Breast Pain After Surgery: Hormonal Effects and Concerns

Breast pain issues?

I would like to ask Dr.
Huang a question...
Last February, I underwent laparoscopic surgery for a chocolate cyst, during which the cyst was removed and my ovary was preserved intact! After the surgery, around mid-March, I started receiving injections to induce amenorrhea (Leuprolide), as my doctor advised that after the surgery, I should allow my ovaries to rest for a while to prevent recurrence.
I received these injections every three months, a total of two injections, and I was amenorrheic for six months.
Then, starting in September, my menstrual cycle gradually resumed, and eventually, my cycle returned to normal.

However, recently I have noticed a new situation that I did not experience before the surgery: after each intimate interaction with my boyfriend, I start to experience breast pain the next day, which lasts until my next menstrual period arrives! This pain persists for two weeks...
When I am not engaging in intimate activities, I experience breast tenderness only a few days before my period, as I used to.
My interactions with my boyfriend are limited to mutual touching and helping each other reach orgasm, with no genital contact, as I insist on avoiding that final step.

I asked the gynecologist who performed my surgery whether this could be related to the injections.
After being amenorrheic for a while, my period returned, and my body started functioning again, which might explain the changes in my condition.
The gynecologist said it was not related and that the breast pain was simply due to hormonal stimulation from sexual activity, advising me not to worry.

Recently, due to this situation, I consulted a breast surgeon and underwent a breast ultrasound, which returned normal results! The breast surgeon mentioned that I have some fibrocystic changes in my breasts, which are benign and common among many women, and that I should not be concerned, recommending regular follow-ups every six months.

Regarding my concerns, the breast surgeon asked if I was taking birth control pills.
I replied that I was not, as my boyfriend and I have not engaged in actual sexual intercourse (as described above), so I have not taken any medication.
I also inquired whether my surgery and the injections could be related.
The breast surgeon said it should not be related, as any side effects would have resolved with the return of my menstrual cycle, and there was a significant time gap in between.
He also asked about the location of the pain around my breast, and I described it as being on the outer sides or underneath, to which he said that was normal and attributed it to hormonal effects.

I asked if other women experience similar hormonal influences that lead to breast pain after sexual activity, and he confirmed that they do.
I responded, "Oh, I thought I was an exception," and he reassured me that I was not.
However, I am still puzzled as to why I did not experience this before the surgery, but only after receiving the injections and once my menstrual cycle resumed.

Additionally, I am concerned that if I engage in intimate activities with my boyfriend right after my period ends, and I experience the same breast pain starting the next day, that would mean I would be in pain for three weeks...
With four weeks in a month, I would only be pain-free during my period, which is quite distressing.
This makes me wonder if it would be better to avoid sexual activity altogether.
Is this situation normal? Will my body gradually readjust?
Moreover, I have not experienced this before, and many women around me do not have breast pain due to intimate interactions.
If this situation persists, could it have any negative effects? Even if it is just due to hormonal influences, does that mean I should avoid sexual activity? I hope you can help me resolve these doubts and concerns...
Thank you, doctor!

Niming, 30~39 year old female. Ask Date: 2019/06/14

Dr. Huang Jianzhong reply Obstetrics and Gynecology

In February of last year, I underwent laparoscopic surgery to remove a chocolate cyst while preserving the ovary.
After the surgery, around mid-March, I started receiving injections to induce amenorrhea (Leuprolide), as the doctor advised that after surgery, the ovaries needed some rest to prevent recurrence.
I received these injections every three months for a total of two doses, and I experienced amenorrhea for six months.
Later, in September, my menstrual cycle gradually resumed, and eventually, it returned to normal.
However, recently I noticed a new symptom that I did not experience before the surgery.
After engaging in sexual activity with my boyfriend, I would start to experience breast pain the next day, which would persist until my next menstrual period, lasting for about two weeks.
When I am not sexually active, I still experience breast tenderness a few days before my period, but my interactions with my boyfriend have only involved mutual touching and helping each other reach orgasm, without any genital contact, as I am adamant about not going all the way.
I asked the gynecologist who performed my surgery whether this could be related to the injections.
After a period of amenorrhea, my body resumed its normal functions, which might explain the changes I am experiencing.
The gynecologist said it was not related and that the breast pain was simply due to hormonal stimulation from sexual activity, assuring me not to worry.

Recently, I consulted a breast surgeon about this issue and underwent a breast ultrasound, which came back normal.
The breast surgeon mentioned that I have some fibrocystic changes in my breasts, which are benign and quite common among women.
He advised me not to be concerned and suggested regular follow-ups every six months.
When I expressed my concerns, the breast surgeon asked if I was taking birth control pills.
I replied that I was not, as I had not engaged in penetrative intercourse.
I also inquired whether my surgery and the injections could be related to my symptoms.
The breast surgeon indicated that it was unlikely, as any side effects would have resolved with the return of my menstrual cycle, and there was a significant time gap in between.
He further asked about the location of the pain in relation to the circumference of my breasts, and I described that it was on the outer sides or underneath.
He reassured me that this was normal and attributed it to hormonal effects.
I also asked if other women experience similar hormonal influences leading to breast pain after sexual activity, and he confirmed that they do.
I was surprised and thought I was an exception, but he clarified that it is not uncommon.
I remain puzzled as to why I did not experience this before the surgery, and why it only started after receiving the injections and resuming my menstrual cycle.
Additionally, I worry that if I engage in sexual activity with my boyfriend right after my period ends, and I experience the same breast pain the next day, it could lead to three weeks of discomfort, as I would only be pain-free during my menstrual days.
This situation is quite distressing.
Regarding the mutual touching and helping each other reach orgasm without genital contact, I experience breast pain the next day, which lasts until my next period arrives.
The solution seems straightforward: find an appropriate method to manage the pain.
However, I am concerned whether it would be better to avoid sexual activity altogether.

Is this really normal? Is it not considered normal, or will my body gradually adjust back to its previous state? It is possible that my body will slowly readjust, and I have not experienced this before, nor have many women around me reported breast pain due to sexual activity.
If this situation persists, could there be any negative effects? There are no negative effects, even if, as the gynecologist and breast surgeon mentioned, it is simply due to hormonal influences.
But does this mean I should avoid sexual activity? There is no need to avoid sexual activity.

Reply Date: 2019/06/14

More Info

Breast pain after surgery, particularly following procedures like the removal of a chocolate cyst, can be a common concern for many patients. In your case, it seems that the pain you are experiencing is linked to hormonal changes following your surgery and the administration of hormonal treatments, such as the Lupron injections you received to induce a temporary menopause.
After surgery, especially one involving the reproductive organs, the body undergoes significant hormonal fluctuations. These changes can lead to various symptoms, including breast tenderness or pain. The fact that you are experiencing breast pain after sexual activity may be related to the hormonal stimulation that occurs during arousal and intimacy. This is not uncommon; many women report increased breast sensitivity or pain during certain phases of their menstrual cycle, particularly when hormonal levels fluctuate.

Your gynecologist's reassurance that this pain is likely a result of hormonal changes is consistent with what many women experience. The breast tissue is sensitive to hormonal changes, and the stimulation from sexual activity can exacerbate this sensitivity. The fact that your breast pain aligns with your menstrual cycle further supports the idea that hormonal fluctuations are at play.
It's also important to note that the presence of fibrocystic changes in the breast, which you mentioned were identified during your ultrasound, is quite common and typically benign. Many women have fibrocystic breasts, which can lead to cyclical breast pain that correlates with their menstrual cycle. This condition is often exacerbated by hormonal changes, particularly estrogen.

Regarding your concern about the frequency and duration of your breast pain, it is understandable to feel apprehensive. If the pain is significantly affecting your quality of life or causing you distress, it may be worth discussing further with your healthcare provider. They may suggest monitoring the situation for a few more cycles to see if the pain lessens as your body adjusts to the hormonal changes post-surgery.
If the pain persists or worsens, there are several management strategies that can be considered. Over-the-counter pain relief, such as NSAIDs (non-steroidal anti-inflammatory drugs), may help alleviate discomfort. Additionally, wearing a supportive bra can provide comfort and reduce movement-related pain.
In terms of sexual activity, it is essential to communicate openly with your partner about your discomfort. If you find that certain activities consistently lead to pain, it may be beneficial to adjust your interactions to minimize discomfort while still maintaining intimacy.
Ultimately, while it is essential to listen to your body, it is also important to seek reassurance from your healthcare providers. If you continue to experience significant pain or if it impacts your daily life, do not hesitate to reach out for further evaluation. Your health and comfort are paramount, and there are often solutions available to help manage symptoms effectively.
In summary, breast pain following surgery can be attributed to hormonal changes and is often a common experience among women. While it can be concerning, it is usually manageable with appropriate strategies and communication with healthcare providers. If the pain continues or worsens, further evaluation may be warranted to ensure there are no underlying issues.

Similar Q&A

Understanding Post-Surgery Breast Pain: Is It Normal After Fibroadenoma Removal?

Hello, doctor! I underwent a breast fibroadenoma excision surgery last February, and I occasionally experience pain that occurs irregularly. However, when I press on my chest, I do not feel any pain due to external pressure. I would like to know if this type of pain is a normal p...

Dr. Chen Ronghong reply Surgery
Hello, breast tumor surgery involves incisions in the skin, which inevitably results in some damage to the sensory nerves. Common sequelae include a prickling or itching sensation at the scar site. If this affects your daily life, you may consult a physician for relief, which can...

Managing Post-Surgery Pain and Side Effects After Breast Cancer Surgery

Hello Doctor: My mother has undergone surgery for breast cancer, and since the operation, she has been experiencing sharp pain at the surgical site, which seems to be nerve-related. This pain occurs intermittently and has not improved despite the doctors saying it would get bette...

Dr. Zhou Jiazhen reply Breast and Thyroid
Dear Daisy, Postoperative pain is a common complication following breast cancer surgery, particularly in patients who have undergone axillary lymph node dissection. The pain is typically located in the axilla, upper arm, and chest area, with some patients experiencing severe sho...

Understanding Post-Surgery Sensitivity and Comfort After Breast Cancer Treatment

Hello! I recently went to the hospital for a check-up and found out that I have breast cancer. At that moment, I really couldn't accept it, especially since I am working abroad and it is inconvenient to return to Taiwan. The doctor believed that immediate action was necessar...

Dr. Wu Yuting reply Surgery
1. Is it normal to find that my breast sensitivity is not as pronounced as before during the recovery period? A: This is a normal phenomenon. 2. I am unable to sleep well at night, whether lying on my side or back, as my chest feels very uncomfortable. Are there any methods to a...

Understanding Post-Surgery Nipple Pain and Complications

Hello Doctor, I underwent nipple inversion reconstruction surgery at the beginning of January. However, about three months post-surgery, I started experiencing pain around the nipple area along with a hard lump. During my follow-up visit, the doctor mentioned it might be related ...

Dr. Chen Jiaming reply Surgery
The nipple is the convergence point of the milk ducts. Surgical procedures may disrupt the original ductal system, potentially leading to obstruction at the outlet, especially if the nipple was previously inverted. This can cause retention of secretions in the milk ducts beneath ...