What factors cause breast tenderness before menstruation?

Patient's question:

Around a week before menstruation each month, I always feel bloated. When I touch it, it also hurts. Is this normal?

Doctor's answer:

With premenstrual tension syndrome, which is associated with an elevated ratio of estrogen to progesterone, excessive or relatively excessive estrogen in the body leads to water and sodium retention, resulting in symptoms such as edema and headaches. Additionally, individuals who are prone to stress, irritability, and depression are more likely to develop premenstrual tension syndrome. This discomfort typically begins 7-14 days before the absence of menstruation and worsens 2-3 days before the onset of menstruation. It is characterized by mental tension, hyperesthesia, irritability, depression, general fatigue, easy exhaustion, insomnia, headaches, difficulty concentrating, and memory impairment. Some individuals may also experience swelling in their hands, feet, and face, lower abdominal fullness, pain, and breast tenderness. These mental symptoms and water and sodium retention symptoms disappear or significantly subside after menstruation begins.

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