Breast Pain & Tenderness During Menopause

Breast pain, also called mastalgia, is common, with up to 70% of women experiencing it at some point (1). It can occur cyclically, sporadically or be constant, and be present in one or both breasts (2). Many report it having a negative impact on their lives, interfering with sexual intimacy, physical tasks and work and social activities (1).

An estimated 40% cite sore breasts among their menopause symptoms. Even if you’ve dealt with breast pain in the past, it occurring during this transitional period of your life can cause concern. However, breast pain in perimenopause or menopause is rarely a sign of something serious.

In this guide, we explain what causes breast discomfort in menopause, what you can do to alleviate it and when you should speak to a doctor.

Is breast pain normal during menopause?

Breast tenderness during menopause is a common occurrence, just as it is during a menstrual cycle and is often the result of hormonal fluctuations.

Many women also find that the size and/or shape of their breasts change during this period (4). Breasts can grow or shrink and feel less full. As your milk system begins to shut down, glandular tissue in the breasts diminishes, causing them to become less dense and more fatty. Further, a loss of elasticity in the breast tissue may also cause sagging (5).

Breast pain after menopause

You can have breast pain at any age, but it is less common in postmenopause than it is in menopause due to hormone levels stabilising.

What causes breast tenderness during menopause?

Fluctuating levels of the hormones oestrogen and progesterone are usually responsible for breast pain during perimenopause and menopause.

In your reproductive years, these hormones play a key role in preparing your uterus for pregnancy and triggering a menstrual period if pregnancy is not achieved. As you enter perimenopause and ovarian function gradually declines, oestrogen and progesterone levels rise and fall unpredictably until menopause when these hormones taper off and levels are stabilised, although at much lower levels than before. These changes in hormone levels can affect breast tissue, leading to breast tenderness in menopause (6).

Breast pain symptoms

The severity, location and sensation of breast pain in menopause may feel different between individuals. It can be described as:

Tenderness
Discomfort
Aching
Throbbing
Sharp
Stabbing
Burning
Tightness
Heaviness
Sore nipples
Itchy nipples (7)

Is it normal for one side to hurt?

Yes, breast pain can occur in just one breast or be more severe in one breast than the other. Although pain caused by hormonal changes tends to affect both breasts, this isn’t always the case (8).

What else can cause breast pain during menopause?

Although changing hormones are usually the cause of breast discomfort in menopause, other things can lead to breast pain at this time of life.

Medications

Certain medications, including antidepressants, blood pressure treatments, and diuretics can cause breast pain as a side effect (6).

Hormone replacement therapy (HRT) can also cause breast pain or tenderness (9). Often, side effects of HRT remedy themselves within three months, once the body has acclimatised to the hormones. However, if HRT is the underlying cause of breast pain, the oestrogen dosage can be reduced, or HRT can be stopped altogether if the pain persists.

Bra support

Wearing an ill-fitting or unsupportive bra can lead to breast pain, especially during menopause when breast tissue may be more sensitive (6). Ensuring proper fit and adequate support can significantly reduce discomfort. Many high street clothing shops offer a free bra fitting service.

Caffeine

High caffeine intake, often from coffee, tea, or energy drinks, can increase breast tenderness in some women (10). Caffeine may heighten sensitivity in breast tissue by stimulating certain hormones, making the discomfort more noticeable during menopause.

Infection

Breast infections, such as mastitis, can cause localised pain, swelling, redness, and warmth and can be accompanied by fever (10). Although more common during breastfeeding, infections can occur at any age and may be related to skin irritation or blocked ducts during menopause.

Cysts

Breast cysts are fluid-filled sacs that can form in breast tissue. They often become more noticeable during menopause as the breasts change shape and size. While typically benign and self-resolving, they can cause tenderness or a feeling of heaviness, especially if they press against nearby tissue (10).

Cancer

Very rarely, breast pain is a sign of cancer, being a symptom in only 1% of cases (11). Pain is not usually the first symptom, but persistent discomfort in a specific area is always best to have assessed. Further, if you’re in menopause and breast lumps have appeared, you should always seek medical advice.

There are numerous charities and support organisations that have a wealth of information on understanding breast changes and the symptoms of breast cancer including:

Find out more about using HRT when you have a history of breast cancer.

What can help with menopause breast pain

Living with breast pain can be difficult and affect your overall well-being. However, there are some steps you can take and things you can try to help minimise discomfort.

Ibuprofen: Ibuprofen can reduce breast pain by relieving inflammation and blocking pain signals. You can take it as tablets or use a gel directly on the area of pain (12).
Stopping smoking: Quitting smoking can improve circulation and reduce inflammation, improving breast pain (13).
Avoiding caffeine: Some studies suggest that eliminating caffeine from your diet is an effective way to manage breast pain (13).
Losing weight: Excess weight may strain breast tissue, so even small weight loss can offer relief during menopause.
A well-fitting bra: Wearing a supportive, well-fitted bra minimises strain on breast tissue and reduces movement-related discomfort.
A warm compress: Applying a warm compress to the breasts can soothe pain by relaxing tense tissues and improving blood flow.
Herbal remedies: Herbal treatments include evening primrose oil, flaxseed, starflower oil and agnus castus (2).

When to see a doctor for breast pain

Although breast pain is not usually cause for concern, you should see a doctor urgently if the pain lasts for longer than two weeks and:

It’s not improving
Painkillers are not helping
The skin on your breast is dimpled, resembling orange peel
There is puckering of the skin around the nipple
You have a hard lump in your breast that does not move around
You have nipple discharge, which may be streaked with blood
You have a rash or crusting around the nipple
Your nipple has sunk into your breast tissue
Any part of your breast is hot, red or swollen
Breast pain is accompanied by a high temperature or feeling hot and shivery
You have a lump or swelling in your armpit or around your collarbone
There’s a sudden and unusual change in size or shape
There’s a family history of breast cancer (13, 14)

The specialists at Menopause Care are here to support women navigating menopause so they can feel their best. When you have a consultation with one of our doctors, they’ll review your medical history, discuss your symptoms and listen to your concerns. From there, they can signpost to resources, provide tailored advice, explain treatment options and arrange referrals if needed.

If you are experiencing breast pain or any other menopause symptoms that are affecting your well-being and self-esteem, we can help. Book a consultation with a menopause doctor to get started.

DisclaimerAt Menopause Care, we ensure that everything you read in our blog is medically reviewed and approved. However, the information provided is not meant to replace professional medical advice, diagnosis, or treatment. It should not be relied upon for specific medical advice.

References