What's in store for your set during this pivotal decade.

Barbara Brody
August 29, 2018

After celebrating the big 4-0, 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 common yet often unexpected change: the size, shape, and feel of your breasts.

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How dramatic the transformation is varies widely and is often closely tied to shifts in your menstrual cycle. "After age 40, many women start having higher surges of estrogen for brief durations," explains Adeeti Gupta, MD, founder and director of Walk In Gyn Care in New York City.

These hormonal ups and downs during perimenopause (aka the change before "the change," which can start roughly five years before menopause actually kicks in) can translate to shorter periods. But they can also impact your breasts. So can gaining weight (also common around this time) and, of course, simply getting older. Here are 6 breast changes you might experience in your 40s.

Your breasts become extra sensitive

As you work your way through perimenopause, there's a good chance that your menstrual cycle will become shorter and shorter—meaning that you'll be getting your period more frequently. And as each period nears, PMS might hit in a big way. "It can lead to more breast tenderness and swelling," says Dr. Gupta. "You might feel like you're going through a type of puberty again."

While you can't stop your hormonal clock, you might be able to ease painful breasts by minimizing external sources of estrogen. Dr. Gupta suggests cutting out soy-based foods (like tofu), since they contain natural plant estrogens, and limiting your consumption of red meat, which may also raise your levels.

They get bigger

Thanks to the triple whammy of weight gain, swelling from estrogen spiking, and inflammation (which increases in the body in your 40s), you might have a sudden need to go bra shopping. "Breasts often get bigger, and most women who already had big breasts cannot stand having even larger ones," says gynecologist and integrative physician Prudence Hall, MD, founder of The Hall Center in Santa Monica, California.

Going up a cup may be inevitable, but maintaining your weight (or losing weight if you're overweight) can help your girls remain at the size you've become accustomed to. Keeping your weight in check also eases tenderness and sensitivity, because stored fat increases levels of estrogen in your bloodstream.

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Breast sag sets in

Serious deflation doesn't usually occur until your 50s, when you're postmenopausal and estrogen levels are at a low. But thanks to gravity, you may start to see some sagging in your 40s. "You lose collagen, skin becomes less elastic, and the tendons—called Cooper's ligaments—lose elasticity and strength," says Dr. Hall.

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 useful for making you (temporarily) look perkier and feel more comfortable? A super-supportive bra.

They pack more lumps and bumps

Again, blame your hormones. "Fibrocystic changes are common in your 40s," says Dr. Gupta. 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 in doubt—or if you suddenly find a lump that wasn't there last month or that doesn't diminish after your period starts—ask your doc to check it out.

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They might become more dense

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. The only way to know if you have dense breasts is to get a mammogram.

Dense breasts are much more common in younger (premenopausal) women compared to older (postmenopausal) ones, but Dr. Gupta says that doesn't mean your breasts automatically get less dense with each passing decade. In fact, she says some women likely have denser breasts in their 40s than they did in their 30s due to all the hormonal changes (though most won't have had a mammogram in their 30s to compare to a mammogram in their 40s).

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 your doctor. (The info should come with your mammogram report.) You should also ask if you're a candidate for a sonogram, says Dr. Hall. "In women with dense breasts, 50% of breast cancer is missed during a mammogram," she says, noting that a sonogram is more accurate.

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Breasts become more prone to cancer

Whether you have dense breasts or not, your risk of developing breast cancer starts to rise when you turn 40. That's why most health experts suggest starting annual screening mammograms at this time. "At least get a baseline, and then you can consider going every 1-2 years depending on your risk factors," says Dr. Gupta.

You may also want to do breast self-exams once a month. Although some medical groups say self-exams aren't necessary because they haven't been proven to save lives, other experts (including Dr. Hall) still believe they're helpful, and many patients have reported finding their own tumors. At the very least, practice breast "self-awareness," which simply means making a habit of paying close attention to what your breasts look and feel like so you can alert you doctor to any changes.