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Swelling of the mammary glands
Last reviewed: 04.07.2025
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Swelling of the mammary glands, that is, an increase in the volume of their cells or stroma, has both a physiological nature and a pathological etiology.
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Causes breast swelling
All physiological processes that occur in the breasts are caused by the synthesis of hormones such as estrogens, progesterone, prolactin, a luteotropic hormone synthesized by the pituitary gland, as well as other steroid hormones produced by the hypothalamus, thyroid gland, and adrenal cortex.
But if the swelling of the mammary gland is not associated with the natural metabolism of hormones, the second option remains - pathology. And there are many versions of its development: from excess (or deficiency) of cholesterol, which is the "raw material" for the biosynthesis of steroid hormones in the corresponding glands, to disruptions in the functioning of these glands or a deficiency of special enzymes necessary for steroidogenesis.
The main reasons for breast swelling, primarily in women, are due to changes in the level of sex hormones.
Thus, swelling of the mammary glands before menstruation, which is observed in most women, is caused by increased synthesis and release of estrogens into the blood - estradiol, estriol and estrone, as well as progesterone, which are produced by the ovaries and the adrenal cortex. Progesterone increases the volume of glandular cells in the mammary gland, and thanks to estradiol, the formation of connective tissues of the breast and an increase in the number of milk ducts occurs. Therefore, swelling and soreness of the breasts are observed before the onset of menstruation.
But swelling of the mammary glands after menstruation is most often a sign of mastopathy - fibrous, cystic, fibrocystic, focal or diffuse. Pain and swelling of the mammary glands in these benign neoplasms occur due to the proliferation of fibrous (connective) tissue of the breast, the epithelium of its ducts or alveoli, as well as the appearance of nodular or stringy formations. Increased sensitivity and hyperemia of the skin on the chest, as well as discharge from the nipples may be noted.
For example, in non-pregnant women, against the background of menstrual irregularities, swelling of the mammary glands may even be accompanied by milk secretion. This is the so-called hyperprolactinemia - increased synthesis of the hormone prolactin, the cause of which lies in the presence of a tumor (adenoma) of the pituitary gland. However, clinical practice shows that this pathology may be a consequence of an ovarian cyst, liver cirrhosis, hypothyroidism or a brain tumor.
Where does it hurt?
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Pregnancy and menopause
Swelling of the mammary glands during pregnancy occurs for natural reasons. In terms of the way we feed our offspring, humans are mammals, and the purpose of breasts laid down by nature is to feed children until they are able to eat other food.
Therefore, this sign during pregnancy - an increase in glandular tissue that will produce milk, the development of alveoli and excretory ducts - is preparation for the upcoming breastfeeding of the child. In addition to estradiol and progesterone, estriol, prolactin and a special hormone synthesized by the surface layer of the trophoblast of the human embryo - placental lactogen - participate in this process.
Women who have passed the childbearing age may experience swelling of the mammary glands during menopause, which is associated with an increase in the volume of fatty and partly fibrous tissue, which, as a rule, displaces the glandular tissue. It also occurs against the background of changes in the functioning of the hormonal system, and cardinal ones at that.
The dominant physiological and biochemical component of hormonal processes during menopause is a decrease in ovarian activity, a sharp reduction in estrogen synthesis by follicular cells, and a complete cessation of estradiol production. This period is characterized by significant changes in lipid metabolism and an increase in total cholesterol levels.
In addition, menopause does not exclude mastopathy, in which the breasts increase in size. Despite a significant decrease in the production of estrogens by the ovaries, adipose tissue is able to deposit estrogens, which are synthesized from testosterone during menopause (it continues to be produced by the adrenal cortex, although in much smaller quantities). These estrogens destabilize the hormonal background, leading to various pathological processes in the breasts.
Swelling of the mammary glands in a child and adolescent
Swelling of the mammary glands in a child occurs mainly for physiological reasons. For example, in newborns (in the first month of life) - the result of the fact that maternal estrogen and progesterone enter the placenta and end up in the fetus's blood, and after birth - in the child's blood.
This phenomenon is defined by pediatricians as a “hormonal crisis of newborns,” which occurs on average in eight out of ten infants, of both sexes.
After a couple of weeks, swelling of the mammary glands in newborns (often with discharge from the nipple) passes naturally. But if an enlargement is detected that does not affect the nipple area, and the baby's body temperature rises, then inflammation is evident - infant mastitis, which can develop into purulent. And then antibiotics will be needed.
Swelling of the mammary glands in girls, which begins after they reach eight or nine years of age, is an absolutely normal process associated with the onset of puberty. During this period, the body begins producing estrogens, in particular, estrone, which is responsible for the formation of secondary sexual characteristics. Their growth occurs gradually and continues throughout the entire puberty period.
If this symptom begins at an earlier age in girls, then doctors state the fact of premature puberty, and in most cases in the complete absence of other signs of the onset of puberty. The child should be shown to an endocrinologist, since everything indicates a hormonal pathology that may be associated with the pituitary gland, hypothalamus, adrenal glands or thyroid gland.
It should be noted that significant swelling of the mammary glands in adolescents (both girls and boys) is possible due to obesity, when fat deposits are concentrated in the chest and shoulder girdle.
By the way, this symptom in boys can be observed precisely in adolescence and is also caused by the onset of puberty. According to medical terminology, this is juvenile gynecomastia, the cause of which is a violation of steroidogenesis in the direction of female sex hormones.
Swelling of the mammary glands in adolescent boys looks like a slight increase in the pigmented area around the nipples (2-5 cm in diameter) with their increased sensitivity. As they grow older, hormone production normalizes and gynecomastia goes away. But if the enlargement does not go away within about one and a half to two years, then the boy may have problems with the thyroid gland, liver or testicles. What exactly - a pediatric endocrinologist should determine.
Swelling of the mammary glands in men
Gynecomastia - the growth of glandular tissue in the mammary glands - is also the result of hormonal imbalances in the body. In particular, decreased testosterone production; insufficient androgen synthesis (hypogonadism); excess progesterone and estrogens in hypercorticism (hyperfunction of the adrenal cortex); excess production of somatotropic hormone by the pituitary gland; increased levels of thyroid hormones (hyperthyroidism), etc.
Experts associate these pathological deviations in the hormonal sphere with both genetically determined features of the endocrine system and with tumor formations of one of the hormone-producing organs - the testicles, adrenal glands or pituitary gland.
In addition, swelling of the mammary glands in men can occur as a result of liver cirrhosis in alcoholics, as well as after long-term use of estrogen-containing hormonal drugs and some antidepressants.
Obesity plays a significant role in the development of this pathology, which can lead to so-called false gynecomastia or lipomastia – the growth of fatty tissue in the mammary gland in parallel with the growth of subcutaneous fat deposits in various areas of the body.
Diagnostics breast swelling
Diagnostics uses a set of methods that allow us to establish the true cause of the pathology. Among them:
- physical examination with palpation of the chest;
- breast x-ray (mammography);
- ultrasound examination (US) of the breast, thyroid gland, adrenal glands, pelvic organs;
- laboratory blood tests for hormone levels (estradiol, prolactin, testosterone, luteotropin, thyrotropin, adrenocorticotropin, etc.);
- enzyme immunoassay of blood;
- urine test (for urea, nitrogen, creatinine, liver transaminases);
- CT or MRI of the adrenal glands, as well as the brain.
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Treatment breast swelling
Treatment depends on the causes of the development of this pathology, but most often these are drugs containing hormones or their synthetic analogues.
Thus, the progesterone-based hormonal drug Progestogel (for external use) is prescribed for women who complain of severe swelling and soreness of the mammary glands before menstruation.
In order to normalize prolactin levels - in case of hyperprolactinemia, Parlodel (Bromocriptine) is used: 1.25-2.5 mg three times a day (after meals).
In case of diffuse forms of mastopathy, the drug with antiestrogenic action Tamoxifen (Toremifene) is quite effective - 20 mg per day. But it should be borne in mind that this drug is contraindicated in the presence of endometriosis and liver dysfunction in a woman.
For treatment of menopause, the drug-inhibitor of estrogens synthesis in adipose tissues Femara is often recommended (taken 1 tablet per day). But this drug gives side effects in the form of headaches and joint pain, nausea and general weakness.
Treatment of hypogonadism (androgen deficiency) in men is carried out with antiestrogenic drugs such as Clomiphene, Clomid or Serophene (orally 50 mg 1-2 times a day).
In cases where hormonal therapy in men has been ineffective, mastectomy is possible - surgical removal of the gland, and in the case of false gynecomastia - liposuction.
Treatment of breast swelling in children - with premature development in girls, as well as with juvenile gynecomastia in boys - has not been developed by clinical endocrinology. It is only necessary to be observed by a doctor and undergo a full examination at least once a year.
However, when the swelling of the mammary glands in boys reaches significant sizes and does not tend to resolve, doctors prescribe the application of a tight bandage to the chest and the use of hormonal drugs to reduce the production of sex hormones. One of the drugs in this group is Danoval (in capsules); the recommended daily dose is 100 and 200 mg, divided into three doses.
Prevention
Unfortunately, prevention of breast swelling is practically impossible, since the specific synthesis of any hormones, including sex hormones, is embedded in the individual genetic code of each person.
However, medical science claims (and practicing doctors do not deny this) that it is quite possible to try to prevent some failures in the hormonal system if you eat right and have a sufficient level of physical activity. For example, men who play sports have normal carbohydrate metabolism and the level of the main male hormone testosterone.
It is not worth creating an additional threat to normal hormonal metabolism by abusing products that contain a lot of phytoestrogens - plant non-steroidal compounds that are similar in structure and effect to human hormones. Such products include all legumes (especially soy), corn and wheat, sunflower and flax seeds, broccoli, asparagus and spinach, potatoes and carrots, dates and pomegranate, parsley and basil, hazelnuts, hard rennet cheeses, dark grapes and red wine, as well as beer produced using hops... In addition to hops, medicinal plants rich in phytoestrogens include ginseng, red clover, angelica, valerian, motherwort, sage, lemon balm, licorice, St. John's wort, geranium, rosemary.
It should be remembered that swelling of the mammary glands, which is not connected with physiologically determined processes in the body and does not correspond to gender characteristics or age norms, is a pathology.
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Forecast
The prognosis is generally positive, but the human hormonal system is very vulnerable, so no one can guarantee that the occurrence of any complications (especially with mastopathy) and more serious diseases is excluded.