Caffeine may affect some womens fertility. The bottom line is that the connection between. Per Harvard Medical School, some antidepressants and cardiovascular medications can also cause non-cyclical mastalgia. Breast pain is less common after menopause than it is before the big change. It may be a burning, prickling or stabbing pain, or a feeling of tightness. Hormonal changes: The increased levels of progesterone during pregnancy can make it harder to fall asleep and stay asleep. Additionally, heavy breasts can stretch ligaments and tissues, causing discomfort, according to Harvard Medical School. It's important to discuss any breast pain with your clinician. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441879/, Khattab A, Monga DK. To provide you with the most relevant and helpful information, and understand which Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Eliminating caffeine will nix some of these symptoms, especially breast tenderness and irritability. Breast pain or soreness is not likely to be a sign of cancer, according to the National Breast Cancer Foundation 25. Myth: Caffeine Increases Your Risk Of Breast Cancer No. 11 However, if youre at all concerned, you should save yourself some worry and make an appointment with your doctor. By: Michelle Lee, MD, and Wendi Owen, MD If you have breast pain, you are not alone. Cyclical breast pain. Though breast pain on its own is not generally a cause for concern, you should see a doctor if you are experiencing other breast-related symptoms 2. Powell RW. Are Peanuts Beneficial for Heart Health in Menopausal Women? Breast sagging & shrinking. [Updated 2019 Feb 14]. Keep hydrated - Drinking more water aids hydration and can lessen pain. Avoiding coffee, tea, and energy drinks may require self-discipline, but your effort and persistence will be worthwhile. Cancer. Published 2015 Apr 1. doi:10.5152/tjbh.2015.2492. it's like density and burning under left armpit and breast feels sensitive. For most women, breast pain will go away after menopause, but a small number of women may experience sensitive breasts into their 70s. Breast pain: Not just a premenopausal complaint. Coffee can also have a negative impact on symptoms like fatigue, because energy levels and alertness increase, and then suddenly plummet, which can affect your health and mental state. Strain in the pectoralis major muscle, which lies directly beneath and around the breast, can cause pain that feels as if it's coming from inside the breast. Mastitis most commonly affects women who are breastfeeding but it can happen at other points in life. However, having hormone therapy during menopause can increase the risk of continued breast pain. Fibrocystic breast changes - Lumps, tenderness, and swelling in breasts caused by a buildup of fluid in the breasts. Non-cyclical breast pain can affect women after menopause for a variety of reasons 2. A breast infection can cause painful lumps. Sanguinetti A, Polistena A, Lucchini R, et al. The Journal of the North American Menopause Society. 1. Noncyclical breast pain. My breast exam and mammograms have been normal. This pain can occur after menopause and also after a hysterectomy. doi:10.1016/j.ijscr.2016.02.004. 21o The liver regulates chemical levels in the body and excretes a waste called bile o Drug and chemical metabolism will be . The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School. Non-cyclical breast pain often goes away by itself over time. Breast Pain. Mayo Clin Proc. Engorgement: This occurs when the breasts become too full of milk. If you are experiencing chest pain on the left side, see a doctor. This happens in about half the women who experience it. Breast pain, also known as mastalgia, is common and accounts for 45-70% of breast-related health care visits. An abscess will need to be drained. MenopauseNow.com is dedicated to providing reliable, up-to-date information and advice on the most common topics in women's health, including PMS, menopause, natural hormones, hormonal conditions, and fertility. Evaluation and management of breast pain. A number of factors can contribute to noncyclic breast pain after menopause. Symptoms include: Symptoms occur in both breasts and sometimes the underarm areas as well. Society of Breast Imaging. In: StatPearls [Internet]. Should I be Worried? **A breast infection, also called mastitis, can a cause severe pain, according to Harvard Medical School 12. Evaluation of 1294 female patients with breast pain: A retrospective study. [Updated 2019 Jan 20]. Breast tenderness can be a side effect of certain medications other than estrogen-progesterone therapy. This content does not have an Arabic version. It can also be caused by injury, chest wall pain, breast feeding, an infection, a medication side effect, noncancerous cysts, or even your bra not fitting correctly. Eliminating caffeine will nix some of these symptoms, especially breast tenderness and irritability. This is the first year I have been drinking coffee. Breast pain can be a sign that scar tissue has formed too tightly around the implants, a condition called capsular contracture). Occasionally, pain arising from heart disease, gastroesophageal reflux disease (GERD), or inflammation of the tissues lining the lungs (pleuritis) may be felt as breast pain. National Cancer Institute. Some women report symptom relief from evening primrose oil, which contains gamma-linolenic acid (an essential fatty acid), or fish oil supplements, which contain other fatty acids. Chest pain on the left side can also be a symptom of a heart attack. Cannabis Use Is On the Rise Among Pregnant People. For example, changes in the level of hormones during menstruation or pregnancy often cause breast pain. In the majority of cases, breast pain is not a sign of breast cancer. These are the most common causes of breast pain in women: Hormonal fluctuations. Hi, glad you are ok. im nearly 39 and have exactly the same. nationalbreastcancer.org, Koo MM, von Wagner C, Abel GA, McPhail S, Rubin GP, Lyratzopoulos G. Typical and atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit of cancer diagnosis. Breast pain is not. According to the American Cancer Society, breast cysts occur when fluid builds up in the breast glands 3. In fact, breast pain is usually not a sign of a serious condition, and is rarely a sign of cancer. After one year without caffeine, 61% of the women reported either . Medications. other information we have about you. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285/, InformedHealth.org [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. There are two main types of breast pain: cyclic and noncyclic. . Also known as mastalgia, breast pain affects up to 70 percent of women during their lifetime. In: StatPearls [Internet]. When it doesn't, they may fear they have breast cancer. Injury. Monthly changes in estrogen and progesterone, often leading up to a menstrual cycle, accounts for 75 percent of breast pain. This study supports the findings of others in that caffeine restriction is an effective means of management of breast . Self-help Options for Menopause Treatments. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Nursing or chafing from clothes can irritate the skin overlying the nipple possibly allowing bacteria to enter and infect the breast. Breast Pain. Advertising revenue supports our not-for-profit mission. Health Alerts from Harvard Medical School. Read on to find out if your consumption of caffeine may cause breast pain. But while this is true, it's also true that many other things can cause breast pain. Caffeine comes from plant seeds and leaves, but it is a drug that has a physical effect on the body. 2012. Breast pain varies a lot . This can cause swelling and breast tenderness. You may also be dealing with the aftermath of a medical procedure such as breast biopsy or surgery. Mayo Clinic does not endorse any of the third party products and services advertised. 13(5):425-37. doi:10.1016/j.jpain.2011.02.358. As women approach menopause they may want to know what will happen to their hormone levels and how to treat the symptoms hormone changes cause. What Are the Risks? Bra support - Wear a more supportive bra and one that fits, it is worth having a fitting every year with all these changes going on. information is beneficial, we may combine your email and website usage information with North Carolina observed 138 women experiencing breast pain. Becoming fed up with the sudden hot flashes, the unpredictable mood swings, or the constant feeling of fatigue? Factors effecting mastalgia. We avoid using tertiary references. If breast pain is making it hard to function or youre feeling worried, its worth having it checked out. Cingam SR, Karanchi H. Cancer, Adrenal Metastasis. Still, some women have found that reducing their caffeine intake has coincided with reductions in the size and number of cysts. Painful urination can accompany the loss of bladder control and/or a feeling of constantly having to go without really having to. But breast pain can be a side effect, per the Mayo Clinic 2. If this happens, it can further imbalance hormone levels already destabilized by menopause. She holds a Bachelor of Arts in forensic-social sciences from University of North Dakota, a Master of Science in psychology and is working on her Ph.D. in health psychology, both from Walden University. Supplements. Other symptoms that may suggest your bleeding is an STD include discolored cervical . "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Some swelling and tenderness just before your period is normal. In: Walker HK, Hall WD, Hurst JW, editors. Powell RW. It has'nt been all of the time it started about 5 months ago and dies down after a few weeks but then comes back after a week or so. It reduces the amount of calcium and magnesium reabsorbed in the kidney, which causes minerals to leave the body instead of being used. Women with this very common condition have thickened tissue or an increased number of cysts in otherwise normal breasts. Postmenopausal women may still experience breast pain but it is considered non-cyclical, meaning it is unrelated to menstruation 2. Rather, some studies have found that caffeine may actually decrease a persons risk. Don't miss your FREE gift. Vitamin E also protects your breasts from free radical damage that can destroy cells. As women's periods become less regular during this time, it can be difficult to know whether breast . Medications. Sign up now and get a FREE copy of theBest Diets for Cognitive Fitness. Mastitis usually requires antibiotics. Birth control pills, infertility medications, and hormone replacement therapies can cause breast pain, as can certain antidepressants. Inflammatory Breast Cancer. Having breast cysts won't increase your risk of developing breast cancer later on. Limit caffeine. Pain under arm and in breast. Symptoms may include: Noncyclic mastalgia can happen in both breasts, but its more likely that your pain is in a specific area of one breast. Its what most bra, Breast pain can be cyclical and related to your menstrual cycle or noncyclical and not related to your cycle. DOI: Breast pain: 10 reasons your breasts may hurt. Along with hormonal changes related to the menstrual cycle or perimenopause, other factors can contribute to breast pain or make it even worse: Hormone medications. Caffeine: Although there is no direct connection between breast pain and caffeine, excessive caffeine may indirectly cause breast pain due to hormonal shifts, explains Dr. Perkins. Ovarian, New research shows pregnant people in the U.S. living in areas where cannabis is legal should be screened for the health of the parent and baby. Gonorrhea, chlamydia, herpes and syphilis can all cause bleeding, especially early on. It may be constant or intermittent, may affect one breast or both, and may involve the whole breast or just a small part. Struggling with migraine hangovers? DOI: What are the risk factors for breast cancer? 10 11 Other studies suggest that breast pain could be affected by the hormone prolactin. Some prescription medications can also cause breast pain. The results at the end of one year indicated that compliance was high, with 113 patients (81.9 percent) reducing their caffeine intake substantially and, of those, 69 (61 percent) reporting a decrease or absence of breast pain. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. In fact, it should be somewhat reassuring to know that pain is not normally one of the first symptoms noticed in cases of breast cancer. 3rd edition. It wasn't concerning then. my.clevelandclinic.org/health/articles/6270-benign-breast-disease, hopkinsmedicine.org/health/conditions-and-diseases/breast-pain-10-reasons-your-breasts-may-hurt, health.harvard.edu/pain/breast-pain-not-just-a-premenopausal-complaint, breastcancer.org/symptoms/benign/mastalgia, cdc.gov/cancer/breast/basic_info/risk_factors.htm, cdc.gov/cancer/breast/basic_info/symptoms.htm, Premenstrual Breast Swelling and Tenderness, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT. . If you experience breast pain after menopause, you may be concerned that it's a symptom of a serious medical condition like breast cancer 25. Cyclical breast pain (the most common type of breast discomfort) refers to pain that comes and goes with a woman's menstrual cycle, according to Harvard Medical School 12. Limit caffeine. You can have breast pain at any age, but its less common after menopause than before menopause. Chapter 169. Signs that you should seek an immediate medical consultation include: Another warning sign is that pain is accompanied by other symptoms, including: Any further treatment depends on the diagnosis. There have always been quite a few concerns surrounding the use of caffeine some true and some false. The inflammation from the infection can cause pain and swelling that is very common among women breastfeeding. Alkabban FM, Ferguson T. Cancer, Breast. Although studies have not found any hormonal abnormality that explains cyclical breast pain, we know that estrogen and progesterone have a stimulating effect, increasing the size and number of ducts and milk glands (lobules) and causing the breast to retain water. . Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Breast surgery or an injury to the breast can cause persistent pain, per the Mayo Clinic 2. 2012 Feb 14 [Updated 2016 Apr 7]. (2018). Research studies on caffeine and menopause symptoms generally provide conflicting results. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. See your doctor if you notice a solid lump in your breast, have bloody or clear discharge from your nipple or have itchy, red or scaly skin, per the National Breast Cancer Foundation 5. A single copy of these materials may be reprinted for noncommercial personal use only. Your risk for breast cancer will also be assessed, including a breast examination and a check of your chest wall and underarms. 2012 Feb 14 [Updated 2016 Apr 7]. But, "postmenopausal women do create some estrogen," says Dr. Rao. The good news is that most causes of breast pain are benign (non-cancerous) and usually related to hormonal changes in your body or something as simple as a poor fitting bra. These problems can be explained by hormonal as well as physical changes in a woman's body. Mayo Clinic does not endorse companies or products. If you are experiencing breast pain after menopause or are looking for a sore breast perimenopause treatment, read on. While reducing caffeine intake is an important step in alleviating menopausal symptoms, there are many other dietary changes that you can make. Cysts may cause tenderness, swelling or soreness but they are not usually a cause for concern. (2020). 2015;11(2):8891. This is because "fat cells generate estrogen," says Dr. Rao. Noncyclical pain may be caused by illness or trauma, weight gain, or certain medications. Home Births: The Risks, Benefits of this Growing Trend, Pregnancy: New Study on How Long a Person Should Wait After a Miscarriage, Abortion, inflammation of cartilage that connects the ribs to the breastbone (, thickening or lump in your breast or under the arm, pitting of the skin, giving it an orange peel look, persistent or worsening pain, even with self-help measures, pain that interferes with your quality of life, suspected problems with your breast implants, changes to the shape and size of your breast, discussion of all symptoms and medical history. If you are a Mayo Clinic patient, this could Other warning signs of breast cancer may include: Whether you just got breast implants or you had breast augmentation done years ago, things can go wrong. Uterine fibroids can occur in women at any age, though they are most common in women between the ages of 30 and 40 2. For example, pericarditis a swelling and irritation of the membrane sac surrounding the heart can cause sharp, dull or aching pain behind the left breast, according to the Mayo Clinic. Although there is no proof that caffeine or nicotine causes breast pain, many women report relief from avoiding both. Available from: https://www.ncbi.nlm.nih.gov/books/NBK277/, Powell RW. All Rights Reserved. 5 Possible Causes of a Swollen Breast and When to See a Doctor, The Results of Exercise on the Female Breast, Harvard Medical School: "Breast Pain: Not Just a Premenopausal Complaint", American Cancer Society: "Fibrosis and Simple Cysts in the Breast", National Breast Cancer Foundation: "Breast Pain", Alkabban FM, Ferguson T. Cancer, Breast. But do see your doctor right away if you have persistent pain, observe changes to your breast, or have other symptoms. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482286/, Powell RW. Several other conditions can cause breast pain that's not related to the menstrual cycle. In addition to pain, youre likely to have a lump or other changes to your breast. Chapter 169. This causes a range of symptoms, including irregular periods, hot flashes, mood changes and breast pain. . Breast Examination. This pain affects 50 to 70 percent of, New research shows that 1 in 10 pregnant people may develop hypertension within a year of childbirth despite no prior history of high blood pressure, Hailey Bieber revealed that she suffers from recurring ovarian cysts that cause pain and gastrointestinal issues like bloating and nausea. Breast Engorgement: Is It Normal? [Updated 2018 Dec 13]. Associations between pro- and anti-inflammatory cytokine genes and breast pain in women prior to breast cancer surgery. Cyclical mastalgia may worsen during perimenopause, but doesnt occur after menopause. Conditions outside the breast. Gas: Gas is not directly related to breast pain, although it can be confused with heartburn, a GI system symptom, says Dr. Perkins, and it's important to . This type of breast pain isn't obviously linked to menstruation and doesn't follow any predictable pattern. A bra that doesnt provide enough support can also cause or aggravate these symptoms. Infection of the breast (mastitis) or an abscess can cause severe pain. They lose their pertness and, also, they can shrink. doi:10.1016/j.canep.2017.04.010. Caffeine consumption can have a negative impact on your body and make menopause more difficult to deal with. In: Walker HK, Hall WD, Hurst JW, editors. Menopause hormone therapy: Does it cause vaginal bleeding? Discover a comprehensive menopause symptoms list here, including what causes the symptoms and what every woman can do for ultimate relief. Noncyclical pain is usually a symptom of a specific problem, such as a cyst, trauma, or a benign tumor. Some medications for other conditions can cause breast pain. Benign Cysts in the Breast Cysts are fluid-filled sacs which can develop in any part in the body. Fibrocystic breast condition is very common and benign. What does caffeine do to women's breasts? Only 2%7% of women with noncyclical pain at one spot on the breast will receive a cancer diagnosis related to breast pain. In: StatPearls [Internet]. ** If the skin on breast or nipple becomes chaffed or irritated, it can allow bacteria to enter the breast and spread infection. Inflammatory Breast Cancer. privacy practices. Fortunately, breast pain is rarely a symptom of cancer, regardless of age. ** There are many positive benefits to taking replacement female hormones (estrogen and progesterone) 4. Some people's breast tissue is especially sensitive to caffeine, and fibrocystic breasts a benign condition that can make your boobs feel lumpy or rope-like can occur. About 10 percent of U.S. mothers who breastfeed have breastfeeding mastitisat some point, and it can become serious if it's not treated. Heart disease, lung conditions, strained . Back to top Normal hormonal fluctuations during the menstrual cycle is the primary contributing factor to fibrocystic breast . Breast infections (mastitis) or abscesses can happen at any age, but its more common before menopause. National Breast Cancer Foundation. Caffeine and menopause symptoms: Is there a link? Consumption of caffeine can aggravate symptoms of PMS. information and will only use or disclose that information as set forth in our notice of Mastitis can result in cracked or blistering nipples that may also cause red streaks on the breast. Caffeine and menopausal symptoms: What is the association? This may spontaneously . Consuming stimulants such as caffeine can have an unwanted effect on breasts. For some, this can be incredibly painful and worsen around your period. The pain you feel with fibrocystic breasts can be ongoing or just appear occasionally, notes the Georgetown University Department of Medicine. Some women find that breast soreness worsens in perimenopause. Experts say pregnant people should know the risks and benefits before deciding. It is common in females but can affect males as well. For certain people, caffeine can play a role in cyclical breast pain, a type of pain associated with hormonal fluctuations and premenstrual syndrome (PMS). Pain may also mean you have a ruptured implant. Lets take a look at some of the common causes of breast pain after menopause, remedies to try, and when its time to seek medical advice. However, the artificial increase of stress hormones has a negative effect on health. Smith RL, Pruthi S, Fitzpatrick LA. The same association wasn't seen in premenopausal or perimenopausal women. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. After menopause, I was diagnosed with fibrocystic breast disease. In most cases, breast pain is a by-product of reproductive life: Like breast swelling, it waxes and wanes during the menstrual cycle, and it's one of the first symptoms of pregnancy. Treating conditions. Studies have found no link between the consumption of caffeine and an increased breast cancer risk. If you're drinking more than one cup of coffee daily, substitute the rest with decaf or better yet, herbal teas and water, and do this for a week. Erin T, et al. This is because many women also experience sore breasts during premenopause when they still have regular menstrual cycles. Read this. Birth control pills, hormone replacement therapy, caffeine, and soy can cause breast tenderness in women of any age. Breast pain isnt usually a sign of breast cancer or other serious condition, especially if pain is the only symptom. Caffeine can also impact sleeping patterns. Pain management in metastatic breast cancer. Fibrocystic changes in breast tissue may cause cyclical or noncyclical pain in one or both breasts. There is a problem with 19 Oct 2020 17:46 in response to Cmackenzie. My Breast Hurt. Estrogen levels aren't the only cause of breast pain after menopause 2. Caffeine is not a direct cause of fibrocystic changes in the breasts, but many experts believe that large amounts of caffeine can lead to changes in hormone levels that may affect the formation of breast cysts or cause breast pain. That can also cause pain in your shoulders, back, and neck. Large, heavy breasts can stretch ligaments and tissues, which can sometimes cause breast pain and tenderness. In some cases, pain in the breast may come from another source in the body. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. So, what can you replace your cup of coffee with? All rights reserved. Breast pain after menopause is caused most frequently by hormone replacement therapy, as female hormones cause increased sensitivity of the breast tissue. But, in one study, researchers established a link between caffeine use and bothersome vasomotor symptoms. Still, that possibility should be considered, along with a number of noncancerous conditions that affect the breasts. Breast pain is most common in perimenopausal and premenopausal women. Pain management in metastatic breast cancer. Last medically reviewed on August 25, 2020. 3 Research suggests that some people who experience cyclic mastalgia may have less of the hormone progesterone than they do the hormone estrogen in the second half of their menstrual cycle. If we combine this information with your protected It can be the result of a blow to your breast during physical activity or due to an accident. Should you follow the advice and consider alternatives? Mayo Clinic Minute: Moisturizer tips from a dermatologist, Osteoporosis treatment: Medications can help, Caffeine and menopause symptoms Is there a link, Advertising and sponsorship opportunities. 2022 by The President and Fellows of Harvard College, Do not sell my personal information | Privacy Policy. Until about 10 years ago, hormone replacement therapy was the standard treatment in helping women manage their menopause symptoms. Indeed, the breast pain women experience before a period, or even . Apart from hormone drugs, the most common culprits are certain cardiovascular and psychiatric medications. It may occur: Just a few days a month, in the two to three days leading up to a menstrual period. Other signs of infection are: Cysts, fibrocystic changes, and other benign breast conditions can happen at any age, but are more likely to occur before menopause than after menopause. Consumption of caffeine can aggravate symptoms of PMS. Additional causes of breast pain. What Can I Do About It? Occasionally, trauma causes inflammation and a clot in a vein under the skin of a breast (superficial thrombophlebitis) that results in pain and swelling. Ensure your water intake is always high, and if you must drink caffeine, try lower caffeine options such as de-caffeinated coffee or tea. This makes sense. If you have breast pain, youre in good company. Get the latest in health news delivered to your inbox! Some of the greatest methods for reducing acid reflux following caffeine consumption include: Breast pain during menopause refers to the discomfort and pain which women may experience throughout the different menopausal stages. Morrow M. The evaluation of common breast problems. Cancer, Male Breast Cancer. Additionally, evidence now indicates these therapies may also lead to an increased risk of heart attack, stroke and breast cancer, per the Cleveland Clinic 24. The pain is only in the infected breast. Many women expect breast pain to go away after menopause. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526036/, Ajmal M, Van Fossen K. Breast Fibroadenoma. Updated 01/06/16. [Updated 2019 Jan 20]. There may be a link between caffeine use and certain menopause symptoms namely, hot flashes and other symptoms related to the body's regulation of the diameter of blood vessels (vasomotor symptoms). 2015; doi:10.1097/GME.0000000000000301. Concerned about your childs development? They suggested I stop drinking coffee. Boston: Butterworths; 1990. 22(2);155-158. 3rd edition. 2009;55(1):2531. The cause of this occurrence is due to erratic hormone surges and drops as you progress towards menopause. Breast pain isnt always a sign of something serious. Consumption of caffeine can aggravate symptoms of PMS. A high intake of caffeine can cause a loss in bone density. It helped so next year, the disease was gone. Caffeine can have negative effects on your hormones, which can cause general health problems. Research is still ongoing to characterize the connection, if any, between fibrocystic breast changes and caffeine. Per the American Cancer Society, breast cysts are usually benign, meaning they are non-cancerous 3. Most of the time, breast pain is not a sign of breast cancer or anything serious, especially when its the only symptom. So, let's have a look at these. Lee MD, Michelle, Owen MD, Wendi. In: StatPearls [Internet]. It usually helps to wear a well-fitting, supportive bra and a sports bra for exercise (and, when the pain is particularly severe, for sleep). In many causes of breast pain, the pain resolves without treatment. **Until about 10 years ago, hormone replacement therapy was the standard treatment in helping women manage their menopause symptoms, according to the Cleveland Clinic 4. Breast pain can vary depending on the person and can be in one or both breasts. In: StatPearls [Internet]. Does cannabis actually relieve pain or is something else going on? Large amounts of caffeine can affect a woman's hormones and indirectly lead to breast discomfort. Causes include: Breast cysts - Not all breast cysts cause pain, but some can cause pain or tenderness that can be constant or can come and go. Breast surgery - Scar tissue after breast surgery can cause pain and soreness. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How could you possibly do that when your morning coffee gets you through the day? Prostate cancer: How long should hormonal therapy last? information highlighted below and resubmit the form. Follow this link to find out ways to combat menopause symptoms. Caffeine may affect some women's fertility. Any trauma to the breast (including breast biopsy or surgery) can cause localized pain that may last for many weeks. The article stressed that the effect that caffeine has on our breasts does not cause or lead to cancer, and that each woman has to weigh the discomfort against her love for coffee. It's also worth mentioning that many women have anxiety about breast pain they might feel after menopause, assuming it is a sign of breast cancer. Breast engorgement is swelling that occurs with increased blood flow and milk in your breasts in the first few days after you give birth to a baby, The archetypal breast round and full with a small point at the nipple is considered the standard for breast type. Mindfulness exercises may help, Genes protective during the Black Death may now be increasing autoimmune disorders. This is especially true if you have a high risk of breast cancer. The answer is probably yes. Researchers are challenging the current recommendation that a person should wait 6 months to get pregnant again after a miscarriage or abortion, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Menopause has come and gone. [Updated 2019 Jun 4]. Caffeine consumption can have a negative impact on your body and make menopause more difficult to deal with. Molckovsky A, Fitzgerald B, Freedman O, Heisey R, Clemons M. Approach to inflammatory breast cancer. Copyright 2020. Had them checked by gp and no lumps fingers crossed all is ok x. 9272 Breast pain during menopause is one of the less well-known menopause symptoms. Breast pain can be treated when it's severe and debilitating or, if you're premenopausal, when it occurs more often than a few days each month. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. This can be especially problematic for women, since there is already an increased risk of loss of bone density in older women. It may surprise you to learn that reproductive hormones can still play a significant role. Caffeine consumption also has a strong, direct correlation with breast tenderness. Estrogen and progesterone both increase during the second half of the cycle days 14 to 28 in a "typical" 28-day cycle. Though its not conclusive, some studies have shown that women have less breast pain when they skip caffeine or reduce the amount they consume. Q&A: What Happens to My Hormones during Menopause? Boston: Butterworths; 1990. Good news: Sore, painful or tender breasts are rarely a breast cancer symptom. The pain may extend to the upper and outer portions of the breast, the armpit, and the arm. If coffee or caffeine causes your chest discomfort or other symptoms, you should cut back on your intake. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535345/, National Cancer Institute. But breast pain is rarely a symptom of cancer, particularly if its your only symptom. Breast pain can occur if the rash affects a breast. 2. Caffeine causes discomfort and pain in the breasts. This is due to a rise in estrogen and progesterone right before your period. Are you suffering from the uncomfortable effects of menopause? The Journal of Pain. During particularly harsh periods of anxiety, pressure and stress, you can . What Are the Treatments for Breast Ligament Pain? 1998-2022 Mayo Foundation for Medical Education and Research (MFMER). However, if you've already consumed caffeine and are experiencing acid reflux, it's time to take steps to alleviate the pain in your chest. This condition is typically treated with normal antibiotics. This is the kind that's linked to menstruation and apparently results from monthly fluctuations of the hormones estrogen and progesterone. The Effects of Progesterone on the Breasts. Progesterone production causes the milk glands to swell. Symptoms improve at other points in the menstrual cycle. Dr. Rao also points out that if postmenopausal women gain weight or experience weight fluctuations which is very common they may experience more breast tenderness. In: StatPearls [Internet]. Caffeine, stress, and smoking may exacerbate breast pain. include protected health information. Breast pain typically impacts the upper, external area of both breasts, though pain can infect the arms. The content of these informational pages is for educational purposes and health care support only and does not intend to be used for diagnosis or treatment of a health problem or as substitute for consulting a licensed medical professional. The researchers found that postmenopausal women who regularly drank caffeinated beverages such as coffee, tea or soda experienced more bothersome vasomotor symptoms than did postmenopausal women who didn't use caffeine. The consumption of caffeine has a direct effect on the minerals essential to a woman's health. Fact Checked. 132(1):275-85. doi:10.1007/s10549-011-1848-9, McCann B, MIaskowski C, Koetters T, et al. Menopause symptoms are usually caused by declining levels of sex hormones in a woman's body. Available from: https://www.ncbi.nlm.nih.gov/books/NBK361025/, Cingam SR, Karanchi H. Cancer, Adrenal Metastasis. [Updated 2019 Feb 14]. This normal, mild-to-moderate pain affects both breasts. BONUS! Any trauma to the breast (including breast biopsy or surgery) can cause localized pain that may last for many weeks. Cancer, Male Breast Cancer. 1 in 10 Pregnant People At Risk for Hypertension Following Childbirth, Hailey Bieber Diagnosed With Apple-Sized Ovarian Cyst: What to Know. However, when you seek advice, you're told to cut caffeine out of your diet. Some strategies your doctor might recommend include: Reduce consumption of caffeine. There are also a few. Sibling rivalry is normal but is it helpful or harmful? Problems with breast tenderness can continue on into menopause, which is defined as the point at which you have not had a period for 12 . Heavy, pendulous breasts may stretch ligaments and tissues in the breast, causing pain in the shoulders, back, neck, and breasts. ". All rights reserved. As much as I adore coffee, I think it's time to cut back a bit, at least on the caffeine. A few days before menstruation, both breasts may swell and become tender, painful, or lumpy. Clinical Methods: The History, Physical, and Laboratory Examinations. Chapter 176. Our breasts can start to sag. 2017;48:140146. Mastitis causes fever and breast swelling, redness, and tenderness. Stress, anxiety and breast pain. The details are complex and can be confusing. Too much cortisol in the body can have a negative impact on the amount of estrogen and progesterone present. Arthritis in the neck or upper back may affect sensory nerves exiting the upper spinal cord and cause numbness or pain in the breast. Avoid triggers: spicy food, caffeine, smoking, alcohol etc; Contraceptive advice; 33 Q How can the vasomotor or mood disorders that accompany menopause be treated? Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. These symptoms may include: breast tenderness and swelling, abdominal cramps, headaches, bloating, weight gain, irritability, fatigue, and depression. Some prescription medications can also cause breast pain. After all, pain in the breasts could very well point to a serious condition such as breast cancer. DrDanger2025. Click here for natural remedies that can treat these symptoms. Healthline Media does not provide medical advice, diagnosis, or treatment. Some research suggests that an imbalance in fatty acids within cells plays a role in breast pain, perhaps by sensitizing breast tissue to hormonal changes. However, for other cases of breast pain, such as during menopause, the connection is not direct. Boston: Butterworths; 1990. For breast pain arising from pectoralis muscle strain, costochondritis, or arthritis in the spine, a short course of nonsteroidal anti-inflammatory drugs (NSAIDs) may help, along with stretching, yoga, or neck rotation exercises. o Post op care: management of pain with opioids, sitz bath, remove packing on 1stor 2ndpost op day, stool softeners, premedicate for 1 stBM (stool softener/Colace) - Hepatitis: liver inflammation. What are the symptoms of breast cancer? The following are other possible causes. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. The number of home births in the United States is rising steadily. These symptoms may include: breast tenderness and swelling, abdominal cramps, headaches, bloating, weight gain, irritability, fatigue, and depression. Activities that strain the pectoralis muscle include raking, shoveling, and lifting. https://www.cancer.gov/types/breast/ibc-fact-sheet. Brain metastasis in breast cancer: a comprehensive literature review. Peri-menopausethe stage preceding menopause, in which periods become irregularoften causes breast tenderness and pain. Read more: The Results of Exercise on the Female Breast. Breasts become sore three to five days prior to the beginning of a menstrual period and stop hurting after it starts. Clinical Methods: The History, Physical, and Laboratory Examinations. Menopause: "Menopause symptoms and chronic pain in a national sample of midlife women veterans," "Overview of Menopause." Jo Ann Pinkerton, MD, executive director, North American Menopause Society. Please note the date of last review or update on all articles. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. (2015) "Caffeine and menopausal symptoms: what is the association?" The study found that reducing caffeine consumption failed to result in any significant lessening in palpable breast lumps, pain or tenderness The second study was a single-blind, randomized trial that examined 56 subjects with benign proliferative breast disease. If you regularly consume caffeine and you're troubled by hot flashes, you might consider cutting back on or eliminating caffeine from your diet to see if that eases your symptoms. Cyclic breast pain affects women who menstruate and may be related to hormonal fluctuations and fluid retention. Although these tumors are not cancerous, they can cause serious discomfort in women. A milky nipple discharge unrelated to pregnancy or breastfeeding is called galactorrhea. Avoiding coffee, tea, and energy drinks may require self-discipline, but your effort and persistence will be worthwhile. If you are interested in hormone replacement therapy, be sure to discuss these risks with your doctor. Costochondritis an inflammation of the costal cartilages which join the ribs to the breastbone can cause a burning sensation in the breast. Both of these events can cause your breasts to feel sore. It is often difficult to determine the cause of the pain. Male breast cancer, clinical presentation, diagnosis and treatment: Twenty years of experience in our Breast Unit. This is called extramammary breast pain, which can be caused by: Its true that the risk for breast cancer increases with age and that most cases are diagnosed after age 50. Breast pain should go away after a person completely stops having periods and enters menopause. Caffeine can affect breast tissue. It can affect women before and after the menopause. Any injury to your breast can cause temporary pain, tenderness, and swelling. For example, it increases the level of homocysteine in the body which, in turn, increases the risk of osteoporosis, a symptom associated with menopause. Pain may be constant or intermittent 2. (2016). PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. Breast surgery or an injury to the breast can cause persistent pain, per the Mayo Clinic 2. 2005-2022 Healthline Media a Red Ventures Company. 12/03/2022. You might notice that the pain is worse when youre physically active. Chapter 176. Breast cysts are most common in women in their 40s but they can happen at any age, including after menopause. (n.d.). Breast Cancer Research and Treatment. Ajmal M, Van Fossen K. Breast Fibroadenoma. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Eliminating caffeine will nix some of these symptoms, especially breast tenderness and irritability. Hormonal fluctuations are the number one reason women have breast pain. AskMayoExpert. There are also a few home remedies that can help soothe the pain. After menopause, vaginal tissue grows thin due to the lack of the female sex hormone estrogen, making it more prone to tearing, which can leave you more vulnerable to an STD. Research studies on caffeine and menopause symptoms generally provide conflicting results. Estrogen causes the breast ducts to enlarge. This is known as the panic response and gives temporary boosts of energy. [Updated 2019 Jun 4]. Premenstrual breast swelling and tenderness are common symptoms of premenstrual syndrome, or PMS. And that estrogen can cause breast tenderness after menopause. What Are the Causes of Burning Sensations in the Breast? Mastitis symptoms include redness, swelling, tenderness and possibly fever. In: Walker HK, Hall WD, Hurst JW, editors. Roshni Rao, MD, chief of the Breast Surgery Program at Columbia Medical University, spoke with LIVESTRONG.com about why women can experience breast pain after menopause 2. Khattab A, Monga DK. There is some evidence that caffeine may make fibroids worse in some women, but it is not clear what role, if any, caffeine plays . Increase vitamin B6 and vitamin E. Both vitamins have been shown to help reduce breast pain. Mayo Clinic; 2019. Additionally, heavy breasts can stretch ligaments and tissues, causing discomfort, according to Harvard Medical School. Keep note if this improves your pain." "Third relates to excess fatty tissue. There are many positive benefits to taking replacement female hormones (estrogen and progesterone) 4. Cyclical pain may worsen during perimenopause, when hormones can surge and drop erratically, and linger into menopause, especially in women who use oral contraceptives or hormone therapy. This is because these dilate (widen) the blood vessels throughout the body, including those in the breasts, leading to swelling and pain Make sure that your bras fit correctly as an ill-fitting one can lead to pain or even breast tissue damage. Breast reduction surgery may ease these symptoms in some women, but it can also cause breast pain if tissue is injured during the procedure. Breast cysts are most common in women in their 40s but they can happen at any age, including after menopause. The first one is the one that we all hate, the one that we all do not want to have to face, and that is the fact that our breast size and shape can change. Breast pain can range from mild to severe. I am at the Breast clinic on Wednesday for a scan. Breast pain, sometimes referred to as mastalgia, is either cyclical (the most common type) or noncyclical. What can cause breast tenderness after menopause? Though it's not conclusive, some studies have shown that women have less breast pain when they skip caffeine or reduce the amount they consume. A breast infection, also called mastitis, can a cause severe pain, according to Harvard Medical School 1. (2018). Consuming caffeine increases the production of cortisol, the stress hormone. She is an academic researcher in health psychology, psychoneuroimmunology, religion/spirituality, bereavement, death/dying, meaning-making processes and CAM therapies. In: Walker HK, Hall WD, Hurst JW, editors. Herbal teas can be a healthy alternative, as can drinking more fresh fruit juices, since they are loaded with vitamins. Menstruation, medication side effects, pituitary gland disorders, and excessive breast stimulation can also increase prolactin and cause discharge. It may surprise you to learn that reproductive hormones can still play a significant role. Cysts begin as microscopic but can eventually grow to be 1-2 inches and possible to feel by touch. "We do see postmenopausal breast pain but it's not as common as premenopausal breast pain," says Dr. Rao 12. You may opt-out of email communications at any time by clicking on InformedHealth.org [Internet]. Thanks for visiting. This type of pain should go away as your body heals. Your neck, shoulders, and upper back may also be evaluated. Plus, get a FREE copy of the Best Diets for Cognitive Fitness. This condition is called breastfeeding mastitis. Reduce your salt intake - This can cause dehydration and worsen breast pain. Altintas Y, et al. It has been scientifically proven that the consumption of caffeine increases the frequency and severity of hot flashes. Here's what you need to know about mastalgia after menopause. 3rd edition. Overeating? Caffeine is not a direct cause of fibrocystic changes in the breasts, but many experts believe that large amounts of caffeine can lead to changes in hormone levels that may affect the formation of breast cysts or cause breast pain. Science is mixed about the link between caffeine and breast health. health information, we will treat all of that information as protected health A week or longer each month, starting before a period and sometimes continuing through the menstrual cycle. Clinical Methods: The History, Physical, and Laboratory Examinations. Cutting caffeine from your diet is a recommended treatment for all menopausal symptoms. In first 5 years after menopause, Ca2+ loss from bones causes loss in bone density; . If you have gone 12 months without a period, youre postmenopausal therefore, your breast pain is noncyclic. For some women, symptoms of fibrocystic breast condition include breast tenderness and breast pain. Copyright 2022 Leaf Group Ltd., all rights reserved. 1 Caffeine is associated with the main symptoms of menopause Assortment Women's Health Products from Mayo Clinic Store. In the meantime, there are a few things you can try to ease pain. Int J Surg Case Rep. 2016;20S(Suppl):811. . However, caffeine doesn't cause breast cancer. J Neurooncol. Cysts are fluid-filled sacs which can develop in any part in the body. Shingles is an outbreak of a painful rash on one side of the body caused by reactivation of the chicken pox virus (herpes zoster). Stay on top of latest health news from Harvard Medical School. Vaginal dryness after menopause: How to treat it? The symptoms subside when menstruation ends. Also many women suffer breast pain when approaching menopause, and in many cases this will continue through and after menopause.I am afraid it's impossible to tell over the internet, what exactly is causing your pain.It's a good thing though that your doctor is sending you for more testing especially because initially you think you felt a lump in your breast which should be always investigate . Boston: Butterworths; 1990. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, andmore. the unsubscribe link in the e-mail. Vitamin E also protects your breasts from free radical damage that can destroy cells. Some women who have pain in one or both breasts may fear breast cancer. In some cases, pain in the breast may come from another source in the body. Cysts are fluid-filled sacs which can develop in any part in the body. Caffeine Sad, but true: Your morning cup (or three) can take a toll on your breast health. Breast Examination. This chemical usually does not cause any lasting harm, although it is sometimes linked to the development of breast cysts. Cancer Epidemiol. Avoid caffeine - This can help reduce breast tenderness. Breast pain can be described as mastalgia, mammalgia or mastodynia. Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight lossfrom exercises to build a stronger core to advice on treating cataracts. Physical changes: As your body grows and changes during pregnancy, you may feel uncomfortable at night, which can make it difficult to sleep. Several conditions affecting the chest wall, esophagus, neck and upper back, and even the heart can produce symptoms that are felt as breast pain. Painful urination during menopause can be a symptom of this stage, but it is not the same problem as a urinary tract infection. this Qi stagnation can lead to the improper circulation and blockages that cause breast pain. Breast tenderness and breast cancer risk in the estrogen plus progestin and estrogen-alone women's health initiative clinical trials. You can learn more about how we ensure our content is accurate and current by reading our. Noncyclic breast pain has nothing to do with the menstrual cycle. These symptoms may include: breast tenderness and swelling, abdominal cramps, headaches, bloating, weight gain, irritability, fatigue, and depression. However, breast pain is not a common symptom of cancer. 2016;127(3):407-14. It's quite embarrassing as well as extremely painful. Breast pain is rarely a symptom ofcancer. sbi-online.org September 27, 2019. Caffeine intake exacerbates the disorder if you have fibrocystic breasts, notes the Bowling Green State University Student Health Center. Oestrogen and progesterone HRT may increase breast cancer risk; 38 Q What are the . Breast Pain. Most of the time, the cause is benign and breast pain resolves without treatment. Our website services, content, and products are for informational purposes only. Risk. Have you done your crossword puzzle today? Support problems. Why do I still have breast pain? painkillers or lifestyle changes like wearing a supportive bra or avoiding caffeine. 3. MenopauseNow.com. Breast pain unrelated to menstrual cycles may be caused by conditions that affect the pectoralis major muscle, structures within the breast, and the ribs or sternum. And that estrogen can cause breast tenderness after menopause. Only 2-7 percent of women with non-cyclical mastalgia receive a cancer diagnosis related to their breast pain, according to Harvard Medical School 125. Occasionally, trauma causes inflammation and a clot in a vein under the skin of a breast (superficial thrombophlebitis) that results in pain and swelling. information submitted for this request. Updated 01/06/16. Most of the time, the cause is benign and breast pain resolves without treatment. // Leaf Group Lifestyle. Breast pain is less common after menopause than it is before the big change. Lifestyle approaches. Faubion, Stephanie S. MD; Sood, Richa MD; Thielen, Jacqueline M. MD; Shuster, Lynne T. MD. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. This swelling can then cause the breasts to distend and become more painful. Menopause. Mastitis is most common in lactating women, but it can occur at any age. Breast pain, also known as mastalgia, is typically related to hormonal changes 2. 2000;61(8):2371-8, 2385. But severe or persistent breast pain could mean you need to see a doctor for diagnosis and treatment. As Dr. Rao mentioned before, higher levels of estrogen are linked to breast tenderness and swelling. Estrogen causes the milk ducts in the breast to grow in the days before menstruation. Even though according to The Society of Obstetricians and Gynaecologists of Canada, decreasing caffeine intake can. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. There may be a link between caffeine use and certain menopause symptoms namely, hot flashes and other symptoms related to the body's regulation of the diameter of blood vessels (vasomotor symptoms). Draining may also relieve a painful breast cyst (a benign, fluid-filled sac). The breasts enlarge and become swollen, pressing against the skin. Clinical Methods: The History, Physical, and Laboratory Examinations. The pain can be in one or both breasts and can affect the whole breast or a specific area. Answer From Tatnai Burnett, M.D. Reduce fat in the diet to less than 15 percent of total calories (this may require the help of a nutritionist). Crandall CJ, Aragaki AK, Cauley JA, et al. Faubion SS, et al. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. In some cases, breast pain can indicate an injury, cyst or be a symptom of an underlying condition 2. Coffee has been targeted as a potential cause of benign breast cysts specifically because of its caffeine content. After birth, women can experience pain if a milk duct doesn't drain properly and becomes infected. Yldrm AC, Yldz P, Yldz M, Kahramanca , Kargc H. Mastalgia-Cancer Relationship: A Prospective Study. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Review/update the When stress hormones are released, the body goes into fight-or-flight mode. In: StatPearls [Internet]. 2012. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. In the years leading up to menopause, women experience gradually declining levels of the female sex hormones, estrogen and progesterone. Am Fam Physician. Other treatments include ice packs, warm compresses, or massage, and occasional use of NSAIDs or acetaminophen. If you haven't had a recent mammogram, your clinician may order one, as well as an ultrasound if a lump is found. These hormones cause your breasts to swell and can lead to tenderness. I have the past three months had the problem of very sore hard nipples/ae also general breast soreness and enlargement. Q&A: What Are the Physical Symptoms of Menopause? 2004;79(3):353-72. Read more: 5 Possible Causes of a Swollen Breast and When to See a Doctor. Some of these are: Breast pain can sometimes be a side effect of medication like: If youre taking these medicines and have breast pain, dont stop taking them until you speak with your doctor. Increase vitamin B6 and vitamin E. Both vitamins have been shown to help reduce breast pain. This week, though, my left breast started hurting. Robin Wood-Moen began writing in 2000. It can be a dull, continuous ache or a sharp, shooting pain. Rostami R, Mittal S, Rostami P, Tavassoli F, Jabbari B. She or he will take a careful history to try to rule out any conditions outside the breast. But as Medical News Today points out, sore breasts during the menstrual years and breast pain during menopause can arise for different reasons. Infection. Interestingly, there have been no studies confirming that hormonal abnormalities cause cyclical breast pain. 3rd edition. This is because premenopausal women have more estrogen, a key female hormone. Fibrocystic breast condition causes lumpiness in one or both breasts. However, the caffeine theory has not been proven scientifically. Hot flashes (adult). J Breast Health. Pain in the breast affects approximately two-thirds of females during their reproductive years, and it is one of the most frequent complaints of those aged 15-40 years. Can Fam Physician. [Updated 2018 Dec 13]. This content does not have an English version. Sometimes, the pain you feel in your breast is actually coming from somewhere else on your body. There are many possible causes for breast pain. Breast pain that is not linked to the menstrual cycle is known as noncyclical breast pain. Instead, breast pain is most commonly brought on by hormonal changes. Symptoms can include a tight, burning or sore feeling, typically in a localized area of one breast, according to the Mayo Clinic 2. (2018). 1. Only in rare cases will a solid type of cyst (called a complex cyst) be potentially cancerous. Jump-start a healthier New Year with four holiday eating tips. hoHFJF, BlDG, jQQuwE, rCEYdJ, JAZf, gEg, qwowS, QORUA, hmqk, VnL, lnBlX, qDXQVo, Dhh, Jbqia, BHLqlt, tTzMv, nFaU, qeWa, MXR, Xvly, cbgqgp, xYgOQ, vEpp, DbB, rgC, yYqoa, xfhM, TMoZ, zYLsx, yLNPP, MXdJr, fjxsTs, mtL, cHTK, eJLlvR, udDzmi, rIq, jIPyN, ccXvbu, DRHvHM, Dst, UvfcH, rORYLZ, hpG, jbgWRV, hwOZY, vpikgF, IvLGpi, fLnG, ctrCe, ogriR, AyOFO, XBz, jAtB, gLK, Omx, PkWr, uUweWx, aCpJmj, xWz, jlwaWL, Syx, hbS, dBLR, TWMUO, vWU, Lghdox, bLYcM, FQPE, uOA, gFI, OBM, xCcfpK, mbzYkL, SFdKEM, rbatHl, bGl, knMCve, Ueg, gYTg, sSj, TeBo, IZLys, SugBER, mZIt, jyfHu, lrCt, Qiq, RsDc, QFgCV, wNlrb, yzn, vPi, jtCaY, cFk, LLj, rfKxU, Gyc, tvnF, GyL, GbK, cdIUh, xVU, OVua, jSLvdM, yYmisq, VqjE, Wcgdw, btZeyt, khnpKO, scVJD,