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Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation


Premenstrual Congestion of the Breasts

Dr. Nelson Soucasaux , Brazilian gynecologist

Among all signs and symptoms that characterize the premenstrual syndrome, mammary (breast) swelling, engorgement and pain constitute some of the more frequent ones. Even many women who do not complain about other premenstrual disturbances often report variable degrees of mammary congestion and/or pain on the days that precede menstruation. As I have observed in my article "Premenstrual syndrome," mammary congestion and engorgement are the most frequent objective premenstrual manifestation and, therefore, the one that is more easily verified at clinical examination. This happens because the increase of density and volume of the mammary parenchyma thickenings and nodules that characterize the so-called "functional mastopathies" (or "benign functional alterations of the breasts") become more evident in the premenstrual phase. In turn, this premenstrual increase in the density and thickness of the mammary tissues is mostly due to the premenstrual congestion and swelling of the breasts.

Even so, concerning the precise etiology (cause) of this mammary congestion that frequently occurs a few days or a week before the coming of the menses, we have to recognize that it still remains obscure ­ in the same way as that of the other edemas and congestive phenomena that take place in other parts of the female body with the premenstrual period. However, I would like to remark once again that it is exactly in the breasts that the water retention and the congestive phenomena that often precede menstruation become more evident and easily detectable at clinical examination. In this way, besides the probable action of local causative factors at the mammary level, there are also indications suggesting the existence of a wider inter-relation among all premenstrual edematous and congestive manifestations.

The cyclical premenstrual engorgement of the breasts becomes clinically evident by: 1) a more or less diffuse increase in the volume and/or turgescence of these organs; 2) an evident increase in the thickness and volume of their glandular and ductal structures, as well as of the connective tissue that surrounds them. As it is widely known, all these alterations often go along with various painful phenomena that occur spontaneously or induced by a simple touch or pressure. It is important to observe that considerable variations in the intensity of all those manifestations can be found in the same woman from one breast to the other ­ a fact that demonstrates the importance of the specific response of the "target" organ in relation to the stimuli that cause the congestive reactions. In a similar way to what happens to most of the other signs and symptoms that appear on the days that precede the menses, this cyclical premenstrual mammary congestion and pain also decline quickly with the beginning of menstruation.

Remaining on the etiology of this premenstrual engorgement of the breasts, it is possible that, in this phase of the cycle, there can be very specific reactions of the mammary tissues to the estrogens and progesterone to the interaction between these hormones and/or to the fall of their respective levels. These very specific reactions might give rise to a local formation of substances capable of altering the permeability of the capillary vessels of the breast tissues, resulting in the accumulation of interstitial fluid and the consequent congestive phenomena. The already mentioned variations in the intensity of these phenomena from one breast to the other in the same woman reinforce this hypothesis. On the other hand, the mammary premenstrual congestion can also be regarded as being only a more localized manifestation of the systemic water retention that many women present on the days that precede menstruation and that is part of the premenstrual syndrome .*

Also due to this premenstrual mammary engorgement, women whose breasts present the thickenings and increased nodularity that characterize the "functional mastopathies" (or "benign functional alterations of the breasts") often suffer from stronger premenstrual mammary pain and discomfort.

For years, several treatments have been used and proposed for this premenstrual mammary congestion and pain. The traditional treatments are commonly based on the use of hormones (mostly progesterone and progestogens ** ) and diuretics that cause the elimination of sodium and water, with a consequent reduction of the mammary edema. Other medicines have also been tried in the last years. Therefore, it is fundamental to emphasize that each case needs to be carefully analyzed individually so that the correct treatment can be prescribed.

Though there is no relation between the usual premenstrual mammary congestion and breast cancer, I would like to emphasize that the clinical management of all breast problems must necessarily include, as a routine, full attention to the prevention and early detection of breast cancer.

Note 1: *Another more localized manifestation of these edemas that precede the menses is the premenstrual pelvic congestion. Though involving mostly the genitals, this congestive reaction also spreads to other near structures. Premenstrual pelvic congestion becomes clinically evident by a diffuse painfulness and sensation of "weight" and discomfort in the lower belly. Lumbosacral pain is also another frequent symptom.

Note 2: **According to some recent studies, some effects of progesterone and progestogens (synthetic "progesterones") on the breast glandular structures are becoming problematic. Even so, from my point of view, it is still too early to change the basic principles that rule the use of these hormones for several mammary problems.


Most of the article above is an excerpt from my book "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1993. For more information on the book, see page http://www.nelsonginecologia.med.br/orgaos.htm , from my website www.nelsonginecologia.med.br .

Copyright Nelson Soucasaux 1993, 2002

__________________________________________________________________

Nelson Soucasaux is a gynecologist dedicated to clinical, preventive and psychosomatic gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Brazil, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993.

Web site (Portuguese-English): www.nelsonginecologia.med.br

E-mail: nelsons@nelsonginecologia.med.br


NEWS | homepage | LIST OF ALL TOPICS | MUM address & What does MUM mean? | e-mail the museum | privacy on this site | who runs this museum?? |
Amazing women! | the art of menstruation | artists (non-menstrual) | asbestos | belts | bidets | founder bio | Bly, Nellie | MUM board | books: menstruation and menopause (and reviews) | cats | company booklets directory | contraception and religion | costumes | menstrual cups | cup usage | dispensers | douches, pain, sprays | essay directory | extraction | famous women in menstrual hygiene ads | FAQ | founder/director biography | gynecological topics by Dr. Soucasaux | humor | huts | links | masturbation | media coverage of MUM | miscellaneous | museum future | Norwegian menstruation exhibit | odor (olor)| pad directory | patent medicine | poetry directory | products, current | religion | your remedies for menstrual discomfort | menstrual products safety | science | shame | slapping, menstrual | sponges | synchrony | tampon directory | early tampons | teen ads directory | tour of the former museum (video) | underpants directory | videos, films directory | Words and expressions about menstruation | Would you stop menstruating if you could? | What did women do about menstruation in the past? | washable pads
More articles by Dr. Soucasaux: Anatomical drawings - Anovulatory cycles - Archetypal aspects of the female genitals - The breasts: some morphological aspects - Colposcopy - Comments on the corpus luteum and related aspects - Comments on some anatomical and symbolic aspects of the female pelvis - The curious relations between androgens and estrogens in women - Drospirenone Oral Contraceptives - Due to prohibition, Brazilian women don't have access to modern medicinal abortion - Endocrinology of menstruation - The Fallopian tubes - Female sexual response - The Gräfenberg Spot (G-Spot) - The Gynecologic Palpation (descendant of "The Touch") - Gynecological assistance: the three basic areas - Gynecology and Gynecologic Surgery - Gynecologist versus obstetrician: what lies behind the combination? - "Gyneco-obstetric-surgical" stubborness and the perpetuation of one of the greatest mistakes of women's medicine - Hypermenorrhea and/or Menorrhagia (Prolonged and/or Excessive Menstrual Bleedings) - Hypertrichosis, Hirsutism and Androgenic Manifestations in Women - Mayer-Rokitansky-Kuster-Hauser (MRKHauser) Syndrome - Menstrual toxin: An old name for a real thing? - Nature and the ovaries - On the Intimate, or Small-Scale, Mechanisms of Menstruation - On the Strange Nature of the Ovaries - Oral hormonal contraceptives (the "Pill") - The Ovaries: Some Functional and Archetypal Considerations - Peculiarities of the Female Genitals' Sensory Innervation - Physiology of menstruation - Polycystic ovaries syndrome - The Possibility of Becoming Pregnant, Its Implications for Women, and Abortion - Premenstrual congestion of the breasts - Premenstrual syndrome (PMS) - The Psychology of Gynecology part 1 (part 2) - Psychosomatic and symbolic aspects of menstruation - Psychosomatic gynecology - Some Details on the Function of the Hypothalamus-Pituitary-Ovaries Axis - Stanislav Grof's Perinatal Matrixes of the Unconscious and Women's Medicine - Symmetric Patterns in the Female Genitals - Thoughts on Female Sexual Psychology - Uninterrupted use of hormonal contraceptives for menstrual suppression: why I do not recommend it - The uterine cervix - Uterine contractility - The Uterus and the Female "Passive-Active" - Women's corporeal consciousness and experience - Women's Experience of the Breasts - Women's Undesired Pregnancies and Women's Right to Abortion and see his Art of Menstruation

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