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|Why am I experiencing breast tenderness during my 6th month of using a Mirena IUD? #667/6
Since getting my second Mirena IUD in January, I have been experiencing significant cyclical breast swelling and exquisite tenderness as well as some increased water retention and bloating. It goes away right about when a period should come (I'm barely bleeding at all with the Mirena), but the breast tenderness lasts a good 2 weeks.
I have had a Mirena since October 2000 and do not recall having such breast tenderness when it was first inserted. Could this possibly be related to the Mirena or just perimenopause (I'm 47)? If so, would taking a diuretic for those 2 weeks possibly help?
Otherwise, I love the Mirena - no menses - nothing to remember.
By-the-way, many years ago when trying oral contraceptives, I could not tolerate even Mircette, LoEstrin or Alesse due to similar significant breast swelling and tenderness.
This is a wonderful website! It gives good, solid advice with research to back it up!!!
I am sorry you are experiencing such breast tenderness using your second Mirena IUD. Breast tenderness was an infrequent cause of termination of use of Mirena (in the classic study comparing Mirena to a copper IUD ? the NovaT). This was a large study of 1821 women having a Nova T inserted. [Andersson ? 1994] Over 5 years just under 1% (0.8%) of women had Mirena removed due to breast tenderness which 0% of women receiving a copper T IUD had it removed due to breast tenderness.
I imagine your transition into pre-menopause could be contributing to this new problem. Clearly, it is an important problem for you.
My best suggestion to you is that you try some of the suggestions below for the management of breast tenderness to see if they help. Over time breast tenderness may resolve on its own. Here are some of the treatments for breast tenderness that may help:
- Wearing a bra that is supportive but not too tight
- Some women have used diuretics for the cyclic fluid retention they experience premenstrually and have found that this decreases breast tenderness.
- Our Bodies, Ourselves, the marvelous book of The Boston Women's Health Collective lists 3 home remedies for breast tenderness: essential fatty acids such as omega? 3 fatty acids; vitamin B-6 and multivitamins; and water. They also list 4 things to do for bloating and fluid retention that can contribute to breast tenderness: vitamin B-6, water; foods such as whole grains, whole flours, beans, vegetables, fruits and yeast; and avoiding caffeine, alcohol and foods high in salt. I am not an expert on these approaches but hold this book and the women who wrote it in high regard.
- Avoiding trauma to breasts/hitting or bumping breasts
There are many causes of breast tenderness. They are outlines in the following list:
- Cyclic fluctuations in hormones can lead to pain in normal menstrual cycles
- Irritation of the nipples, from friction with clothing, rough handling
- Improperly fitting bra, particularly under wire designs
- Physical activity without adequate support/heavy lifting
- mastitis, an infection of the ducts of the breasts; not well-defined area of infection
- Breast abscess ? well-defined area of infection
- Mondor's disease (superficial thrombophlebitis of veins on upper, outer aspect of breast)
- Tietze's syndrome/costochondral separation
- Dermal cysts
- Fibrocystic disease
- Excessive caffeine consumption
- Bruising from rough sex play
- Muscle pull (of pectoral muscles or possibly the neck)
- Excess estrogen
- Breast cancer
- Breast papilloma
- Sclerosing adenosis
- Ductal ectasia (ectasis is an inflammation of the breast ducts that is not caused by bacteria.)
- Engorgement from lactation after birth
- Pinched nerve in the back or neck
- Cycles where a woman does not ovulate ? estrogen has a proliferative effect on tissues on the breast, and if she does not secrete testosterone to stop this effect it can cause pain.
Her reply to us on 8-21: "Thank you for replying to my concern about premenstrual breast tenderness and bloating. The strange thing is that it seems to have resolved without any intervention. I had about 4 cycles with significant premenstrual breast swelling, tenderness and bloating since then. Now I have had about 3 periods with only mild (and very tolerable) changes."
"Who knew! But thanks for the suggestions anyway. Your website is great. I'll pass it on to my friends."
My reply on 8-31: I am glad that your breast tenderness has stopped. Please do tell your friends and your doctor or nurse practitioner about this website.
One year later: Have you continued to have no problems with the breast tenderness? Are you pleased with your Mirena IUD? How often are you having a period?
To learn more about the advantages and disadvantages of the Mirena IUD, go to our website: www.managingcontraception.com and click on Choices. You can also order this wonderful new educational book from our website or by calling 404-875-5001. Do you have your copy yet?
Key Words: Mirena IUD, cyclical breast swelling, tenderness, water retention, bloating, period, perimenopause, diuretics, oral contraceptive, causes, cycles
Andersson K. IN Levonorgestrel-releasing and copper-releasing (Nova T) IUDs during five years of use. A randomized comparative trial: Contraception 1994; 49, January
The Boston women’s health book collection: Our Bodies, Ourselves; Touchstone - 2005
Posted 8-2-2005, Updated 8-6-2007, Updated 5-12-2011
Robert A. Hatcher MD, MPH|
Professor of Gynecology and Obstetrics
Emory University School of Medicine
The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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