Why do breasts hurt just before my period?

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By Dr Vincent Karuhanga

About 10 days before my period, I get breast pain. However, this never used to happen and I am worried I might have cancer. A breast scan gave me a clean bill of health. What could be the problem?

Dear Oryokot,
The hormones that bring on periods (oestrogen and progesterone) are also important in preparing breasts for breastfeeding after delivery.
The feeling of breast pain therefore comes from the inner breast tissues enlarging to prepare for breast feeding and this starts in earnest around the time of ovulation.

In case you get pregnant, the hormones continue to rise and prepare the breasts leading to breast and nipple pain during the period.
If you do not get pregnant, then the hormones will go down causing a reduction in the pain.

However, the same will return usually as an indication that your next period is near. Sometimes, breast pain may come as part of other symptoms largely known as premenstrual tension syndrome (PMS) that may include mood changes and menstruation related headaches.

Although any woman can get breast pain during their period, it is common in those approaching menopause. Therefore, any woman who may not have experienced breast pain before can get it as she gets older.

Many women live in fear of having breast cancer when they experience breast pain but this pain is largely not associated with cancer even when the pain may be associated with breast lumps.

Harmless or benign breast lumps including fibrocystic breast disease or fibroadenomas may also exhibit menstruation related breast pains.

Wearing a properly fitting support bra, putting hot or cold packs when the pain seems unbearable, taking over the counter painkillers, taking lots of water while limiting salt intake, cutting weight, eating a high-fibre, low-fat diet, increasing on physical exercise and sleep hours may all cut down on breast pain.

Also, much as your breast pain may be harmless, please visit your doctor for better diagnosis and advice.

What is PID and can it cause backache?

Bwogi
Dear Bwogi,
PID is an abbreviation for Pelvic Inflammatory Disease which is due to infection involving the internal female sexual organs (womb, fallopian tubes and ovaries).

This can be the reason the sufferer may be given antibiotics and pain relievers.

PID can also mean prolapsed intervertebral disc which means displacement of the cushion between vertebrae or back bones.

Both PIDs can lead to back pain though due to the disc, may cause more severe back pain. Recently it was reported that in many cases of prolapsed discs, there may be an infection with bacteria that reside on the skin and cause acne (Propionibacterium acnes) and here use of antibiotics may be curative. So both PIDs may be treated using painkillers and antibiotics.

Is he HIV positive?

I am 25 years old and in love with a 63-year-old man. Recently, a friend told me that his wife died of Aids which he denied saying she died of cancer. Although all tests done have come out negative, I do not trust him. Is he lying? Adela

Dear Adela,
Aids is a set of symptoms resulting from HIV infection. This infection can be passed from an infected person to one who is not infected through unprotected sex, (vaginal, oral or anal), from an infected mother to her baby during pregnancy but mostly during delivery among other ways.

It is important that lovers first have at least two HIV tests (the second after three months of the first test) before engaging into unprotected sex. Then they should keep doing routine HIV tests to ensure that they do not eventually get infected unknowingly.

It is likely that the man is not infected if you went together to a reputable Lab and got results together because results can be manufactured from elsewhere without going to the said lab.

Sometimes a sexual partner may die from HIV infection while his/her partner is safe (discordant couples). It is true that a partner may die from cancer-related to HIV infection yet the other partner is also safe. It is also true that one may have cancer but have symptoms such as weight loss, loss of appetite, oral candida, cough and diarrhea, all symptoms commonly found in HIV patients.
So, if you are not sure of his sta
tus, please go with him to a reputable lab or hospital for tests and if he is negative, make sure you routinely continue to test.

I cannot advise you on whether to leave your man or not. You say he loves you and your only problem with him is suspicion about his HIV status which you can sort out amicably.

Is she possessed?

I am 40 years old and recently married to a 23-year-old woman. However, while asleep, she slaps me and when I ask her about it the following day she has no recollection of what happened. What could be the cause? Jaffali
Dear Jaffali,

If it is true that she is slapping you without knowing it, this could be one of the unusual behaviours, movements, emotions, perceptions or dreams referred to as parasomnias that happen during sleep that may include sleep walking, and sleep eating.

Most times, these parasomnias occur in children who later outgrow them but in some people, they can be triggered by alcohol, lack of sleep, emotional stress, medications, or fevers among others.

It is likely that your wife’s slapping episodes happen in the deepest part of her sleep or during the dreamy part of sleep and hence she may slap you unknowingly and not be able to recall the episodes.

During the deeper part of sleep (non-Rapid eye Movement Sleep, non-REM sleep) people’s muscles are not paralysed so just like sleep walking they may sleep slap. Also, they may slap during the dreamy part of sleep (Rapid Eye Movement Sleep, REM sleep) because they have a disorder where their muscles may not be paralysed. During the dreamy part of sleep, muscles are paralysed so that people do not act in their dreams and hurt themselves or others sleeping near them.

Sometimes these sleep disruptive disorders may be mistaken to be due to charms or bad spirits so that instead of consulting a medic, people may go for prayer or even visit a witch doctor that is if they have survived lynching being taken to be night dancers or witches. Parasomnias more often run in families and not surprisingly witches and night dancer families may be hunted down.

Much as the night slapping episodes may disturb your sleep, it is important to visit a psychiatrist for help otherwise stress accruing from this may worsen the slapping apart from degenerating into physical harm of self and you who sleeps near her.

The doctor will also try to find out whether your wife could be having some trigger factors that can be dealt with to stem the problem.
Although separation of beds can help to alleviate the problem in the short run, it may increase stress which may degenerate into depression.
Before seeking the services of a psychiatrist, securing her in bed may meanwhile help out in case the problem worsens. You may think that she may harm you but, in the end, she may harm herself as well.
Send your questions to: [email protected]
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