Women's Health

What you really need to know about your breasts

Admit it. There's no other body part you obsess about more than your breasts, and no wonder: They enhance our sexual pleasure, nourish our babies, and change (all too visibly) over time. And there's a lot to feel angst over, too, from finding a lump to feeling a strange pain. 

Worry not: We've got answers to all your breast questions and concerns. Read on for your complete guide to "the girls."

Problem #1: Breast Pain

The lowdown. All-over tenderness is usually caused by hormonal changes (hello, PMS!). It may worsen in your 40s, when perimenopause begins. Pain in one specific spot is most likely due to muscle strain. More rarely, you can also feel pain from a cyst, which is a fluid-filled sac, or from a fibroadenoma, a benign mass. If you're nursing, you may have mastitis, an infection that can occur when a duct gets clogged.

What it feels like. Aches can feel stronger in the outer part of the breasts, where you have
more tissue. Strains cause a sharper, burning pain.

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Rx. See your gyno. If you have a lump, she may send you for a mammogram, but don't worry: Breast pain is usually not associated with cancer. She can also give you antibiotics for mastitis. Strains—which can happen after lifting something heavy—usually go away on their own; over-the-counter anti-inflammatories can help.

If you seem to have cyclic pain—meaning it's period related—your doc may suggest taking vitamins B6 and E, which studies have shown ease symptoms, or prescribe medications such as Danazol to balance your hormone levels.


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Problem #2: Discharge

The lowdown. Believe it or not, it's totally normal for a bit of fluid to come out of your nipples when you squeeze them. That's just the normal proteins and liquids that live in your ducts. "They're pipelines made to carry milk, so a little fluid now and then shouldn't be surprising," Love says.

You may notice it more if you're approaching menopause, since fluctuating hormones can elevate your levels of prolactin, the hormone that tells your breasts to make milk—causing you to produce discharge even if you're not lactating. It may also be exacerbated by certain meds such as the birth control pill or blood pressure drugs. Just don't keep squeezing, because stimulating your nipples sends a message to your brain to keep making that liquid-producing prolactin.

What it looks like. Clear, milky white, yellow, green, or even bloody fluid that can range in consistency from thin and watery to thick and sticky.

Rx. Call your gyno if your discharge has any tinge of blood, or if it's coming out when you're not squeezing your nipples. About 80 percent of the time, the cause is intraductal papilloma, which is a noncancerous growth in your ducts, says Dr. Katherine Lee, a breast specialist at the Cleveland Clinic Breast Clinic in Ohio. To treat them, your ducts are examined and removed surgically if any blockages are found; just to be safe, the cells are checked for cancer.

If your nipple discharge is coming from both breasts, your doctor should check your prolactin levels to make sure you don't have galactorrhea (spontaneous milk flow). This is usually due to a problem in your pituitary gland, like a small tumor or reaction to certain medications, Love says. Nipple discharge can indicate breast cancer about 10 percent of the time in women between the ages of 40 and 60, so if you don't have a papilloma or galactorrhea, your doctor will likely send a sample of the fluid to a lab to check for cancer; he may also want to do a mammogram.

The good news? "If it is cancer, it's most likely just confined to the milk duct, which has a 10-year survival rate of 99 percent," Lee says.

Problem #3: Sagging

The lowdown. Blame the stretching of the Cooper's ligaments. "It's like wearing the same bra for years—inevitably, the fabric will wear down," says Dr. Adam Kolker, a plastic surgeon and an associate clinical professor at the Mount Sinai School of Medicine in New York City. "The collagen and elastin in your skin also break down, causing sagging everywhere, including your breasts." And as you get older, hormonal changes mean denser glandular tissue is replaced by softer, spongier fat that's more prone to drooping.

If you've had kids and/or breast-fed, you may notice the sagging even more: "When you're pregnant or nursing, your body sends signals to your brain to keep your breast glands engorged," Kolker says. "After you're done breast-feeding, the glands shrink back down and may become even smaller than before. But since your skin has been stretched out, the breast will look deflated." That's also true if you've gained or lost a lot of weight.

Rx. Since breast tissue is mostly fat, and contains no muscle, exercise won't help reverse sagging, as there's nothing to tone. But exercises that firm up the pectoral muscles around your chest will help pull up those ligaments, making your set look a little perkier, too.

When you hit the gym, a supportive sports bra is a must. "Many of the women we fit have gotten breast ligament tears—which contribute to sagging—from skipping a sports bra or wearing the wrong kind," says bra-fitting expert Susan Nethero, founder of the Intimacy lingerie stores (myintimacy.com). Skip compression sports bras, which hold your breasts against your chest and have molded cups that aren't supportive enough to fully prevent bounce. 

Instead, look for a bra that encapsulates each breast with stitched-in seam support or underwire. Just don't waste money on breast-firming pills or creams—there's absolutely no evidence they work, Kolker says.