Ask a doctor on the topic of Gynecology

Swollen and tender breasts after period

July 27, 2011 | 10,00 EUR | answered by Dr. med. Ralf Berg

Hello,

I am so desperate that I am asking here for help. Just to clarify: I have a gynecologist appointment at the end of August. I couldn't go earlier because I am going on vacation. Some background information: I am not taking any birth control pills, my cycle is between 28-36 days (somewhat irregular), I have severe PMS symptoms (breast pain, headaches, nausea, water retention, intestinal cramps, bad skin), I am definitely not pregnant, and my thyroid is completely fine (I recently had it checked). During my period, I also suffer from very severe abdominal pain (worst on the first day, then it subsides). I mentioned the possibility of endometriosis, but since I had a check-up in March with no findings (the doctor said endometriosis usually presents with cysts, so-called "chocolate cysts," and everything looks fine with me) and as long as I am not looking to conceive (I am 25 years old), she will not perform a laparoscopy without a valid reason, as every girl seems to have some sort of abdominal pain, and this procedure carries certain risks.

Now, the problem. For about 2 months, I have been experiencing stronger PMS symptoms during my period. I went to the gynecologist who prescribed me birth control pills. It was a medium dose (Valette or Maxim). I took them on the first day of my period at 8:00 pm and felt intense nausea and vomiting 4-5 hours later. I believe (and this is just layman knowledge) that I did not tolerate them well. Or maybe I specifically do not tolerate estrogen? I did not continue taking them, the issue is resolved. (I was against taking the pill anyway, and would have only taken it for my PMS symptoms).

After that, my period continued as usual, just longer. 7 days instead of 4. Very concerning (related to taking the pill once?? My boyfriend, who is also a doctor, thinks it is possible that I messed up my hormone balance). Now, onto the main problem: I got the breast swelling and pain before my period (as usual), during it (also normal), and now a week after my period, I still have very strong breast swelling, sensitivity to touch, and pain. Not the nipples, but everything around them. Visually, no redness, no warmth. You can just tell that the glands are swollen. My breasts are regularly examined by the gynecologist and no abnormalities were found until now.

My question: How unusual are these prolonged swellings? I am very worried. I don't fit into my bras (and I already have enough bust size), I am going on vacation, and that naturally annoys and psychologically burdens me. When walking, even if the bus jolts a bit, you can feel it :/ I really have no desire for

Dr. med. Ralf Berg

Dear patient,

You are indeed already doing a lot, and you have already ruled out quite a few of the possible causes. Perhaps you have noticed during your research on the Internet that you are not alone and that many younger women are struggling with these PMS complaints. In this context, I would also classify your current breast pain. Apparently, you react very strongly to hormone changes in general and especially after describing your symptoms, to estrogen.

I believe that a hormone check will not help you further. One can expect that your levels will be at the upper end of the normal range, and your body will accordingly feel this.

So, what can I advise you:
1. In a practical sense (even if you may have already implemented this yourself), try to support your breasts, for example with a sports bra that reduces movement.

2. I would advise you to take phytohormones (e.g. Cimicifuga, Agnus castus) instead of synthetic hormones. If you have already tried all of this, homeopathic remedies can sometimes achieve significant improvements that cannot be achieved with conventional medication.

3. Even though it may be a small consolation, these complaints fortunately decrease with age. Also, after pregnancy, most women seem to have less intense reactions to hormones.

4. I believe that, apart from the recommendations under point 2, there is not much more you can do. In no case would I advise you to cancel your vacation, because I sense between the lines that you are under a lot of pressure not only because of the PMS complaints. Even if the discomfort cannot be eliminated, it is easier to bear in a generally relaxed situation.

I regret that I cannot offer you a miracle therapy, but I can assure you that your complaints are common and in a narrower sense not medically "pathological," but rather an expression of pronounced female fertility, which corresponds to your age.

Yours sincerely,
Dr. R. Berg