Is my breast pain a sign that I might be perimenopausal?

=Q My breasts often feel tender, and can be painful, which gets worse before a period. I'm 42 and my cycle is still regular, but could this be a sign of the perimenopause?

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The Changing levels of hormones that occur during the menstrual cycle can cause breast tenderness, particularly in the week before a period.

Many women say this gets worse in their forties, but it's not usually a sign of perimenopause and your relatively young age and regular periods suggest that your ovaries are still working normally and you are not approaching the menopause yet.

Quite why some women get tender breasts and others don't isn't known but there is some evidence that having low levels of the fatty acid GLA can contribute to cyclical breast pain so it may be worth trying a supplement such as evening primrose oil or starflower oil, which may help (though it may not make any difference).

Though eating a low fat, high fibre diet and reducing caffeine and alcohol are sometimes suggested for breast pain, unfortunately there is very little evidence to show this makes any difference. However, wearing a well-fitting, supportive bra - especially during exercise - can help.

You have not said what you are doing for contraception, but taking the combined pill can help stop cyclical breast pain and, as long as you are not a smoker or overweight, is suitable for most women in their forties. The progesterone only pill is also worth a try.

I am aware many women worry breast pain is a sign of cancer, but this is very rarely the case, especially if the pain changes during your cycle.

If you feel any lumps or changes in your breast tissue however, you should see your GP.