Symptoms of Breast Pain in Menopause

Breast pain, also called mastalgia, is common. It affects up to 70% of people with breasts throughout their lives. It is usually associated with fluctuating hormones, such as during the menstrual cycle, or periods of hormonal changes, like puberty and perimenopause. However, breast pain can continue after menopause (when periods have stopped for at least 12 straight months) as well.

Mastalgia is rarely a symptom of breast cancer, but breast pain at any age or stage should be discussed with a healthcare provider to determine the cause.

Read on to learn common types of breast pain and what causes them.

Frequent Symptoms

Breast pain varies among individuals and even within the same person. It can be constant or come and go. The level of pain can also vary from day to day and may occur in one or both breasts.

Breast pain and discomfort may feel like:

• Soreness
• Discomfort
• Burning
• Tenderness to the touch or sensitivity to clothing
• Sharp, stabbing, or throbbing pain

There are different types of breast pain, which can also influence symptoms.

Cyclic Mastalgia

Also called cyclic breast pain, this type is the most common, accounting for about 75% of all breast pain. It is linked to the menstrual cycle and other hormonal changes such as puberty, pregnancy, the period after giving birth (before milk comes in), and perimenopause.

Cyclic mastalgia may continue into menopause, especially if the person is taking medication containing hormones, such as oral contraceptives or hormone replacement therapy.

Cyclic pain associated with the menstrual cycle typically starts a few days to two weeks before menstruating. It usually occurs in both breasts, but it can occur in just one. The pain generally occurs in the upper and outer portions of the breast(s), but can extend into the underarm area and the arm. Symptoms usually subside when the menstrual period is over.

Cyclic breast pain may feel like:

• Swollen breast(s)
• Pain that is dull, heavy, or aching
• Pain that ranges from mild to more severe, and often gradually increases as menstruation approaches
  

Noncyclic Mastalgia

Noncyclic mastalgia, also called noncyclic breast pain, is not linked to hormones and doesn't tend to follow a predictable pattern. It can involve one breast or both, the whole breast or just a part, and can be constant or temporary.

Noncyclic breast pain occurs most often in people who are in postmenopause.

Noncyclic pain typically indicates a specific problem, such as:

• A cyst (fluid-filled sac within the breast)
• Trauma (injury) to the breast
• A benign (noncancerous) tumor
• Conditions unrelated to the breast, such as those affecting the chest wall, esophagus (food tube), neck, upper back, or heart, which can have symptoms that feel like breast pain

Noncyclic breast pain may feel like:

• Soreness
• Tightening of the breast
• A burning sensation

Fibrocystic Breast Changes

As many as 50%–60% of people with breasts experience fibrocystic changes, such as thickened tissue or cysts in breasts that are otherwise normal.

These changes can cause pain or discomfort that is cyclic or noncyclic in both breasts or just one.

Breast Cysts

Most breast cysts occur between ages 35 and 50, but they can happen at any age.

Breast cysts can vary in size—but are usually round or oval—and tend to have smooth, obvious edges. Some breast cysts are firm, but most feel pliable.

Breast cysts are not usually cancerous, and having them doesn't increase your chances of developing breast cancer. But, their presence may make it harder to detect breast cancer should it develop.

Breast cysts don't always cause pain or discomfort and don't always require treatment if they aren't bothering you.

Symptoms of breast cysts vary, but some symptoms are:

• A bump or lump in the breast tissue
  
• Pain or tenderness around the area of the cyst(s)
• Cysts that increase in size just before menstruating and decrease in size when your period is done
• Nipple discharge (can be clear, yellow, gold, or brown)

Fibrous Breasts

Many people have breast tissue that can feel fibrous (e.g., ropelike or lumpy). This tissue is considered normal, but can make detecting breast cancer more difficult. Performing regular self-exams can help you learn what your breast tissue normally feels like so that you are more likely to notice changes.

Fibrous tissue doesn't always cause symptoms or pain, but some people feel pain or tenderness in the fibrous tissue in the upper breast area and on the sides near the underarms. If this discomfort does occur, it's likely to happen just before menstruation.

Mammary Duct Ectasia

Mammary duct ectasia is a condition in which a breast milk duct widens, causing its walls to thicken. This can block the duct and lead to fluid buildup. It can occur at any age, but is more common in people who are approaching menopause.

Often, mammary duct ectasia has no symptoms. It usually is only discovered during a breast biopsy performed for another reason.

If symptoms do occur, they may include:

• Nipple discharge (often sticky and thick)
• Tender and/or red nipple (nipple may also be pulled inward)
• A lump around the abnormal duct caused by scar tissue

You should discuss any noticeable lumps with your healthcare provider.

Other Causes of Breast Pain

Breast pain can be a result of many factors, including the following.

Medication

Medication associated with breast pain include:

• Hormone drugs (such as hormone replacement therapy, oral or injected contraceptives, or fertility treatments)
• Certain cardiovascular medications (for conditions of the heart and blood vessels)
• Certain psychiatric medications (such as antidepressants)
• Diuretics ("water pills" that rid the body of sodium and water)
  

Infection

Mastitis (infection of the breast) or an abscess can cause breast pain. This is most common in people who are lactating (breastfeeding) but can happen to anyone with breasts. Along with the pain and tenderness, breast swelling, redness, and fever are likely to occur.

Trauma or Injury

This includes a breast biopsy (removing a sample tissue for examination in a lab) or surgery.

Pain from trauma to the breast may last for weeks. Pain and swelling may also occur if the trauma causes inflammation or a clot under the skin.

Poor Breast Support

Heavy breasts, especially when not well-supported, can cause breast pain, as well as pain in the shoulders, neck, and back.

Cancer

It is rare for breast pain to be due to cancer, but it should be considered among the many other possible causes.

Conditions Unrelated to the Breast

• Strain in the pectoralis major muscle (lies directly beneath and around the breast)
  
• Costochondritis (inflammation of the costal cartilages that attach the ribs to the breastbone)
  
• Arthritis in the neck or upper back
  
• Shingles (painful rash)
• Heart disease
• Gastroesophageal reflux disease (GERD, acid reflux)
• Pleuritis (inflammation of the tissues lining the lungs)
  

Risk Factors for Breast Pain

Caffeine, stress, and smoking may exacerbate breast pain.

Research suggests that some people who experience cyclic mastalgia may have less of the hormone progesterone than they do the hormone estrogen in the second half of their menstrual cycle.

Other studies suggest that breast pain could be affected by the hormone prolactin.

When to See a Healthcare Provider

While breast pain is not usually a sign of something serious, it's important to see your healthcare provider to determine the cause, especially if you are experiencing symptoms.

Symptoms that may warrant a trip to your healthcare provider include:

• Breast pain that is not improving, or not helped by pain medication
• Fever or feeling hot and shivery
• Chest pain
• Any part of the breast is red, hot, or swollen
• A history of breast cancer in your family
• Symptoms of pregnancy (or a positive pregnancy test)
• A lump in the breast (especially if it is hard and does not move around)
• Thickening in the breast
• Nipple discharge (may be clear, yellow, or streaked with blood)
• Change in the shape or size of one or both breasts
• Dimpled skin on the breast
• A rash on or around the nipple
• Nipple has sunk into the breast
• Hard or swollen breasts within a week of giving birth
• Any symptoms that concern you

Summary

There are many types and causes of breast pain. Breast pain may be cyclic or noncyclic. It can be due to hormonal changes, such as during the menstrual cycle, pregnancy, or menopause, or to conditions such as fibrous tissue, cysts, or other factors. These include trauma to the breast or conditions unrelated to the breasts.

Cyclic breast pain may worsen as people approach menopause. Noncyclic breast pain occurs most often in people who are in postmenopause.

Breast pain is not a common symptom of breast cancer and is usually not a sign of something serious. However, breast pain should be checked by a healthcare provider, especially if accompanied by other symptoms.

A Word From Verywell

If you are experiencing breast pain, don't panic. Breast pain is common and can occur at any age, including for people who have been through menopause. It is rarely a sign of cancer and usually doesn't indicate something serious. However, you should consult your healthcare provider if you are feeling breast pain to determine the cause and discuss ways to manage it.