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I have no idea if this would work, but I have silicone nipple guard thingies for keeping the pokey bits tucked in under a thin bra or no bra at all. They adhere to the skin pretty easily without adhesive because the skin is sticky enough. I think they’re normally called pasties? It would help with the fabric friction from clothes at least.
I hope you find some relief soon!!
Thanks for the suggestion! I do have a set of these and I tried them but even just the pressure of them touching my nipples was uncomfortable. But it's worth a try again - maybe inside a looser-fit bra would be better?
Go to the baby aisle of a store and check out the breastfeeding section. I had creams and ice packs and other items for nipple soreness. I can’t speak to your specific pain but maybe something there will help.
Oh that's a good idea! I didn't have kids so I never would've thought of that. Thanks!
evening primrose is not exactly evidence based medicine, ibuprofen or acetaminophen are more likely to help with the pain
but I'm wondering why the doctor prescribed 300 mg nightly, that's a larger dose than I would expect 🤔
I take 100 mg / night, and I've heard 200 mg is a common dose as well, but I haven't heard of more than 200 mg being taken typically - you could try talking to the doctor about reducing dose and see if symptoms are reduced?
Presently, the current guideline available for management of mastalgia includes first-line treatment, which consists of physical support (well-fitting bra or hot/cold compress), acetaminophen or NSAIDS (oral or topical), stop or reduce hormone replacement therapy or oral contraceptive, caffeine abstinence, and EPO [38]. In this review, it was found that EPO had no difference compared to the placebo or other treatment in reducing breast pain for women with mastalgia.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8296106/
I wonder though if the nipple pain is from the progesterone or the increased estrogen - it's hard to say exactly. I only call out the progesterone because it seems like a higher dose than I'm used to seeing, but increased estrogen can cause breast soreness, too.
You may also find the soreness reduces as you adjust to the dose. For that reason, I definitely recommend keeping a log to help you keep track of symptoms (it can be really hard to figure out the right HRT doses, so a log can be helpful for tracking changes to dose and the effects they had).
With the journal you might be able to track the symptoms you had from perimenopause and contrast it with the symptoms you have from the HRT, then adjust the dose until you find that happy medium where your peri symptoms are well managed but you also aren't dealing with side effects from too much HRT, like breast soreness.
Good luck with finding the right dose for you - sorry I don't have more practical advice, my own soreness from HRT actually caused me to be unable to sleep at times and I never found a suitable treatment ... hell, sometime I still get soreness, my partner accidentally brushed against me in the grocery store the other day and I was like "ow", lol - sometimes I'm just sore, usually when my estrogen and progesterone levels are higher (I cycle mine on a weekly basis).
Yeah I was surprised when she mentioned evening primrose as well, but I'm at my tits' end so I figured I should at least look into it. I did find a paper on PubMed indicating that evening primrose and Vitamin E as combination or standalone therapy could help with cyclical breast pain so plausibly it could be helpful. However that seems to be contradicted by the review article you shared.
I started at 100mg progesterone and that wasn't enough. Tried 200mg for a while and that helped to some degree with the brain fog and night sweats but I was still having long periods of sleeplessness at night. So on her recommendation I went up to 300mg. She said I could technically take up to 400mg but 300 seems to be the sweet spot for symptom relief. But I do think the nipple pain coincides with the increased progesterone.
Thank you as always for such a detailed and well thought out reply! If I figure out a solution for this I'll be sure to share it with you. We deserve better in life than perpetually sore nips!
prog definitely helps with sleep for most folks
I have to take my prog rectally, it turns out the liver filters out most of it when taken orally and you get very little increase in blood levels as a result (read more here), so you might consider trying 100 - 200 mg rectally and see if that helps the sleep issue for you. Personally I find oral is less effective for my sleep than rectal administration, but that varies significantly from person to person.
Night sweats and brain fog screams low estrogen, though - I would have tried increasing estrogen for those symptoms, not progesterone. Maybe see if you could get a cream that would allow you some flexibility in dose timing and amount, then once you know what works you would know a better long term stable dose for your patches. Sometimes low enough estrogen can cause sleep problems too, so it may not be a problem solved by taking more prog if you just need a bit more estrogen.
I'm so sorry you're going through this, but I'm also happy you're staying invested in finding a solution and not just trying to tough it out 💖
I had early menopause, been on 200mg progesterone for quite a while (I only take it every other week though, otherwise I start going a bit crazy, I was originally told to take it 2 weeks in every 4).
When I started I got a lot of chest pain, but from the inside. It's calmed down now, so fingers crossed this is a temporary issue for you!
that's weird, progesterone has a pretty short half-life (oral prog has a half life of 16 - 18 hours), after a day or two I would think the dose you took would be fully out of your system 🤔 typically progesterone is prescribed and taken daily (usually every night, since it can create sleepiness).
I was put on it quite a few years ago, maybe the normal dosages etc have changed. All I know is that one week on / one week off doesn't result in me having trouble sleeping, and I have a reasonable amount of energy :-)
My wife is now peri and going through all kinds of period fuckery, her doctor told her if she wanted HRT she'd have to go work it out in her own.
I love how consistent women's healthcare is :-/
100 - 200 mg is about the same dose most people take AFAIK (I personally take 100 mg / night). I find I only really need prog to help me sleep when my estrogen is high, so when my estrogen is waning I skip my prog doses and I sleep fine.
For the on week, are you taking it every night for a week, and then taking a week off without it? That's super interesting!
My wife is now peri and going through all kinds of period fuckery, her doctor told her if she wanted HRT she’d have to go work it out in her own.
I love how consistent women’s healthcare is :-/
And yeah, I'm regularly pissed when I hear how gynecologists are treating their patients - refusing to take blood tests for symptoms of low estrogen because of birth control (and offering nothing), not taking symptoms seriously, not being proactive and helpful to ensure obvious signs of low estrogen aren't treated ... it's so common and predictable, it's hard not to see medicine as inherently sexist, tbh.
Sometimes I have one day without it in the middle of the week, but it's a bit easy to loose track.
The idea of a lower dose every day sounds really appealing, consistency would be nice! I'll ask the pharmacy about getting some 100mg next time I run out - thanks, I haven't thought about changing it for ages and there's no harm in trying :-)
Let's hope so - I'd love it if this just went away!
There are various products designed to help with soreness while breastfeeding, perhaps those could provide some relief by shielding your nipples?
A quick search found these, but I can't speak to their efficacy: https://shellies.co/
Seashell nipple shields! These are cool, I'll have to check out the reviews. I don't know if they'd be comfortable - seems like something hard against my nipples would be painful - but it seems like they're cooling which might help. Also I could be a secret Little Mermaid haha
I am dreading menopause so I feel for you! When I was running I used to where a really thick bea, I know people with no breasts often wear tape over them. Sorry that's all I've got! Have you thought about asking in parenting? I bet some people who've been pregnant might know