Many women experience changes in their breasts throughout their lives. In this episode, our guest, Dr. Nneka Nvene a family medicine physician with Memorial Hermann Medical Group, discusses common, hormone-related breast changes, including why they happen and what to expect. Learn about lifestyle factors that can influence these changes, the importance of breast self-awareness and when you should consider speaking to your doctor.
Melanie Cole, MS (Host): Welcome to Everyday Well®, a health and wellness podcast brought to you by Memorial Hermann Health System. Tune in for the latest tips and information about health care topics that matter most to you. Today, we're discussing a topic that a lot of women may experience, hormonal breast changes.
Hormonal shifts can impact how your breasts look and feel, whether you have a regular period, are pregnant, are transitioning through menopause, or are postmenopausal. What's common when it comes to these breast changes? What factors can influence them, and when might it be time to talk to your doctor? Joining me to tell us about that is Dr. Nneka Nvene. She's a family medicine physician with Memorial Hermann Medical Group.
Dr. Nvene, thank you so much for joining us today. How and why do breasts change with the menstrual cycle? Give us a little lesson here on how that happens.
Dr. Nneka Nvene, MD: Absolutely. So, our breast tissue is very sensitive to hormonal fluctuations within the menstrual cycle. Particularly the two hormones that we think about are estrogen as well as progesterone. In the first half of your cycle, estrogen, it stimulates the growth of your milk ducts. And then, after ovulation, particularly in the second half, your progesterone starts to rise significantly, and that causes the glands in your breast to swell.
You know, with this combination of hormone changes that happen, you will start to feel like your breasts are swollen, they're tender, they're more sensitive and sometimes even lumpy in the days prior to your menstrual cycle. These symptoms are common, they're totally normal, and they typically resolve as your period begins.
Host: Well, thank you for explaining that because for a lot of women, that can be a little bit disconcerting when you feel some of those lumps and bumps that come with those shifts in our hormones. Do only those with menstrual cycles experience hormonal breast changes?
Dr. Nneka Nvene: Absolutely not. So, these changes, they're not limited to women in their active menstrual cycle phases. You know, while these cyclical changes are most common during your reproductive years, and that typically spans from early teenage years to your late 40s, early 50s, right, it doesn't always happen during this period of time. They can happen during other life stages.
For example, think about puberty during those teenage years. Think about during pregnancy, your breast tissue does change. And then, of course, it can change with breastfeeding. All of these things and these changes definitely affect your breast tissue. And of course, as women go through perimenopause and menopause, these fluctuating hormones tend to cause tenderness and swelling. And even after menopause, for women who are on hormonal replacement therapy, they may notice similar breast changes as well. So, overall, these hormones, they play a role across your entire lifespan as a woman.
Host: And we all know that every woman is different. So, we're all going to experience these fluctuations differently. And for some, they go through their periods and post with nothing. And some people, it's painful, they're swelling, all the things that go along. So, we're all so unique and different.
But one thing that we're learning, Doctor, is lifestyle factors. So, can some of those affect these changes, like certain dietary factors, whether it's obesity or what we eat? Because we know that some foods contain estrogen. And so, are any of these kinds of things, factors, do they come into play?
Dr. Nneka Nvene: Absolutely. So, our daily habits, they play a role in how we as women experience hormonal breast changes throughout our lifespan. As a younger woman or of those women who are in their reproductive years, simple changes like reducing your caffeine intake or reducing your salt or sodium intake can help kind of ease the swelling and tenderness that happens right before your cycle starts.
However, you know, when you're going through perimenopause and menopause, those changes are a little bit different. And I know it sounds very simple, but maintaining a really balanced diet, exercising, staying well-hydrated, all these things help to manage your overall hormonal shifts. They don't necessarily stop them from happening, but they definitely provide support and comfort and facilitate a smoother transition as you go through this phase.
Host: We hear about self-breast exams, and not everybody really knows how to do them. And when young girls start going to their gynecologist, they sort of learn. And as they start to grow their breasts, they sort of learn. But can you tell us a little bit about the importance of those self-exams and even give us a little lesson on how to do it?
Dr. Nneka Nvene: Awesome. So, I will tell you the self-breast exam is so important, and it's really important because you need to get familiar with the normal look and feel of your breasts, right? Because it's important so you can be able to easily identify if there's any new changes or unusual changes that you notice. So, we normally typically tell people that the best time to actually do a breast self-exam is a few days after your menstrual cycle. Because at that time, your progesterone and estrogen are at their lowest and your breasts are less likely to be swollen or tender.
So, simply raising your arm, putting it behind your head, and then gently palpating your breast, starting with the outer quadrants and gradually going in towards the nipple, can help you get a good feel of how your breasts feel when you're not on your menstrual cycle.
Host: So if we learn to do that and we feel some things and as you say, there's lumps and bumps and sometimes it's like, ooh, the back of your hair stands up, you know. You're like, "Oh, what is that?" And some of them are normal, and some of them, that's why we have to get to know our breasts, because then we learn how that cyclic hormonal changes happen. So, what's normal, what's not. But what are some of the symptoms, things we should watch out for, red flags that would prompt us to go, "Okay, well, that is not normal. I need to call my doctor"?
Dr. Nneka Nvene: Yes, absolutely. So, I will tell you, it is important to call your doctor and schedule an appointment. If you notice a new lump or a mass that feels very different from the surrounding breast tissue, call. If you are having any nipple discharge, particularly nipple discharge that's bloody or that you're expressing discharge without necessarily squeezing your breast, you want to call the doctor. If you are having skin changes where it seems like it's dimpling or puckering or even that the nipple is sort of inverted, so it's not poking out, it's actually poking in, right? That would be a reason to go see the doctor.
And just all in all, if you are having persistent pain or lumps or you're just concerned and it's not related to the hormonal changes that happen during your menstrual cycle, it's always best to take your symptoms and your concerns to your provider or your doctor, and they can be able to order imaging studies to best look at what is going on with your breasts. And so, this is why it's super important that if you're a woman over the age of 40, to keep up with your annual mammograms in order to better know what your breast tissue is looking like at the time.
Host: So, I'd like you to touch on that for just a second, Dr. Nvene. If you experience breast tenderness, when is the best time to schedule a screening mammogram? And because a lot of women listening are going to say, "Well, if I have breast tenderness, I don't want my mammogram then," because they think it's going to really hurt. And I can tell all the women listening who have never had one, it's like one second. It really is not a big deal. But give us the best time to schedule them and what you want women to know about that.
Dr. Nneka Nvene: So definitely, if you are in the reproductive stage of your life, the best time to schedule your mammogram is a week after your period ends. So during this phase, your estrogen is at its lowest, your progesterone is at its lowest. And therefore it's significantly going to reduce the breast swelling and tenderness that you are experiencing. And so, this makes the mammogram process far more comfortable when you are no longer experiencing that.
However, if you are a woman no longer having any cycles for whatever reason, surgically, that you're no longer producing any hormones or that we are now in the menopausal phase, getting your mammogram, you can do that at any time of the month. And it's just helpful that regardless if you do experience some tenderness, let your mammogram radiologist know about this and they can further look at it.
Host: I'd love your best advice here, Dr. Nvene, because this is such an important topic. I'd like you to speak to women about the importance of screening, about the importance of getting to know our own bodies, our own breasts, so that we can identify those hormonal changes as they happen and being our own best health advocate. Because if we don't put our own masks on, we can't take care of those that we love, and we all know that we are the caregivers of society. So, give us your best advice for being our own best advocate.
Dr. Nneka Nvene: I couldn't agree with you more. I mean, the importance of this kind of talk or speech is really just about understanding your body, understanding what normal looks like for you. That could be so empowering for women, because then you're able to identify when something is abnormal or new or just different.
And once you notice that something is abnormal, don't wait. Don't hesitate. Call your provider. Call your doctor. They do have your best interest at heart. They do want you to be healthy, and they will order your mammogram and make sure that we are seeing and understanding these changes way early in advance.
And so, the earlier we get detected for things and we're more aware of our health, the more important it is to maintaining our health at all stages of our life.
Host: Thank you, doctor, so much for joining us today and sharing your compassionate, and I can hear the passion in your voice, your expertise. So, thank you so much again. And understanding your body and its normal cyclical changes is empowering. If you have any concerns about your breast health or notice any persistent changes, it's important to speak with your health care provider. Early detection and awareness are key to maintaining your health. And to learn more, please visit memorialhermann.org/mammo.
I'm Melanie Cole. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics that interest you. This is Everyday Well, a health and wellness podcast brought to you by Memorial Hermann Health System. Thanks so much for joining us today.
