Premenstrual swelling and tenderness of both breasts occurs during the second half of the menstrual cycle.

Symptoms of premenstrual breast tenderness may range from mild to severe. Symptoms typically peak just before each menstrual period and improve immediately after or during the menstrual period.

Breast tissue may have dense, rough, "cobblestone" feel to the fingers -- usually more marked in the outer areas. There may also be an intermittent or persistent sense of breast fullness with dull, heavy pain, and tenderness.

During the menstrual cycle, estrogen production increases and peaks just prior to midcycle. This causes enlargement of the breast ducts. Premenstrually, progesterone peaks near the 21st day (in a 28-day cycle) and causes growth of the breast lobules (milk glands).

Premenstrual swelling and tenderness of the breasts is commonly associated with premenstrual syndrome (PMS) and fibrocystic breast disease (benign breast changes). Fibrocystic breast changes are not completely understood, but are believed to hormone related since the condition usually gets better with menopause.

Premenstrual breast tenderness and swelling probably occur to some degree in nearly all women. Symptoms severe enough to cause concern or limit function may occur in many women during their childbearing years. The rate may be lower in women taking birth control pills. Risk factors may include family history, a high-fat diet, and too much caffeine.

• Menstrual cycle
• Estrogen medications
• Adolescent pregnancy
• Early pregnancy