Q&A: Breast Tenderness after a Hysterectomy
Question: I've had a hysterectomy, but I still have my ovaries. Sometimes I get breast pain, and I wonder if it has to do with my cycle. Is there any way to tell where I am in my cycle, with no period?
Answer: If you have your ovaries, you are probably still having an ovarian cycle - which includes ovulation, and all the hormonal changes that happen before and afterward.
After a partial or total hysterectomy, you don't have a period to let you know where you are in your cycle. If it was a total hysterectomy, which means that the cervix was removed as well, you won't see cervical fluid to clue you in about timing either. (The cervix is the "neck" of the uterus, which protrudes into the back of the vagina. The crypts in the cervix produce the cervical mucus that we see on the days leading up to ovulation.)
What DOES still happen when you have your ovaries is ovulation. In the post-ovulation phase, you can still have PMS symptoms like breast tenderness, acne, increased emotional sensitivity and mood changes. You'll also have a higher Basal Body Temperature (BBT) after ovulation.
If you want to track your cycles after a hysterectomy, the best way is by taking your BBT every morning. Get a thermometer made for charting BBT. Some of them come with graphs for plotting your temperature, or you can find one online or use a Fertility Awareness charting app.
Take your temperature first thing on waking every morning, before you get up to go the bathroom, have a glass of water, or anything else. You want to get the temperature that is just a reflection of your body lying there being alive - your "basal" metabolism.
Graph your daily temperatures. If you are ovulating, you will see a phase of low temperatures before ovulation, and then a shift to a phase of higher temperatures that lasts 9-16 days.
Then, your temperatures will switch back to a lower range, which tells you that a new cycle is beginning. (The day when your temperature drops to the lower level is the day you would get a menstrual period if you were still having them).
The difference between pre-ovulation low temperatures and post-ovulation high temperatures is not dramatic, but it is distinct when you graph it. The "low" and "high" temperatures might be as little as 0.2 degrees apart, but when you lay them out on a graph, you will clearly see one phase of low temperatures, and one phase of high temperatures.
This is also a great way to check on your thyroid function, and watch your cycles in times of hormonal change, such as perimenopause, or health changes.
To check out whether your breast pain or tenderness relates to your cycle, note your days of breast pain on your chart. If this pain is a PMS symptom, you will see it begin sometime after your BBT rises, and end when the new cycle begins (when your temperature drops).