Changes in mammary glands at menopause: pain, swelling, burning, thickening, tingling

The signs of the restructuring of the female body that occurs with the onset of menopause also include changes in the mammary glands during menopause. This is almost inevitable, since at the end of the reproductive period, the production of sex hormones in women naturally decreases.

However, it should be borne in mind that changes in the mammary glands during menopause can also be pathological.

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Causes of menopausal breast changes

The condition of the mammary glands is determined not only by sex steroids – estrogen, estradiol, progesterone and prolactin, but also by pituitary hormones – follicle-stimulating hormone (FSH), which influences estrogen synthesis, and lutropin (LH), which stimulates progesterone production. But estrogen and progesterone produced in the ovaries, which regulate and control the reproductive cycle of women, continue to play a key role during menopause.

And the main reasons for changes in the mammary glands during menopause are a sharp decrease in the level of estrogen, caused by the fading of ovarian function. This causes many symptoms associated with menopause, since the stimulating effect of this sex steroid on the metabolism of tissues of the entire body, including mammary gland tissue, is reduced.

The etiology of changes in the breast during menopause, which are physiologically normal, is explained by atrophy of the glandular tissue of the mammary glands and their secretory lobuloalveolar structures. During the natural process – involution of the mammary glands – fibrous-fatty transformation of tissues occurs: the volume of glandular tissue gradually decreases, and connective tissue capsules are filled with fatty tissue.

In addition, due to the decrease in estrogen, the connective tissues of the mammary gland stroma lose elasticity and become thicker, approaching the structure of denser fibrous tissue.

By the way, if you take hormones to relieve menopausal syndrome, your mammary glands may become denser: synthetic analogues of progesterone, like the endogenous hormone, promote the proliferation of mammary gland tissue cells. But this can result in serious problems and the development of pathology.

Pathological changes in the mammary glands during menopause are also associated with hormonal factors in most cases. Moreover, the pathogenesis of such changes is explained by constant fluctuations between estrogen and progesterone. The fact is that in response to a decrease in the level of estrogen (to help compensate for its deficiency), the adrenal glands begin to synthesize more androstenedione (a precursor of testosterone). It is transformed by the cells of adipose tissue into estrone, to which the estrogen receptors of the tissues of the mammary glands are sensitive. At the same time, progesterone continues to be produced by the adrenal cortex, and if it "outweighs", fluid retention occurs in the body and in the tissues of the mammary glands, causing mastodynia - discomfort, swelling of the mammary glands, a feeling of heaviness and even pain in the mammary glands during menopause.

And when the estrogen level is higher, the available progesterone is not enough to reduce the reaction of estrogen receptors in the tissues of the mammary glands. And then the processes of proliferation of connective tissue cells are activated, due to which fibromastopathy can develop during menopause.

Women of age quite often discover a lump in the mammary gland during menopause (and sometimes not just one) - a sign of fibrous changes in the mammary glands, for example, fibroadenoma. With the expansion of intralobular milk ducts, associated with fibrosis of their walls and the formation of cysts, fibrocystic mastopathy occurs.

Excessive growth of adipose tissue can lead to fatty hypertrophy of the mammary glands, and localized increased division of fat cells can lead to lipoma (a benign fatty tumor of the breast).

If minor pain in the breast at the beginning of menopause is temporary and, as noted by mammologists, goes away naturally, then more intense and prolonged pain, as well as swelling of the mammary glands with discharge from the nipple, should alert a woman, since the condition of the breast during menopause is unpredictable.

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Symptoms of menopausal breast changes

The first signs of involutional processes in the tissues of the mammary glands are manifested by a change in their size and some pain (which was already mentioned above). At the same time, breast enlargement in some women is associated with increased progesterone, which stimulates the formation of fatty tissue in the mammary glands. At the same time, any changes in the estrogen-progesterone ratio become a trigger for the so-called involutional fibrosis, in which fatty tissue in the breast is displaced by connective tissue.

In women with normal weight and progesterone levels close to normal, there is no accumulation of fatty tissue in the breasts to replace glandular tissue, and their mammary glands become smaller. But in both situations, the loss of glandular tissue eventually leads to a reduction in the mammary glands. And in combination with reduced elasticity of connective tissue, this is expressed in the fact that the glands lose their shape and sag.

Also noted are the following general symptoms of changes in the mammary glands during menopause:

• displacement of nipples from the center to the side;
• darkening of the areolas, on which hairs may appear;
• stripe atrophoderma of the skin and subcutaneous tissue of the breast (stretch marks);
• expansion of the space between the glands.

If fibromastopathy develops during menopause, pathological changes in the mammary glands are often detected by chance, especially if the formations are small. Among the symptoms of fibrous neoplasia, specialists note the same focal or diffuse compaction in the mammary gland during menopause and mastodynia; hyperemia of a separate area of skin or the appearance of a capillary network is possible, an increase in lymph nodes in the axillary region is possible.

Many pathological changes in the mammary glands of women during menopause can be considered as consequences of their involution, which had certain complications, for example, excessive accumulation of fatty tissue in the mammary glands. Of all the phases of mammary gland development, involution is considered the least studied and the most conducive to the manifestation of pathologies of the female reproductive system.

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Diagnostics of menopausal breast changes

Diagnosis of changes in the mammary glands during menopause begins with a medical examination: age-related changes in the breast are obvious to the doctor, but palpation is mandatory.

If the mammologist or gynecologist did not see or feel anything suspicious, then tests are not needed. But to confirm the absence of pathologies, an X-ray examination is carried out - mammography.

In case of a lump in the mammary gland during menopause or other clearly pathological symptoms, a blood test is taken (general and for hormones); instrumental diagnostics are used (X-ray, ultrasound, Doppler sonography, ductography, CT); a biopsy is prescribed (to determine the benignity of formations in the breast).

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Differential diagnosis

Differential diagnosis should distinguish physiological changes in the mammary glands during menopause from their spontaneous atrophy due to hyperandrogenism, polycystic ovary syndrome, after treatment of breast cancer with antiestrogens, as well as due to significant weight loss, for example, in eating disorders.

Treatment of menopausal breast changes

Natural age-related involution of the mammary glands is not a disease, therefore treatment of changes in the mammary glands during menopause is not provided.

And when a woman consults a doctor with this problem, she will be recommended to take vitamins A, C and E - as antioxidants that support normal metabolism. And to reduce the stretch marks that appear on the chest, you can try using stretch mark cream.

True, if breast changes cause a woman to feel discomfort, the question of surgical intervention may be considered, but this is not surgical treatment, but cosmetic mammoplasty, which corrects the shape of the mammary glands and the position of the nipples.

And medicines are used in the treatment of diseases. In particular, if fibromastopathy is diagnosed during menopause, Danazol, Diphereline, Letrozole (Femara) can be prescribed; homeopathy suggests Mastodinone or its analogue Cyclodinone.

More complete information on the treatment of the above-mentioned pathologies of the mammary glands (drugs, their method of administration and dosage, contraindications and side effects) is presented in the publications - Formations in the mammary gland, Fibroadenoma of the mammary gland, and Mastopathy during menopause

And folk treatment and herbal treatment are described in detail in the material - Treatment of mastopathy with folk remedies

Prevention

Prevention, that is, prevention of age-related changes occurring in the mammary glands due to natural aging, is not yet possible. Although there are creams with collagen or cocoa butter that help reduce the flabbiness of the skin of the chest, they are not able to slow down the process itself.

Mammologists consider regular self-examination, as well as visiting a doctor and undergoing mammography, to be the prevention of mammary gland pathologies.

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Forecast

As the famous song goes, “life cannot be turned back”... This applies to the prognosis of physiologically conditioned age-related changes in the mammary glands during menopause.

And pathological changes can develop in different ways and quite often - towards oncology. Therefore, the prognosis for fibromastopathy during menopause depends on many factors, including hereditary. According to European oncologists, women of menopausal age account for about half of all diagnosed cases of breast cancer.

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