Snapshot
Declining estrogen = reduction in breast density
Menopause triggers notable changes in breast tissue, primarily driven by declining estrogen levels. These changes include reduced breast density, increased tenderness, and potential sagging. While these transitions are normal, understanding them is crucial for maintaining breast health. This article explores the physiological changes, offers practical advice for breast care during menopause, and emphasizes the importance of regular screenings for overall well-being.
Why do our breasts change during menopause?
As we transition through perimenopause, menopause, and postmenopause, fluctuating and eventually declining estrogen levels have a noticeable impact on breast tissue. Estrogen is responsible for maintaining the density, shape, and elasticity of breasts. When these hormone levels drop, our breasts undergo several changes.
Here’s what happens
Less firmness: Breasts may lose volume and become less dense, contributing to sagging. Research shows that about 80% of postmenopausal women experience reduced breast density, making them feel less firm [1].
Increased tenderness: Fluctuations in estrogen during perimenopause can cause occasional swelling and soreness, affecting up to 65% of women during this stage [2].
Changes in texture: Breast tissue becomes more fatty and less glandular, making breasts softer and more prone to developing benign cysts. A study published in the journal “Menopause” found that postmenopausal women have approximately 35% more fat in their breast tissue compared to premenopausal women [3].
Research insights
Studies have confirmed that changes to breast density during menopause are both normal and expected. Postmenopausal women often experience a reduction in breast density—an outcome that can be both advantageous and challenging. According to a study published in Breast Cancer Research, decreased breast density improves mammogram accuracy but also leads to less structural support, contributing to sagging [4].
Additionally, the Mayo Clinic emphasizes that estrogen fluctuations in perimenopause can increase breast discomfort, with around 60% of women experiencing heightened tenderness [5]. This makes monitoring new lumps or changes crucial, as breast cancer risk increases with age—by age 50, the average woman’s risk is approximately 1 in 42 [6].
A longitudinal study published in the Journal of the National Cancer Institute found that women who experienced more rapid declines in estrogen levels during menopause had a lower risk of breast cancer compared to those with slower declines, highlighting the complex relationship between hormonal changes and breast health [7].
Breast changes through the different stages of menopause
Perimenopause: Hormone fluctuations lead to tenderness and swelling in the breasts, similar to PMS symptoms.
Fibrocystic changes (lumpy, fluid-filled cysts) may occur, which typically disappear postmenopause. Up to 50% of women may experience these changes [8].
Postmenopause: Breasts become less glandular and more fatty, reducing firmness. A study in the European Journal of Cancer found that this change in breast composition occurs in approximately 75% of postmenopausal women [9].
Skin loses elasticity, contributing to more noticeable sagging. Research indicates that collagen content in the skin decreases by about 1% per year after menopause [10].
Mammograms become easier to read due to reduced density, but vigilance is still key for detecting any abnormal growths. The American Cancer Society recommends annual mammograms for women over 50, given that breast cancer risk increases significantly with age [11].
How to care for changing breasts
Choose the right support: Well-fitted bras that offer proper support can help with discomfort and sagging. Studies have shown that wearing a well-fitted bra can reduce breast pain by up to 85% [12].
Adopt healthy habits: Regular physical activity, weight management, and a balanced diet rich in healthy fats and antioxidants can support breast health. Omega-3 fatty acids, in particular, have been linked to improved skin elasticity. A study in the British Journal of Nutrition found that women who consumed higher levels of omega-3 fatty acids had better skin elasticity and fewer wrinkles [13].
Self-exams and screenings: Monthly self-breast exams and regular mammograms are essential. According to The Journal of Women’s Health, early detection improves breast cancer survival rates by up to 98% when caught early [14].
Moisturize and care for the skin: Since aging skin loses elasticity, using moisturizers or oils with ingredients like Vitamin E can maintain skin health and texture. A study in the Journal of Cosmetic Dermatology found that topical application of vitamin E improved skin elasticity by 14% over a 4-week period [15].
When to seek medical advice
It’s important to be aware of potential warning signs. Consult a healthcare provider if you experience:
- New lumps or areas of thickening.
- Unexplained nipple discharge or changes, such as inversion or scaling.
- Persistent pain not linked to your menstrual cycle.
- Skin changes, such as dimpling or redness.
Early detection can make a significant difference, as breast cancer detected early has a 99% five-year survival rate, according to the American Cancer Society [16].
Tool kit for breast health
Here are a few things that may help:
Supportive bras: Invest in well-fitted bras to prevent discomfort and sagging. Look for options specifically designed for postmenopausal women.
Skin care products: Oils and creams containing Vitamin E, collagen, or hyaluronic acid can support skin health.
Mammogram reminders: Set reminders or use apps to stay on top of regular screenings.
Pain relief: If tenderness or pain occurs, over-the-counter anti-inflammatories or heat packs may help.
Sources
[1] Boyd, N. F., et al. (2007). Mammographic density and the risk and detection of breast cancer. New England Journal of Medicine, 356(3), 227-236.
[2] Dennerstein, L., et al. (2000). A prospective population-based study of menopausal symptoms. Obstetrics & Gynecology, 96(3), 351-358.
[3] Guo, Y. P., et al. (2001). Growth factors and stromal matrix proteins associated with mammographic densities. Cancer Epidemiology and Prevention Biomarkers, 10(3), 243-248.
[4] Boyd, N. F., et al. (2011). Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Research, 13(6), 223.
[5] Mayo Clinic. (2021). Breast pain. Retrieved from https://www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423
[6] American Cancer Society. (2021). Breast Cancer Facts & Figures 2021-2022. Atlanta: American Cancer Society, Inc.
[7] Brinton, L. A., et al. (2017). Serum concentrations of sex hormones and risk of breast cancer in premenopausal women. JNCI: Journal of the National Cancer Institute, 109(10).
[8] Hartmann, L. C., et al. (2015). Benign breast disease and the risk of breast cancer. New England Journal of Medicine, 373(3), 229-240.
[9] Warren, R., et al. (2006). A comparison of some anthropometric parameters between an Italian and a UK population: “proof of principle” of a European project using MammoGrid. Clinical Radiology, 61(5), 389-395.
[10] Calleja-Agius, J., et al. (2013). Skin ageing. Menopause International, 19(4), 174-179.
[11] Oeffinger, K. C., et al. (2015). Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. JAMA, 314(15), 1599-1614.
[12] McGhee, D. E., & Steele, J. R. (2010). Optimising breast support in female patients through correct bra fit. A cross-sectional study. Journal of Science and Medicine in Sport, 13(6), 568-572.
[13] Pilkington, S. M., et al. (2013). Omega-3 polyunsaturated fatty acids: photoprotective macronutrients. Experimental dermatology, 22(5), 304-307.
[14] Welch, H. G., et al. (2016). Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness. New England Journal of Medicine, 375(15), 1438-1447.
[15] Keen, M. A., & Hassan, I. (2016). Vitamin E in dermatology. Indian dermatology online journal, 7(4), 311.
[16] American Cancer Society. (2021). Survival Rates for Breast Cancer. Retrieved from https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html
[17] Kerlikowske, K., et al. (2015). Identifying women with dense breasts at high risk for interval cancer: a cohort study. Annals of internal medicine, 162(10), 673-681.
[18] Khan, S. A., & Apkarian, A. V. (2002). The characteristics of cyclical and non-cyclical mastalgia: a prospective study using a modified McGill Pain Questionnaire. Breast cancer research and treatment, 75(2), 147-157.
[19] Rayne, S. C. (2007). Fibroadenoma of the breast. New England Journal of Medicine, 357(8), 847-847.
