From Perky to Painful- Tender Breasts During Perimenopause and Menopause

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About one-third of women experiences tender breasts in early perimenopause.

It’s ironic, isn’t it? From our “tender” preteen days, most of us couldn’t wait until that first sign of womanhood. We couldn’t wait to buy — and wear — our first training bra. Now if only we could train our breasts to not be so sore all the time!

Of course, you’ve got to be careful what you wish for. My daughter, Sarah, was a late bloomer and prayed for boobs. They didn’t appear on the scene until she was about 18 or so. Fast forward 16 years, Sarah writes a wonderful blog called, smilescurlsandbaby – lessons, joys, and laughs in baby making and life!  She found pregnancy took her breasts to a whole new letter, “Ain’t Nothin’ But a G-Thang….Baby….”!

Pregnancy is not the only life cycle phase that can affect intimacy. During perimenopause, sore breasts can cause marital intimacy to suffer as well. “My breasts are off-limits to my husband when I’m mid-cycle,” said one perimenopausal friend. “He can’t even look at them without getting the ‘evil eye’ from me! My breasts are so painful that sometimes I can’t even bear to have the shower head pointed toward them.”

Another woman told me there’s no way she can sleep on her stomach. And mammograms are out of the question. She suggested that clinics make accommodations for women who suffer from painful breasts. She said she’d probably pass out if she had to undergo a mammogram when her breasts are tender. Since her periods (and thus her sore breasts) are unpredictable, she wishes a few appointment slots could be kept open each month. That way, women like her could make last-minute appointments when their breasts are not tender.

Can you relate? Are you yearning to go back in time to the ’60s, when bra-burning was popular? Throughout our lives, MC Hammer’s “Can’t Touch This” appears to be a recurring theme. It’s important to note that breast tenderness is manageable and is unlikely to indicate a serious problem.

As your period nears, extra fluid in your breasts can make them feel more tender, lumpy, or swollen than other times of the month. Without a normal cycle to count on, it becomes pretty much impossible for perimenopausal women to know when those breasts are going to start throbbing, according to the National Cancer Institute.

Your hormone levels change in perimenopause. This can make your breasts feel tender, even when you are not having your menstrual period. Your breasts may also feel lumpier than they did before.

According to Mayo Clinic, breast pain may be associated with certain medications such as antidepressants – including selective serotonin reuptake inhibitors (SSRI) antidepressants.  The National Breast Cancer Foundation, Inc. lists the following medications as possible culprits for painful breasts: Digitalis preparations, Methyldopa (Aldomet), Spironolactone (Aldactone), Certain diuretics, Anadrol, and Chlorpromazine.

If you’re taking hormones (such as menopausal hormone therapy, birth control pills, or injections), your breasts may become denser.

To add insult to injury (literally), without regular estrogen supply, breast tissue can become dehydrated, inelastic, shrink, and lose its shape, according to Johns Hopkins Medicine. This has nothing to do with the size of your breasts and everything to do with hormones. Goodbye, perky, hello sagging!

Come perimenopause and menopause time, those hormonal ebbs and flows can become a veritable rollercoaster ride. Some post-menopausal women also experience breast discomfort.  Following are several treatment options to consider:

Progesterone Treatments

Even as your estrogen levels take a nosedive toward menopause, they can periodically increase during perimenopause. Dr. Jerilynn C. Prior, an authority on menstrual cycles and the effects of hormones on women’s health, notes that during perimenopause we often hear about estrogen levels being low, but it is important to note that estrogen levels can be high and out of balance with progesterone, as well.

Progesterone treatments can keep estrogen peaks from over-stimulating the breasts and causing discomfort, according to Dr. Prior. If you’re still menstruating (even haphazardly), progesterone treatment is typically prescribed for use during only a certain portion of the cycle, usually for about six months.

Hormone Replacement Therapy (HRT)

Natural progesterone can also help alleviate breast soreness. Natural progesterone, identical to the hormone the body produces, is often easier to tolerate.

A word of warning: If you are on hormone replacement therapy and suddenly experience breast tenderness be sure to go back to your menopause specialist and have your HRT tweaked a bit. It is possible that you are on too much estrogen.


Not into meds? Try primrose oil. According to the American Academy of Family Physicians (AAFP), primrose oil is rich in omega-3 fatty acids, which can reduce the inflammation associated with breast swelling and tenderness. Just follow the directions listed on the back of the bottle. Vitamin B and E supplements can also help reduce breast inflammation — and pain. Definitely consult with your physician before taking any supplements.

It’s important to know that breast tenderness/pain is a common symptom of perimenopause and menopause, and unlikely to signal anything more serious, such as breast cancer. However, you know your body best. If you suspect that something is not right with your breasts, make an appointment with your doctor.

Suffering in silence is OUT! Reaching out is IN!

Click here to download my free eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide To Surviving and Thriving During Perimenopause and Menopause.


After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • I didn’t realize this. I guess I’ve been super-lucky.

    • Ellen Dolgen


  • I’m with Carol, I also didn’t realize this but it’s good information in case it starts to happen.

    • Ellen Dolgen

      Every women is different – you may be one of the lucky ones and skip this symptom all together!

  • There’s one good thing about menopause…eventually it’s over!

    • Ellen Dolgen


  • Glad this has not been one of my symptoms!

    • Ellen Dolgen

      Every women is different. Glad you skipped that one, Lois!

  • I remember the days of breast pain right because menstruation. I do not miss that! Ah, another positive thing about post-menopause!

    • Ellen Dolgen

      I had breast tenderness pre-period each month. Not fun :<(

  • The only time I felt breast pain was when I was pregnant. If I felt that now it would be quite a shock! I am glad menopause is over!

    • Ellen Dolgen

      There is no one-size-fits-all journey. It is nice when you are post menopause and your symptoms subside!

  • Wow! I never knew how bad this was. I guess I am a lucky one never to have dealt with any of this in my lifetime.

    • Ellen Dolgen

      Everyone is different…..some people breeze through…some have a harder time.

  • Leave it to those changing hormones…they’ll get you every time.

    • Ellen Dolgen

      Totally! My daughter just had her first baby – 11 days ago. She is now experiencing night sweats, her hormones will settle down soon. We had a few laughs over it….she now gets the perimenopause/menonpause hormone roller coaster!!!

  • Where were you when I was in my mid-40’s and thinking I was absolutely crazy?? Another great, informative, important piece, Ellen.

    • Ellen Dolgen

      I wish I knew what I know now, too, Ruth! Let’s work together to educate the younger sisterhood so that they are more prepared than we were!!!

  • Oh nice, just one more piece of me to fall into disrepair with menopause.. I don’t have much breast tissue, never have, I lift weights and use my pectoral muscles to keep things perky.. Thankfully menopause don’t impact my pecs..

    • Ellen Dolgen

      No worries…. every women is different. I just like to be sure women are prepared for perimenopause and menopause so that they can get the help they need and deserve. No one told me a thing about it….so when I first started having brain fog (that was my first symptom) I thought I was in the early stage of Alzheimers. This added unnecessary stress. Also, since I had no idea brain fog was one of the over 30 symptoms of perimenopause and menopause – so naturally I did not reach out to my Gyno first! Had known this was a symptom of menopause it would have saved me three years of a nightmare!

  • nursissistic

    i went through the ” tender breasts” phase before my periods, during PMS, during/after pregnancy,. and during the early part of my personal menopausal jeremiad. (now i just have hot flashes, which are so intense i need HRT.) your information is great news-and-use. if nothing else, i’ll be able to pass it along to my daughters. i love your website. thank you.

    • Ellen Dolgen

      Thanks for sharing your experiences with us. I am so happy that you found the support you needed with your hot flashes. I am on bioidentical HRT – it changed my life! I had tremendous brain fog, sleeplessness, hot flashes and a dry vagina! Now as I approach my 61st birthday, I am very happy that I started on HRT early in my menopause journey. I am thrilled you are going to educate your daughters…..we need to make sure the next generation is not blind-sided by perimenopause and menopause. They might get a kick out of the music video I commissioned on the topic. It premiered on the KATIE Show and recently on TODAY Kathie Lee & Hoda….

  • happy

    Oh thank you for this information. I really was having a hard time understanding what was going on with all this breast tenderness…. no let’s call it what it is Pain! I think I’ve found it through you blog…. It is Progesterone!

    • Ellen Dolgen

      So happy to hear the blog was helpful. If you have any further questions, you can always email at

  • carrie

    Has anyone considered reduction or removal? {with replacement of saline implants of course} The reason i ask this is it would serve several purposes, one being to stop the pain. second would be to decrease your chances of breast cancer down the road, and lastly you would have “perky” breasts for the remainder of your life!
    I can’t see the downside in this, and if Angelina Jolie did it, maybe this is something to be considered for those of us who’s pain isn’t tolerable.
    Beside the back aches, the neck aches, and the sagging drooping mess they’ve become.
    Thanks for column!!

    • Ellen Dolgen

      Carrie, that would be a very radical and aggressive response to painful breasts.

  • Mallory Deckard

    I’m only 32 and experiencing severe painful breasts. Is this normal?? I went thru temporary menopause a few yrs ago after intense chemotherapy and radiation at 27 yrs Old. Then miraculously conceived my youngest child, doc was shocked bc they dais i would never be able to get pregnant. Afterwards i had my regular cycle every month. Recently found out i was anemic, my hemoglobin, potassium abs magnesium were critically low. Not sure if that happens to cause my hormones to fluctuate. So my question is, is this normal for me to be this young experiencing all these things. night sweats and so severe breast tenderness and pain! ?

    • Ellen Dolgen

      Mallory, I am so sorry you are going through so much. I would recommend finding a good menopause specialist to help guide you through your symptoms. I have some great tips on how to find a menopause specialist in this Dear Ellen. You might want to read my Menopause Mondays Blog titled, Breast Cancer and Menopause. I interviewed two wonderful doctors at the Yale Cancer Center. They mention that for hot flashes for their cancer patients they often recommend, Remifemin (estrogen-free black cohosh). You might want to speak to your healthcare professional about that product for hot flashes. For your breast pain issues, definitely circle back with your doctor. Good Luck! Keep me posted!

  • Laura

    Thank you for the information. I am 51.. Have struggled with large breast all my life. Triple D, then after the baby years F and G. I never take my bra off as it hurts so badly I even try to hold them with one arm while showering or else just give up and shower in bra. The only relief seems to be living in my bra 24/7. Intimacy ha! I won’t even consider a mammogram. Exercise which I love is very difficult. This serious pain just started within the last 2 months. I have suffered in silence but will not any longer. The info of more dense breast tissue and swollen is exactly what I have and at least I have some sort of explanation.

    • Ellen Dolgen

      Laura, I am so sorry that you have had to struggle with large breasts. This can be very difficult for a woman. If you are having unusual pain, I would definitely talk to your healthcare professional about this. I understand that you are concerned about having a mammogram due to the pain issue, however, there are other ways to do breast screening such as an ultra sound or MRI. Speak to your provider about this as well. Some women say that cutting back on caffeine, wine and chocolate can help sore breasts. I would eliminate one at a time and see if it helps. In the meantime, make that doctor appointment!

  • Kristen

    Thank you for this information. I can sense your compassion and it is both comforting and reassuring. I am typically quite resourceful, but have been struggling to find any conclusive answers regarding why my breasts exploded from a 34D to a 34F overnight. I am seeing a hormone doctor/MD who is very reputable. He shared with me that most women stop producing Testosterone by the age of 40, which is the hormone responsible for our sex drive, burning fat, etc. We also discussed that I was estrogen dominant, which in my case actually meant I wasn’t producing enough progesterone (sister hormone to estrogen). Blood work confirmed his suspicions that my count was very low for testosterone and progesterone. He prescribed a cream that is produced in a compound pharmacy, as I wasn’t comfortable taking synthetic steroids, and opted for the Bioidentical Hormone Replacement Therapy. I am not one of those people who is anti-pharmaceuticals……..I just didn’t feel comfortable taking synthetic hormones for various reasons. Most of the perimenopausal symptoms I was experiencing at age 44 subsided and/or completed disappeared upon nightly use of plant based hormone cream (hair loss, poor complexion, foggy brain,) however neither my hormone doctor nor my Gyno can explain the very large increase in breast size (that didn’t go down in size event though my hormone levels have been stabilized). I have been experiencing severe back pain and now have a bulging disc that I can’t help but believe is attributed to having the equivalent of two 5 pound weights attached to my chest 24/7. I would absolutely get a reduction if my insurance would pay for it, but since I have implants it isn’t looking that way (even though I didn’t get implants to have a larger chest…….simply to fill out the void that was left after breastfeeding my children.)

    Sigh………I know there are worse conditions in the world, but I sure wish I could solve the mystery of how to minimize my breast size. I even lost most of the additional weight I gained in a few brief months, but did not lost any size in my chest.

    • Did your breast size increase after you started taking the bioidentical hormones? Many women find that this means they are on too much estrogen replacement. They back down a bit and it helps. I would speak to your menopause specialist about that.