{"id":7542,"date":"2026-04-07T02:51:38","date_gmt":"2026-04-07T02:51:38","guid":{"rendered":"https:\/\/www.healthoptibody.com\/?p=7542"},"modified":"2026-04-07T02:51:38","modified_gmt":"2026-04-07T02:51:38","slug":"why-you-should-never-dismiss-painful-breasts-as-just-another-menopausal-hormone-side-effect-especially-if-it-happens-at-night-dr-martin-scurr","status":"publish","type":"post","link":"https:\/\/www.healthoptibody.com\/?p=7542","title":{"rendered":"Why you should never dismiss painful breasts as just another menopausal hormone side-effect, especially if it happens at night – DR MARTIN SCURR"},"content":{"rendered":"

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I am a 67-year-old woman and have been suffering with breast pain for several years. At times it is excruciatingly painful, particularly at night. Tests have found no obvious cause.<\/span><\/p>\n

Name and address supplied.<\/span><\/p>\n

Dr Martin Scurr replies:<\/span>\u00a0Breast pain is always something to check with a doctor but given the length of time you have had this, it\u2019s almost certainly due to a benign cause.\u00a0<\/p>\n

In your longer letter, you mention you\u2019re on hormone replacement therapy (HRT) and I suspect this is the most likely reason for your pain. The oestrogen in HRT can stimulate the breast tissue so that it becomes engorged with blood, leaving it swollen and tender.<\/p>\n

It always affects both breasts rather than just one and, as in your case, the pain is often worse at night when you\u2019re lying down. This is simply because of the pooling of blood in the already sensitive tissue in this position.<\/p>\n

Breast pain can also be triggered by fibrocystic changes in the tissue. Breasts are made up of three main types of tissue \u2013 glandular, fatty and connective or fibrous \u2013 which hold the other two types in situ.\u00a0<\/p>\n

This fibrous tissue can collect in small lumps, often in both at the same time \u2013 it\u2019s not clear why, though it may be linked to changes as a result of pregnancy.<\/p>\n

This is less common in post-menopausal women, so if fibrocystic changes were to blame for your pain, you probably had it prior to the menopause<\/a> and the HRT has exacerbated it.<\/p>\n

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I think it\u2019s also safe to rule out problems relating to the chest wall or rib cage, such as costochondritis \u2013 inflammation in the joints between the ribs and the sternum (this is usually as a result of strain or respiratory infection and would be felt more widely around the chest region than just the breasts).<\/p>\n

My advice is to stop HRT for three months to see if your breast pain settles down \u2013 your GP should be able to suggest other, non-hormonal treatments or advice (such as pain medication or acupuncture, or other complementary therapy).<\/p>\n

I <\/span>have had Raynaud\u2019s disease in my left hand for over a decade. It\u2019s very painful and now the skin on my fingers is breaking up. Other than keeping it warm, is there anything I can do?<\/span><\/p>\n

Anthony Hughes, Cardiff.<\/span><\/p>\n

Dr Martin Scurr replies:<\/span> Raynaud\u2019s disease is where blood vessels in the toes and other extremities (e.g. the tip of the nose) spasm in response to cold \u2013 as a result, the fingers etc will turn white then blue, and on warming, the skin flushes red and the affected fingers can become very painful.<\/p>\n

This is known as primary Raynaud\u2019s \u2013 the fact that your skin is breaking up suggests you have secondary Raynaud\u2019s phenomenon, where the symptoms are due to an underlying problem, typically an autoimmune condition affecting the connective tissue and impeding blood flow \u2013 this in turn can cause ulceration of the skin.<\/p>\n

But if an autoimmune problem was the issue, this would have been evident earlier in your life.<\/p>\n

It\u2019s more likely you have atherosclerosis, a build-up of fatty deposits that obstructs blood flow in your arm.\u00a0<\/p>\n

You also mention that you were referred to a vascular surgeon but surgery to improve blood flow was ruled out as you are taking the blood-thinner warfarin and this can raise the risk of a life-threatening bleed during surgery.<\/p>\n

But there are medications that may help \u2013 nifedipine, used for angina and high blood pressure, works by dilating the arteries. So, too, does glyceryl trinitrate ointment, which is massaged into the fingers.<\/p>\n

But the ointment can only be used sparingly, twice daily as it can cause dizziness, facial flushing and nausea (as can nifedipine, which may also cause headaches).<\/p>\n

And as you say, keeping your hands warm must be part of the solution.<\/p>\n

In my view… Fat pill linked to \u2018electric shock\u2019<\/h2>\n

Like many GPs, I\u2019m now taking care of an increasing number of patients who\u2019ve bought weight-loss jabs online.<\/p>\n

Mostly they\u2019re looking for me to reassure them about side-effects \u2013 many have heard about the rare but worrying risk of acute pancreatitis and there are other scare stories.<\/p>\n

So far, I\u2019ve seen nothing untoward other than nausea and diarrhoea \u2013 and hair loss with significant weight loss.<\/p>\n

For the past year, I\u2019ve been prescribing Ozempic, which contains semaglutide, for patients with type 2 diabetes.<\/a><\/p>\n

Some of my weight-loss and type 2 diabetes patients are reluctant to self-administer injections. So I\u2019ve suggested the oral version of semaglutide which, while less effective, also suppresses appetite and helps with weight reduction.<\/p>\n

But I now learn from recent studies that 5 per cent of those taking this suffer dysesthesia, an unpleasant burning electric shock sensation affecting the skin. It\u2019s not clear if this also occurs with the jabs, but it demonstrates, once again, the need to carefully balance the benefits of new treatments against the (emerging) risks.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

I am a 67-year-old woman and have been suffering with breast pain for several years. At times it is excruciatingly painful, particularly at night. Tests have found no obvious cause. Name and address supplied. Dr Martin Scurr replies:\u00a0Breast pain is always something to check with a doctor but given the length of time you have<\/p>\n","protected":false},"author":1,"featured_media":7543,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[520],"tags":[],"class_list":{"0":"post-7542","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-hot"},"_links":{"self":[{"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=\/wp\/v2\/posts\/7542","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7542"}],"version-history":[{"count":0,"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=\/wp\/v2\/posts\/7542\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=\/wp\/v2\/media\/7543"}],"wp:attachment":[{"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7542"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7542"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.healthoptibody.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7542"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}