Sore breasts in menopause and perimenopause: why it happens and when to get checked

Your breasts feel heavy, tender or bruised. A bra that was fine last month now feels too tight. It might be both breasts or just one, and it might come and go or seem to hang around for weeks.

Sore breasts in menopause and perimenopause are common, and usually not a sign of anything serious. The NHS lists hormone changes during the menopause as one of the causes of breast pain. It also says breast pain by itself is unlikely to be a symptom of cancer.

Still, it's natural to worry. So this page explains why it happens, what you can try, and the changes that do need a GP to look at them. Please read the box below first.

What does menopause breast pain feel like?

Breast Cancer Now describes breast pain as heaviness, tenderness, burning, prickling or stabbing, or a feeling of tightness. It can be:

• in both breasts or just one
• across the whole breast or in one area
• spreading into your armpit, down your arm or to your shoulder blade
• mild, or bad enough to make a hug or a seatbelt hurt

The Menopause Charity puts it simply: breasts "may feel tender, sore or sensitive to touch". If your nipples feel sore along with the rest of your breast, the same causes and self-help apply.

Why are my breasts sore in perimenopause?

Breast tissue reacts to hormones. Breast Cancer Now explains that changing hormone levels during your monthly cycle make breast tissue more sensitive, which can cause pain. It says around 2 out of 3 women get this kind of "cyclical" breast pain at some point.

In perimenopause, your hormone levels start to go up and down. Women's Health Concern says this is often when symptoms are most noticeable. The Menopause Charity says sore breasts are common around periods because breast tissue is sensitive to hormone swings, and that this can carry on into menopause.

So if your periods are becoming irregular, your breast pain may become less predictable too. Keeping a note of your pain alongside your periods can help you see a pattern.

Is breast pain after menopause normal?

Once your periods have stopped for good, pain linked to your cycle usually stops too, Breast Cancer Now says. But breast pain after menopause still happens, for a few reasons.

HRT. Breast pain or tenderness is a known side effect of both oestrogen and progestogen. The NHS says side effects often go away after a few weeks, and suggests sticking with HRT for at least 3 months if you can. See a GP if side effects are severe or last longer than that. They may suggest a different dose or type of HRT, or a different way of taking it. Breast Cancer Now adds that if pain starts or gets worse on HRT and doesn't settle after a short time, you should tell your GP. Please don't stop HRT without talking to them first.

Non-cyclical breast pain. This is pain that isn't linked to periods. It can happen before or after menopause. Breast Cancer Now says the cause is often unclear, but it can be linked to:

• a benign (not cancer) breast condition
• past breast surgery or an injury
• having larger breasts
• some medicines, such as certain antidepressants, and some herbal remedies, such as ginseng
• stress and anxiety

It says non-cyclical pain often gets better or goes away by itself over time, in about half of women who have it.

Pain from the chest wall. Sometimes pain feels as if it's in the breast but comes from the muscles or ribs underneath. A pulled muscle can do this. So can costochondritis, an inflammation where the ribs join the breastbone. The NHS says it can cause sharp pain at the front or side of your chest, often worse when you move, breathe deeply or press on it. It usually gets better on its own.

When to worry about breast pain after menopause

This is the question most women really want answered. Here's the honest picture.

Pain on its own is rarely the warning sign. The NHS says breast pain by itself is not usually a symptom of breast cancer. The warning signs of breast cancer can come with or without pain. What matters more is any change in how your breasts look or feel: a lump, a change in size or shape, dimpled skin, a change in skin colour, nipple discharge or a nipple that turns in.

But the risk of breast cancer does go up with age. The NHS lists being over 50 as a risk factor. That's why it matters to know what your breasts normally look and feel like, and to get anything new checked.

The NHS also says to see a GP if you have breast or armpit pain and close relatives have had breast or ovarian cancer.

Don't wait for your mammogram. In England, NHS breast screening invites women every 3 years from age 50 up to their 71st birthday. After that, you can still ask for a screen every 3 years. But if you notice a change, see your GP straight away, even if you had a screen recently.

Itchy breasts and nipples in menopause

Itchy skin is common after menopause. The NHS says it often gets better over time. Dry, irritated skin is often part of it, and moisturising can help. Our page on perimenopause itchy skin has more on why this happens.

There's one thing to know about itchy nipples, though. Paget's disease of the nipple is rare, but it is usually linked to breast cancer. It causes a red, scaly rash on the nipple that can be itchy, sore or burning, and it can look like eczema. The NHS says any change to the skin of the nipple or the darker area around it should be checked by a doctor. Itching with a normal-looking nipple is unlikely to be Paget's, but it's still worth having a doctor look.

What can help sore breasts: things to try

These ideas come from the NHS and Breast Cancer Now.

Get a bra that fits. Wear a supportive, well-fitting bra in the day, a sports bra for exercise, and a soft bra at night. If your bra no longer feels right, a fitting can be worth it.

Try a painkiller. Paracetamol or ibuprofen tablets can help, and so can an anti-inflammatory gel rubbed onto the sore area. Ask a pharmacist first, especially if you have asthma, stomach ulcers or kidney problems.

Look at caffeine and alcohol. Breast Cancer Now says a GP may suggest cutting down on both, and eating a low-fat diet with more fibre. It's honest that the evidence for diet changes is limited, but they're easy to try.

Keep a pain diary. Note each day how bad the pain is, and when your periods come if you still have them. Breast Cancer Now's booklet includes a simple chart. It will help you and your GP spot a pattern.

Be careful with supplements. The NHS says there's little evidence that vitamin E or evening primrose oil help breast pain. Talk to your GP or pharmacist before trying any supplement.

What your GP can do

Breast Cancer Now says your GP will:

• examine your breasts and ask about the type of pain and how often it comes
• possibly ask you to lean forward, to tell whether the pain is in the breast or the chest wall underneath
• possibly ask you to keep a pain chart

If the pain is linked to HRT or another medicine, they can talk through your options. If they're not sure what's causing it, or you have other breast changes, they may refer you to a breast clinic for a closer look. That's a normal next step for a closer look.

If the pain is severe and nothing else has helped, a specialist may talk to you about stronger hormone-blocking medicines. These have side effects, so Breast Cancer Now says they're only offered after a proper discussion of the benefits and risks.

When to see a GP about breast pain

Book an appointment if:

• you have any of the changes in the box at the top of this page
• the pain is new or different for you
• the pain isn't getting better, or painkillers aren't helping
• it's in one spot and doesn't go away
• it started or got worse on HRT and hasn't settled
• close relatives have had breast or ovarian cancer

Breast Cancer Now says ongoing breast pain can make you feel anxious or low. That's understandable, and it's a good reason to see your GP too. It also runs a free helpline, staffed by specialist nurses, on 0808 800 6000. Our symptoms checklist lets you note everything you've noticed and print it for your appointment.

Related

Breast pain often goes along with perimenopause period changes, perimenopause itchy skin and other skin changes in menopause. You can see them all in our list of perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms