[51F] With swollen tender breasts and thick mucus vaginal discharge

Patient Description

A 51-year-old female has been experiencing swollen and tender breasts for over a week, with no relief from any measures. The swelling developed gradually and affects both breasts. Additionally, she reports a thick mucus vaginal discharge for the past three days, which is more than usual. There have been no recent changes in lifestyle or stress levels, and she has not started any new medications or hormone therapies. Her menstrual cycle has been very irregular for the last two years, but she has not experienced any hot flashes or night sweats. There is no family history of breast cancer or other breast conditions. The patient has a medical history of Type 2 diabetes, diagnosed 23 years ago, and Major Depressive Disorder and Generalized Anxiety Disorder, diagnosed 3 years ago. She is currently taking Ozempic 1 mg once a week, Wellbutrin 450 mg in the morning, Buspar 45 mg daily, and a multivitamin. There are no known drug allergies. The patient does not use protection with her husband due to a tubal ligation 23 years ago and has not had any new sexual partners.

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Arora's Assessment

What might be happening

Your symptoms could be related to several possible conditions:

  1. Hormonal Changes: At 51, you might be experiencing perimenopause, which can cause breast tenderness and changes in vaginal discharge. Hormonal fluctuations are common during this time.

  2. Infection or Inflammation: The thick mucus discharge could indicate a vaginal infection, such as bacterial vaginosis or a yeast infection, which can also cause discomfort.

  3. Diabetes-Related Changes: Diabetes can sometimes affect hormone levels and increase the risk of infections, which might contribute to your symptoms.

Typical treatments or tests might include a physical examination, hormone level tests, or a vaginal swab to check for infections.

What you can do

For Swollen and Tender Breasts:

  • Consider wearing a supportive bra to reduce discomfort.
  • Apply warm or cold compresses to alleviate pain.
  • Over-the-counter pain relief, like ibuprofen, may help, but consult your doctor first.

For Vaginal Discharge:

  • Maintain good hygiene and wear breathable cotton underwear.
  • Avoid douches or scented products that can irritate.
  • If symptoms persist, see a healthcare provider for evaluation and possible treatment.

General Health:

  • Keep managing your diabetes with your current medications and lifestyle.
  • Use MDandMe to journal your symptoms, track progress, and share notes with your provider.

What you should look out for

Seek medical attention if you notice:

  • A significant increase in breast pain or swelling.
  • Discharge with a strong odor or unusual color.
  • Fever or other signs of infection.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What are common symptoms of perimenopause and how can they affect breast tenderness and vaginal discharge?

Perimenopause is the transition period before menopause, often starting in a woman's 40s or 50s. Common symptoms include irregular menstrual cycles, breast tenderness, and changes in vaginal discharge due to fluctuating hormone levels. These hormonal changes can cause the breasts to feel swollen and tender and may alter the consistency and amount of vaginal discharge.


How can diabetes influence hormonal changes and increase the risk of infections?

Diabetes can affect hormone levels by impacting insulin and other hormone production, potentially leading to imbalances that may cause symptoms like breast tenderness. Additionally, high blood sugar levels can weaken the immune system, making it easier for infections to develop, including vaginal infections.


What are the signs of a vaginal infection and when should I seek medical attention?

Signs of a vaginal infection include unusual discharge (thick, white, or yellowish), a strong odor, itching, irritation, and sometimes pain during urination or intercourse. It's important to seek medical attention if these symptoms persist, worsen, or are accompanied by fever, as they may require specific treatment.


What lifestyle changes or home remedies can help alleviate breast tenderness?

To alleviate breast tenderness, consider wearing a supportive bra, applying warm or cold compresses, and taking over-the-counter pain relief like ibuprofen (after consulting with a doctor). Reducing caffeine and salt intake, maintaining a healthy diet, and managing stress can also help manage symptoms.


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