Nipple and breast pain is one of the many possible symptoms of perimenopause, the time period leading up to the end of menstruation. “Lack of sleep, lack of energy, sore nipples, and mood swings,” one woman shared in a survey by ThisIsMenopause. Breast pain can be uncomfortable enough that activities like wearing a bra or exercising can be painful.

Here’s what to know about sore nipples and breast pain during perimenopause so you can feel better and ensure you’re taking care of your breast health.

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Hormonal Changes and Breast Pain

Breast pain and tenderness, as well as nipple soreness, are connected to hormonal changes. When you’re in perimenopause, the hormones estrogen and progesterone can fluctuate significantly. Eventually, they’ll decline, leading to the end of menstruation and menopause.

When levels of these hormones rise, your breast tissue can swell. This swelling may occur in the milk ducts and glands, which can lead to more fluid in the breast. Swelling can cause pain in your breasts and nipples.

If you have cysts or fibroadenomas (benign, solid tumors) in your breasts, your hormones can change their shape and size, as well as how sensitive they are. This can cause breast pain too.

While hormones usually cause breast pain, certain lifestyle factors might make it worse. If you drink a lot of alcohol and/or caffeine, consume salty foods, or smoke nicotine products, these can make inflammation in your breasts worse.

What Does Normal Breast Pain Feel Like?

Everyone’s experience varies. You might experience breast and nipple pain together or separately.

Your breasts and nipples might feel sore and achy. You may feel like your breasts are tender when they’re touched. Some people experience a feeling of tightness in or around their nipples and breasts. Stinging from deep inside the breast is also fairly common.

When To Talk to a Doctor About Breast Pain

There are a few signs that mean it’s time to talk to a healthcare provider about your breast pain. Make sure to see a medical professional if you have:

• Pain with a skin change, like a dimple, lump, or discharge — If pain comes along with a dimple in the skin of your breast, a lump in your breast, or unusual discharge from your nipple, get medical advice right away.
• Pain that interferes with routines — If your pain keeps you from daily activities and lasts more than a few days (around your period, if you’re still having them), even when you’re using self-care techniques, talk to a healthcare professional.
• Pain with signs of infection — Breasts that are red and warm and/or red streaks on the skin might be signs of infection and need medical attention.

If your pain feels like it’s under either or both breasts, it may actually be in your chest wall, the middle of your chest, or in your ribs. It’s easy to mistake this for breast pain. Anytime you’re not sure if you can pinpoint the location of your pain, talk to a doctor to figure out what’s going on.

Pain between your breasts may be caused by problems with the cartilage in your chest (costochondritis). If the pain feels like it’s under your breast, it may be heartburn or related to your lungs. Even if you think you know the cause of your pain, it’s important to consult a healthcare professional for an exam versus self-diagnosing.

Managing Breast Pain During Perimenopause

There are a number of things you can do to help relieve breast pain in perimenopause. Talk to your doctor about what might work best for you, then follow up with them if your breasts still hurt.

Hormone Therapy for Breast Pain

Menopause hormone therapy (also called hormone replacement therapy or HRT) helps relieve a lot of perimenopause symptoms, including breast pain.

Some find hormonal therapy makes their breast pain go away entirely. Others find that their breasts still hurt, but HRT makes the pain more predictable so they’re ready when it comes.

It’s important to note that hormone therapy can also cause breast pain. Pain caused by these hormones can last even after hormone levels have dropped and your menstrual cycle is gone. In these cases, switching medications or changing your dose may help alleviate the pain you’re experiencing. If you’re having a lot of breast pain and you think it might be connected to hormone therapy, talk to your doctor. They can help you figure out how to feel better.

Self-Care for Breast Pain

If you’re still dealing with breast pain even with hormonal therapy, you can’t use hormonal therapy, or you haven’t started it yet, there are ways to help manage breast and nipple pain. It may take some trial and error to figure out what works for your lifestyle and your body.

Find the Right Bra

Investing in a sports bra that fits you well will compress your breasts and help eliminate swelling. This can prevent pain even when your hormone levels rise. Make sure you get sized properly, by a bra professional, to find a bra that will have maximum effectiveness for you.

Manage Stress

Staying on top of stress can also help. Stress can affect your hormones, so managing it can help with your symptoms. You can figure out what works for you, but many people use breathing exercises, yoga, or meditation to manage stress.

Avoid Foods and Substances That Cause Swelling

Watching what you eat and drink can also help limit swelling. Avoiding the foods and beverages mentioned above (alcohol, caffeine, and salt) can help your breasts feel better. It may help to start doing this a few days before you expect to get your period, if your menstrual cycle is still predictable for you.

If you smoke nicotine products or use marijuana, cutting back on those could help too.

Get Active

Exercise may also help, though it tends to be better at preventing breast pain than at making it go away. Some people swear by swimming because the natural buoyancy of the water alleviates pressure on your chest.

Consider Over-the-Counter Pain Relievers

You may need pain medication to help with sore breasts or tender nipples. You can usually buy these over the counter, and your doctor can recommend particular medications. It’s important to remember that pain relievers won’t treat the cause of your breast pain. They can make you feel better, but they won’t affect your hormones.

Other short-term options that may help with your breast pain include anti-inflammatory creams, which you may need to get from your doctor.

Try Heat or Ice

Heating pads or ice packs are tried-and-true ways of treating soreness, body aches, and cramps. Using heat and ice on your breasts can also help reduce pain and lower inflammation.

Talk to Your Doctor About Natural Remedies

Some people find that natural remedies help their breast pain. However, natural remedies don’t have much scientific evidence behind them. If you want to try them, talk to your doctor to make sure you’re doing so in a way that’s safe for you. Possible natural remedies include acupuncture, flaxseed, soy, vitamin E, evening primrose oil, and B vitamins.