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    breast pain for over two weeks
    chargerchik2505 posted:
    yes i had a tubal 4 yrs ago i have sever endometriosis where im n pain extreme pain every single day i have periods all the time, but lately ive had severe severe breast pain and my whole life my boobs have never hurt or been sore before my period, the only time my breasts have been in pain like this is when im pregnant, i have two daughters, my tubes were tied after my second, its difficult for me and my husband to be "intimate" bc of my endometriosis, well two wks ago i had a break from having a period so we were "intimate" now ive had two periods only three days apart bc of my endometriosis but my breasts hurt so bad like they feel engorged almost, cant touch em hurts to wear a bra even a shirt touching them is extremely painful, could i be pregnant?
    Jane Harrison Hohner, RN, RNP responded:
    Dear chargerchik: If one is having pregnancy type symptoms and has had sex then pregnancy should always be ruled out. Most tubals are bilateral tubal ligations (BTLs), but there are a number of different techniques used and each has a different failure rate. One researcher looked at the 10 year cumulative failure rate for each type (Peterson, 1996):

    Unipolar coagulation=0.75%
    Postpartum tubal excision=0.75%
    Falope or Yoon ring=1.77%
    Not postpartum tubal=2.01%
    Bipolar coagulation=2.48%
    Hulka clip=3.65%

    In your specific situation, because of the severe endometriosis, it is even more difficult to conceive. Thus, I would hope and expect your pregnancy test to be negative.

    So why the marked, bilateral breast tenderness? While there can be breast pain coming from the chest wall (eg muscular pain) my best GUESS Is as follows. You mentioned constant, erratic bleeding. That can arise from endometriosis of the muscular walls of the uterus ("adenomyosis") and/or hormonal causes such as missed ovulations.

    Hormonal breast tenderness tends to be on both sides, and is thought to be related to increasing levels of hormones such as estrogen. In a month without an ovulation, not only can a menstrual period be missed or with very erratic bleeding, but there can be breast tenderness as well. This is similar to the increased breast tenderness experienced by some women when first taking postmenopausal hormone therapy--or birth control pills. There are many other causes of breast pain (eg infections, herpes zoster) but most often these occur on one breast —not both.

    Bottom line, rule out pregnancy first for if one does conceive with a tubal ligation there is an increased risk for a tubal/ectopic pregnancy. If the pain continues see your GYN for a focused breast exam.


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