Breast Pain in Menopause: Signs, Symptoms, and Complications - Verywell Health

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Before and during menopause, it is common to experience pain or tenderness in your breasts. Breast pain may go away after a person completely stops having periods and enters menopause. However, having hormone therapy during menopause can increase the risk of continued breast pain.

A person with a uterus reaches menopause after 12 months without a menstrual period. This stage follows a transitional period called perimenopause, where estrogen and progesterone levels in the body fluctuate unpredictably. The spikes in hormone levels during perimenopause can affect breast tissue, making your breasts hurt.

Although many people with pain in one or both breasts may be concerned that it is breast cancer, breast pain is not commonly a symptom of cancer.

Discover the typical signs of breast pain before, during, and after menopause, and when to seek help.

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Frequent Symptoms

A few benign breast conditions cause mastalgia—the clinical term for breast pain. Some are related to the menstrual cycle, and some are not. The different types of breast pain all come with their own set of signs and symptoms.

Cyclic Mastalgia

Cyclic breast pain varies with the menstrual cycle, so it increases and decreases in response to hormone swings. The pain of cyclic mastalgia often feels like a dull, heavy aching in both breasts and is located throughout the breast and into the armpit areas.

Since this type of pain is linked to menstruation, premenopausal people are most likely to experience it. For postmenopausal people, most breast pain is noncyclic.

Symptoms include:

A dull, heavy, or aching pain
Similar pain in both breasts
A gradual increase in the amount of pain in the lead up to your period

Noncyclic Mastalgia

Noncyclic breast pain may be felt inside, beneath, or near the breast. When it occurs, this sharp or burning breast pain may be felt all over or in one specific area. Noncyclic breast pain commonly results from medication-related hormone changes, including those induced by hormone replacement therapy.

Noncyclic breast pain is more likely than cyclic to be related to a breast or chest wall lesion. It can be caused by large pendulous breasts, breast cysts, ductal ectasia, mastitis, or inflammatory breast cancer, among other causes.

Symptoms include:

General soreness, tightening of the breast, or burning sensation
Pain can be either sporadic or consistent
Pain will often be in a particular area of the breast

Up to one-third of people taking postmenopausal hormone therapy may experience some degree of noncyclic breast pain.

Fibrocystic Breast Changes

Fibrocystic breast changes refer to a noncancerous condition that is characterized by breast fibrosis and cysts, which cause tender lumps or bumps in one or both breasts.

Fibrocystic breasts are most common between the ages of 20 and 50. However, if you’re postmenopausal, you may experience fibrocystic breast changes due to hormone therapy.

The primary symptom of fibrocystic breast tissue is its lumpy, rope-like texture. You may also have:

Generalized pain
Swelling
Round or oval-shape cysts filled with fluid
Fibrous tissue that resembles scar tissue
Enlarged breast lobules (adenosis)

Typically, lumps aren’t attached to surrounding tissue but will move slightly when manipulated.

Mammary Duct Ectasia

Mammary duct ectasia is a benign breast condition that causes milk ducts to widen and thicken. It’s more common in those who are getting close to menopause, but it can happen after menopause, too.

It frequently causes tenderness in the nipple and areola.

Mammary duct ectasia often causes no symptoms and is found when a biopsy is done for another breast problem. When symptoms do occur, they can be quite alarming, as some mimic the symptoms of breast cancer:

A small lump just under the nipple
Tenderness/irritation of the nipple and areola
Pink or red color to the nipple and areola
Thick nipple discharge that is often sticky and dark green or black, though it may also be yellow, white, clear, or even bloody
Nipple retraction (nipple pulls inward)

Rare Symptoms

Sometimes pain occurs so close to your breast that it’s hard to tell if the pain is actually in your breast or beneath it. There could be several non-breast-related reasons behind your pain that must be considered:

Costochondritis: This is a potentially painful inflammation of the chest wall cartilage. If the cartilage near your sternum (breastbone) becomes inflamed, pain may be felt on the right or left side of the chest within the breast area.
Chest wall injury: If you’ve been lifting, exercising, or bending improperly, you may have developed a pulled muscle in your chest wall, or it may be brought on back pain—which may feel the same as a sharp, knife-like, or burning pain in your breast.
Muscle spasm: There are chest wall muscles below your breast that may spasm, causing pain that may last just a few seconds or several days. Pain from tense chest wall muscles can occur on either side.
Spine disease: Degenerative changes of the spine, such as cervical or thoracic disc disease, can sometimes cause breast pain—often reported as a burning sensation.
Fibromyalgia: This may also cause an aching, sore pain anywhere in your body, and chest pain is not uncommon. Fibromyalgia can affect muscles, joints, and connective tissues, creating generalized or focused pain.

Heart Attack Symptoms

What may be perceived as breast pain could be a sign of a heart attack. Potential symptoms of a heart attack that warrant immediate medical attention include:

Chest pain or pressure
Pain in your neck, jaw, or left arm
Shortness of breath
Sweating
Nausea
Lightheadedness or passing out
A feeling of impending doom

If you are experiencing potential symptoms of a heart attack, head straight to the emergency department of the closest hospital or call 911.

Risk Factors for Breast Pain

Your breast soreness may be related to menopause, or it could be a symptom of another condition. Your risk of having breast soreness is higher if you take certain medicines.

Some drugs with mastalgia as a side effect include:

Water pills (diuretics): Increase urination and used to treat kidney disease, heart disease, and high blood pressure
Hormone replacement therapies (HRT): Usually refers to a combination of the female hormones estrogen and/or progesterone
Digitalis: Prescribed for heart failure
Methyldopa: Used to treat high blood pressure
Selective serotonin reuptake inhibitors (SSRIs): Used to treat various mental health conditions (Note: breast pain from SSRIs is rare.)

Other risk factors for breast pain include:

Wearing a poorly fitting bra
Gaining weight or having large breasts

When to See a Doctor

It’s important to see your doctor for any new breast or nipple pain. While most cases of breast pain are easily managed, you would not want to delay a diagnosis of breast cancer or a serious non-breast-related cause like a heart condition.

It’s true that the risk for breast cancer increases with age and that most cases are diagnosed after age 50. But breast pain is rarely a symptom of cancer, particularly if it’s your only symptom.

Other warning signs of breast cancer may include:

Thickening or lump in your breast or under the arm
Pitting of the skin, giving it an orange peel look
Nipple discharge
Nipple retraction (turning inward)
Swelling, redness
Change in size or shape of your breast

Your doctor can help determine if your breast soreness is hormonal or if another condition might be causing your symptoms.

A Word From Verywell

Most breast pain isn’t a sign of a serious medical condition, and if your breast tenderness is due to a transition into menopause, it will likely go away once your periods stop.

If your pain doesn’t improve or you have other symptoms, take the time to seek medical help. Talking to your doctor may help you find out if your breast soreness is menopause-related or due to another condition.

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