Ways Your Breasts Change in Your 40s

After turning 40, it's not unusual to notice a few signs of aging staring back at you in the mirror. While some of the changes shouldn't entirely come as a surprise—fine lines around your eyes, a middle that's a bit softer than it was in your 20s and 30s—others are more unexpected. One familiar, yet often surprising change is the size, shape, and feel of your breasts.

How dramatic the transformation is varies widely and is often closely tied to shifts in your menstrual cycle. At this time in your life, you're reaching a phase called perimenopause. During perimenopause, your ovaries become smaller and produce less estrogen. This phase can last from about age 45 to 55 years, but can also happen earlier or later.

These hormonal ups and downs during perimenopause can translate to changes in your menstrual cycle. They can also cause changes to your breasts after age 40, as can gaining weight (also common around this time) and, of course, simply getting older.

Why Do Breasts Get Bigger With Age?

Technically, they don't. It's not age that makes your breast get bigger. It's weight gain—and people happen to gain weight as they age.

Going up a cup size may happen in your 40s if you're also going up in jean size. Maintaining your weight (or losing weight if you're overweight) can help your breasts remain the size you've become accustomed to. Keeping your weight in check also eases tenderness and sensitivity. Plus, exercise can positively affect estrogen levels, helping you keep unwanted weight off.

At the end of your 40s and beyond, you may actually notice your breasts changing in the opposite way. At menopause, it's normal to lose fat, tissue, and glands in your breasts. This can make your breasts appear smaller and less full.

Here are five other breast changes you might experience in your 40s and ways to prevent, slow, and manage them.

Your Breasts Become Extra Sensitive

As you work through perimenopause, your menstrual cycle may change. Your cycle could become longer or shorter than usual, and you may skip periods. As each period nears, PMS might hit in a big way.

Tender and sensitive breasts are relatively common before and during perimenopause. The pain is generally described as a heaviness, tightness, discomfort, or burning sensation in the breast tissue. It can occur in only one breast or both.

While you can't stop your hormonal clock, you might be able to ease painful breasts in other ways:

• Wear a well-fitting sports bra: A good sports bra can help minimize, contain, and support your breasts to reduce pain.
• Use hot and cold compresses: Try this technique before bedtime, especially if you have problems getting restorative sleep due to sore breasts.
• Modify your diet: You can start by reducing or eliminating how much tea, coffee, chocolate, and carbonated soft drinks you have. You may also see benefits from following a low-fat diet high in vitamins and fiber. Physical activity may also positively affect how your body makes and uses estrogen. Don't skip the workout if your breasts are feeling tender. Just take it easy and be proud you're exercising.
• Use pain medication: You may see relief from ibuprofen or acetaminophen and NSAIDs. Pain medication can be applied to the skin of the tender area (topically) or taken as a pill (orally).
• See a healthcare provider: If these remedies aren't working for you, talk to a healthcare provider. Prescription medications are also available to treat breast soreness.
  

Breast Sag Sets In After 40

You probably won't see too much sagging in your 40s. Serious deflation doesn't usually occur until your 50s, when you're postmenopausal and estrogen levels are at a low. The loss of the connective tissue at this time is a main reason for this change. Loss of tissue means less elasticity and more sagging.

The skin over your breasts provides structural support. In your mid-20s, breast skin elasticity starts to decline; at about 45 years, you start to lose skin thickness too. These changes lead to decreased support, aka sagging.

You also have ligaments that help support your breasts. These ligaments are called Cooper ligaments. Over time and with age, these ligaments become stretched, resulting in sagging.

These changes are purely aesthetic, but if they're bothering you, don't skimp on the push-ups. Strengthening the muscles behind your breasts can help reduce the appearance of sag. What's also helpful in making you (temporarily) look perkier and feel more comfortable? A super-supportive bra.

More Lumps and Bumps Appear

Changes in your breast can happen at any age. For example, changes in the fibrous tissue of your breasts and/or cysts—fibrocystic changes—are very common in your 30s or 40s.

You might notice that your breasts feel lumpier, which is generally nothing to worry about as long as the changes are similar in both breasts. It's also normal for your breasts to feel progressively bumpier as your period approaches.

When you're nearing menopause, you may also notice changes. Breast lumps are common around this time and are usually noncancerous.

When in doubt—or if you suddenly find a lump that wasn't there last month or doesn't diminish after your period starts—see a healthcare provider to check it out.

Breast Density Might Change

Breast density isn't something you can feel. It refers to the amount of fat you have versus the amount of denser tissue like glands and ducts. Getting a mammogram is the only way to know if you have dense breasts.

Dense breasts are pretty common. About half of all women aged 40 years and older who get a mammogram have dense breasts. Hormone therapy during menopause and a low body mass index is associated with higher breast density. Getting older and having children may lower breast density.

Breast density is important because it makes it harder for radiologists to spot cancer on a mammogram, and density in and of itself seems to raise the risk of breast cancer. If you don't already know if you have dense breasts, ask a healthcare provider. (The info should come with your mammogram report.)

You should also ask if you're a candidate for an ultrasound if you're concerned about breast cancer. About one in eight mammograms will have a false-negative result when cancer is present but not detected on the test. Women with dense breasts are more likely to get a false-negative result.

Breasts Become More Prone to Cancer

Whether you have dense breasts or not, your risk of developing breast cancer rises as you age. Getting screened for breast cancer can help you spot changes in an early stage. The first mammogram is important because it gives doctors a reference for comparison if any changes are seen later in life.

Talk to your healthcare provider in your 40s about when and how often you should get screening mammograms. As of May 2023, the U.S. Preventative Services Task Force (USPSTF) recommends that cisgender women and people assigned female at birth get mammograms every two years beginning at age 40. This is 10 years earlier than the current guidelines.

Here are tips for how you can be proactive about your health to help lower your risk of developing breast cancer:

• Maintain a healthy weight.
• Be physically active.
• Don't drink alcohol or drink only in moderation.
• Ask your healthcare provider about the risks of medications, including hormone replacement therapy or birth control pills.
• Breastfeed, if possible.
• Talk to your healthcare provider if you have a family history of breast cancer, specifically changes in your BRCA1 and BRCA2 genes.
  

Breast self-exams seem to have become a thing of the past. Self-exams aren't necessary because they haven't been proven to save lives. They can also lead to unnecessary procedures and worry.

At the very least, practice breast "self-awareness." This simply means paying close attention to what your breasts look and feel like to alert your healthcare provider to any breast changes after age 40.

A Quick Review

As you reach the age of 40 years and approach perimenopause, hormonal changes will cause changes to your breasts. Besides noting changes in your breasts' size, shape, and elasticity, you might also notice more bumps and lumps.

Aging comes with an increased risk of breast cancer. Aside from being proactive about your health, it's also important to keep up to date on breast exams and screening mammograms. Early detection is vital to treatment.