a specific quadrant, etc.)
• Whether you have pain in both breasts or one
• How often you have breast pain, and on which cycle days (if trackable)
• How long pain lasts (hours, days, weeks)
• Pain severity on a scale of 1-10
• What makes pain better or worse (medication, bras, activities, etc.)
• Where in your breast any changes or lumps are
• Whether you have any nipple discharge, and what color it is
• Your breast medical history, including the date of your last mammogram and any personal or family history of breast problems
• Current medications and supplements
• Lifestyle factors (caffeine intake, stress levels, sleep quality)

Questions to ask your doctor:

• Could my breast pain be related to perimenopause hormones?
• Do I need a mammogram or ultrasound?
• Should I try hormone therapy or other treatments?
• Are there medications I'm taking that could be causing breast pain?
• When should I be concerned about breast pain?
• Would tracking my hormones help identify patterns?

How to Get Relief from Perimenopause Breast Pain

When you're hit with perimenopause breast pain and you need relief, try:

Immediate relief strategies:

• Over-the-counter pain relievers, like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)
• Warm or cool compresses on the parts that hurt (whichever feels better—some women prefer cold, others warm)
• Warm bath or shower to relax tense muscles
• Gentle massage using circular motions away from the nipple

Incorporating breast-friendly strategies in your daily life can also help relieve perimenopause breast pain [1,4]:

• Wear a supportive bra: Bras that are the right size and shape for your breasts give you optimal support and comfort. Sports bras can be particularly helpful for breast pain relief.
• Eat a breast-friendly diet: Cutting back on caffeine, following a low-fat diet, and eating more fiber and unsaturated fats (think: vegetables, fish, avocados, and nuts) may help ease perimenopause breast pain.
• Reduce sodium: High sodium intake can increase fluid retention, which may worsen breast swelling and pain. Limit processed foods and add less salt to meals during times when breast pain typically occurs.
• Try vitamins and nutritional supplements: While evidence is limited, taking vitamin E, vitamin D, or evening primrose oil may help improve perimenopause breast pain. Always talk to your doctor before trying any vitamins or supplements.
• Try a breast-friendly sleeping position: Sleeping on your back or on your side with a pillow tucked underneath your breasts can help ease pressure and relieve pain.

When to consider medical treatment:

If home remedies aren't providing adequate relief, talk to your doctor about:

• Prescription pain medication
• Hormonal treatments to stabilize fluctuating hormones
• Medications like danazol or tamoxifen (rarely used, but effective for severe cases)
• Adjusting current medications that may contribute to breast pain

Perimenopause breast pain: The bottom line

Perimenopause breast pain is common, and you often don't need to worry about it. Up to 70% of women experience breast pain at some point, and the vast majority of breast pain is not related to cancer.

Still, that doesn't mean this perimenopause symptom isn't frustrating and painful! To help ease perimenopause breast pain in the moment, try warm or cool compresses, or pain relievers as needed. Strategies that support your breasts can also help manage pain, like a good bra and a breast-friendly diet.

Be sure to talk to your doctor if you find any lumps or notice changes in breast size and shape. Your doctor can also help if you have intense breast pain or pain that doesn't go away.

For the next steps in your perimenopause care, consider tracking your hormones at home. When you understand your body inside and out, you can take control of your perimenopause journey, from managing symptoms like perimenopause breast pain, to monitoring your health, to feeling your best in your changing body.

Ready to take control of your perimenopause journey? Learn more about the Oova perimenopause kit and start tracking the hormone patterns behind your symptoms today.

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Frequently Asked Questions About Perimenopause Breast Pain

Is breast pain during perimenopause a sign of breast cancer?

No, breast pain is rarely a sign of breast cancer. Studies show that less than 2% of breast cancer cases present with pain as a primary symptom [3]. Breast cancer is much more likely to present as a painless lump, skin changes, or nipple changes. That said, breast cancer can occasionally cause pain, particularly if a tumor is large or pressing on surrounding tissue. The most important thing is to see your doctor about any breast changes, lumps, or persistent pain that worries you, most will be benign, but it's always better to get checked.

Why do my breasts hurt more during perimenopause than they did before?

Perimenopause causes more dramatic hormone fluctuations than your regular menstrual cycle. While reproductive-age women experience relatively predictable rises and falls in estrogen and progesterone, perimenopausal women experience erratic spikes and crashes. These estrogen surges can be higher than what you experienced during normal cycles, stimulating breast tissue more intensely and causing more severe pain [2,4]. Think of it like the difference between gentle waves and turbulent swells, both involve water movement, but the intensity differs significantly.

Can stress make perimenopause breast pain worse?

Yes, stress can worsen perimenopause breast pain in several ways. Stress affects hormone levels, potentially amplifying the hormonal fluctuations that drive breast pain. Stress also increases inflammation in the body and lowers your pain threshold, making you more sensitive to discomfort. Additionally, stress often leads to behaviors that worsen breast pain, like poor sleep, increased caffeine consumption, and muscle tension in the chest and shoulders. Managing stress through relaxation techniques, exercise, and adequate sleep may help reduce breast pain severity.

Should I be concerned about breast pain that comes and goes?

Breast pain that comes and goes is typically less concerning than persistent pain in one spot. Cyclical pain, pain that fluctuates with your menstrual cycle or hormone changes, is almost always benign and hormone-related. Even noncyclical pain that varies in intensity is usually not serious. However, you should see your doctor if the pain is severe, lasts more than a few weeks, occurs in one specific spot consistently, or comes with other symptoms like lumps or skin changes.

Can exercise make perimenopause breast pain worse?

High-impact exercise without proper breast support can definitely worsen breast pain. Activities like running, jumping, or aerobics cause breast movement that stretches Cooper's ligaments (the connective tissue supporting your breasts), leading to pain and discomfort. The solution: invest in a high-quality, properly fitted sports bra designed for your activity level. Look for encapsulation bras (which support each breast individually) rather than compression bras if you have larger breasts. Low-impact activities like walking, swimming, yoga, or cycling may be more comfortable during flare-ups of breast pain.

Will my breast pain ever go away?

For most women, breast pain significantly improves or resolves after menopause when hormone levels stabilize [1]. Perimenopause typically lasts 4-7 years, though this varies. During this time, breast pain may come and go. Once you've been without a period for 12 consecutive months (the definition of menopause), most cyclical breast pain ends. However, if you take hormone replacement therapy after menopause, you may continue to experience some breast tenderness.