What causes sore breasts during menopause, and what can help?

Having sore or painful breasts – known medically as mastalgia – is a common symptom of the menopause transition. It's more prevalent during perimenopause when hormone levels are in a state of flux, but you may also experience breast pain after menopause when low oestrogen can cause changes to the composition of your breasts.

The sensations of menopausal breast pain can range from soreness to shooting pains – but it’s important to be aware that these symptoms are rarely a sign of a more serious condition and that having breast pain does not increase your risk of developing breast cancer.

Below, we’ll look in more detail at the links between perimenopause, menopause and sore breasts, and consider some approaches that may help to manage the discomfort.

Sore breasts during perimenopause

Perimenopause is the name for the years leading up to menopause when your levels of reproductive hormones like oestrogen and progesterone can fluctuate wildly.

Sore breasts are a common symptom of perimenopause. Studies have found that almost 40% of women report breast tenderness around this time and that it becomes less common the closer they get to menopause, when periods stop and hormone levels start to stabilise.

Even before you enter perimenopause, there’s a good chance you’ve experienced sore breasts as a premenstrual symptom. This is known medically as cyclical breast mastalgia. Ahead of your period, surging hormone levels can lead to changes to your breast tissue, making your breasts fuller and heavier and causing tenderness.

During perimenopause, hormones levels fluctuate even more, meaning your periods can become erratic and symptoms like cyclical breast pain can be worse or last longer.

Using hormonal contraceptive medication could add to this. It’s also worth being aware that sore or swollen breasts along with a missed period can be an early sign of pregnancy.

Sore breasts after menopause

Breast pain caused by hormone changes tends to get better as you approach menopause and in many cases will be gone by the time your periods stop. However, some women still have sore breasts after menopause.

If you’ve recently started hormone replacement therapy (HRT), the change in hormone levels could be contributing to your breast pain. This should get better within a few weeks as your levels stabilise. If not, talk to your doctor who may suggest trying a different form of HRT.

Sore breasts after menopause can also be linked to the physical effects of natural hormone changes.

Weight gain is common at this time of life, while an increase in the ratio of testosterone to oestrogen, due to lower oestrogen levels, changes the way fat is distributed around your body, with less on your hips and thighs and more around your torso and breasts.

Around 1 in 5 women find their breasts get larger after menopause. Having larger, heavier breasts can cause breast tissue to stretch, leading to pain.

What does menopausal breast pain feel like?

Soreness or tenderness are common examples of menopausal breast pain but the sensations can vary from woman to woman, and may differ depending on where you are in the menopause transition.

Menopausal breast pain and discomfort can include:

• soreness
• aching
• tenderness
• pricking
• shooting or stabbing pains

Pain can affect one or both breasts, can extend into your armpit area, and may be accompanied by your breasts feeling swollen or heavy.

Treatments and remedies

If you’re experiencing menopause breast pain, there are some things you can try that could help.

A better bra

Hormonal changes during the menopause transition can cause your breasts to get larger or change shape, so if you have breast pain it could be that you need a bigger or better fitting bra.

Make sure your bras fit comfortably and provide the right level of support. If you’re not sure, a professional bra-fitting service can help.

If you breasts get sore at night, try wearing a soft bra in bed for added support.

Medication

Over-the-counter painkillers like paracetamol or ibuprofen can help with sore breasts. They also comes as gels that you can rub into your breasts to treat the pain more directly.

If you’re experiencing severe pain and other treatments aren’t helping, your doctor may prescribe a drug called Tamoxifen that blocks the effects of oestrogen and is also used to treat breast cancer. It can have significant side effects so is only likely to be used in more extreme cases of mastalgia.

Herbal remedies

If you’re looking for a herbal remedy for hormonal breast pain, the following could be worth trying – although there’s more support for some than others.

• Chasteberry: There’s good evidence that this herb – also known as vitex agnus-castus – can help with cyclical breast pain. The NHS suggests trying a dose of 4 milligrams (mg) per day for two to three months. But do look out for possible side-effects, which can include changes to your period.
• Flaxseed: The NHS says adding around 25–30 grams (g) of flax seeds to your meals each day could help to improve cyclical mastalgia, as well as your overall health. Sprinkle them on yoghurt, oats and salads or use in baking.
• Evening primrose oil: While there are some small studies suggesting this supplement might help with breast pain, the NHS says the evidence is very limited. If you take blood thinning medication or have an increased risk of bleeding, talk to your doctor before taking evening primrose oil.

Probiotics for menopause symptoms

Probiotics are friendly bacteria that can help maintain the balance and health of your gut microbiome. That includes your estrobolome, the part of your gut microbiome responsible for processing and recirculating oestrogen around your body.

The strains of probiotic bacteria in Better Gut have been chosen specially to support women during perimenopause and after menopause.

They can provide a range of benefits, including:

• less bloating
• improved gut function
• healthier sleep
• better vaginal health
• more energy
• reduced hot flushes

When to see a doctor

Breast pain alone is generally not a symptom of anything more serious, but you should see a doctor if:

• your pain doesn’t improve
• painkillers aren’t helping
• you also have a high temperature or feel hot or shivery
• any area of your breast is red, hot or swollen
• there’s a hard lump in your breast that doesn’t move
• your breast has changed shape
• you have a family history of breast cancer
• the skin of your breast is dimpled like orange peel
• you get nipple discharge, which may be streaked with blood
• you have a rash around your nipple
• your nipple has sunk into your breast

Summary

Breast pain and discomfort are common during perimenopause, triggered or made worse by fluctuations in your hormone levels.

For most women, these symptoms will start to improve and eventually disappear as they head towards menopause and their periods stop.

If you’ve reached menopause and are experiencing breast pain, hormone changes could also be a factor, contributing to an increase in fat around your breasts and putting more strain on your breast tissue.

Help for managing breast pain during the menopause transition includes over-the-counter painkillers and gels, herbal remedies such as chasteberry and flaxseed, and making sure you have a comfortable, well-fitted bra.