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Clicking here will allow you to subscribe to new blog posts.") - By [Pam Fichtner](https://sephirahealing.ca/the-hub/my-blog/author/sephira-sasktel-net.html) - On August 05 2026 - 11 min read [ ](#)- [ Print](https://sephirahealing.ca/the-hub/my-blog/print/why-do-women-normalize-pain.html "Print") - [ Subscribe](https://sephirahealing.ca/javascript:void(0) "Subscribe") ## [ Why Do Women Normalize Pain? 4 Ways Pain Shows Up and What Can Help ](https://sephirahealing.ca/the-hub/my-blog/why-do-women-normalize-pain.html) [ ![Why Do Women Normalize Pain? 4 Ways Pain Shows Up and What Can Help](https://sephirahealing.ca/images/Blogs/Sep-Blog%20Main%20Page.png?nocache=6a9a68cd0bab9) ](https://sephirahealing.ca/the-hub/my-blog/why-do-women-normalize-pain.html) # Why Do Women Normalize Pain? 4 Ways Pain Shows Up and What Can Help #### Breast tenderness, chest tightness, swelling, burnout, and the symptoms women learn to ignore **Pam Fichtner, BA, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan** --- **TL;DR** *"After nearly 30 years of practice, the thing that surprises me most is not how much pain women are in. It's how long they've been in it without anyone asking."* • 70% of people living with chronic pain are women, yet historically about 80% of pain research was conducted on men ([Harvard Health](https://www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562)) • Women wait about 30 minutes longer than men to be seen for pain in emergency settings, and are less likely to receive pain relief at the same reported pain levels ([PNAS, 2024](https://www.pnas.org/doi/10.1073/pnas.2401331121)) • One in six women waits more than a year for a pain diagnosis, compared with one in ten men ([Gender Pain Gap Index, 2026](https://eu-assets.contentstack.com/v3/assets/blt73c3051f4cacd5b5/blt654c281afb20be25/69fb0db21d1c51a523ec3174/FINAL_Nurofen_GPG_Report_Design.pdf)) • Pain normalization is not a personal failing. It's the result of being taught, repeatedly, that your discomfort is less urgent, less credible, or less worth investigating • Breast tenderness, chest tightness, swelling, fatigue, and tension are among the most commonly normalized symptoms, and among the most treatable • Fall is when people rebuild routines. This is a good time to stop waiting for a crisis and start paying attention to the signals you've been overriding Many women live with pain for months or years because they've learned, from doctors, from culture, and often from their own families, that it's probably "just stress," "just age," or "just part of being a woman." I'm sharing what the research actually says about why women's pain gets minimized, the four layers of pain (physical, emotional, mental, and self-silencing) that can build on each other, how it affects us, and how the right kind of support can help. If you only take one thing from this page, take the question at the end. "I don't know why I'm crying." Her appointment had barely begun when her tears started to roll down her face. It caught her completely off guard, she was embarrassed, and immediately began apologizing for "getting emotional." It happens more often than you might think, and it doesn't surprise me anymore. People often assume those tears are caused by the treatment itself. That hasn't been my experience. Most of the time, the tears come because the pressure has gotten so heavy, and for the first time in a long time, there's a safe space to release it. Her story is not unusual. Her intake form listed tight shoulders and stiffness in her upper back. That kind of musculoskeletal tension is the fight-or-flight response at work, and it's one of the most common ways I see stress show up in women. But the moment I touched her neck, the weight she had been holding for months, maybe years, finally had somewhere to go. I'm Pam Fichtner, a Registered Massage Therapist and the founder of Sephira Healing in Saskatoon. I've been doing this work for nearly 30 years, and the thing that surprises me most is not how much discomfort women are carrying. It's how long they've been carrying it without anyone, including themselves, treating it as something worth investigating. September is Pain Awareness Month, and I think it's a good time to ask some different questions. When did we start believing discomfort was simply part of being a woman? And why do we apologize for it? Most of the women I see wait to come in until they've been living with pain for months. Sometimes even years. *"I thought it was just stress."* *"I figured it was part of getting older." "I didn't want to make a fuss." "I just thought I could push through."* ### **That's not normal. That's normalized.** **~** And notice the word doing all the work in those sentences: "just." It's the word women use to minimize their own experience. And it's usually the word they were handed first by someone else. Research continues to show that women are more likely than men to have their pain minimized or undertreated in healthcare settings. A 2024 study of more than 21,000 emergency department visits found women were consistently less likely than men to receive pain relief, even at the same reported pain levels ([Guzikevits et al., PNAS, 2024](https://www.pnas.org/doi/10.1073/pnas.2401331121); [Harvard Health, 2025](https://www.health.harvard.edu/pain/the-dangerous-dismissal-of-womens-pain)). You might recognize the name Bindi Irwin, the Australian conservationist, television personality, and daughter of the late Steve Irwin, the Crocodile Hunter. Bindi lived her pain publicly. For ten years, she was told her pain was simply something you deal with as a woman. When she finally had surgery, doctors found 37 endometriosis lesions ([NBC News, 2023](https://www.nbcnews.com/news/amp/rcna73918)). > [ > > > > > > > > > > > > > > View this post on Instagram > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ](https://www.instagram.com/p/DWh2wu9gSy7/?utm_source=ig_embed&utm_campaign=loading)[A post shared by Bindi Irwin (@bindisueirwin)](https://www.instagram.com/p/DWh2wu9gSy7/?utm_source=ig_embed&utm_campaign=loading) I see the other end of this in my treatment room. The doctor will just say, "You just have to live with that." And I'm like: no. I get so frustrated, because if they'd come in five years earlier, they could be moving and feeling so much better. Instead, women are still minimizing their own symptoms and delaying conversations or care because they assume what they're experiencing is "normal." --- ## **Pain Doesn't Always Look the Way We Expect** When most of us hear the word pain, we think of an injury or illness. But we all know pain can show up in a lot of different ways. Sometimes it is obvious but sometimes it's slow, gradually becoming part of how you live everyday life. Here's how that happens. I've watched it in slow motion for nearly three decades. A symptom appears. It gets dismissed, by a doctor, a partner, or the woman herself. She learns not to mention it. And over time, the nervous system adapts to whatever is consistently present. The contrast between "comfortable" and "not comfortable" fades, and she stops noticing. That isn't weakness. It's the nervous system doing exactly what it's designed to do. But it has a cost, and that cost compounds. #### **1. Physical Pain: The Discomfort We Push Through** This is the pain we usually notice first. ![Breast and Chest Tightness](https://sephirahealing.ca/images/Blogs/Sep-Blog2.png) Breast tenderness. Chest tightness. Neck and shoulder tension. Pelvic discomfort. Persistent headaches. Digestive discomfort. A feeling of fullness or heaviness in breast and chest tissue. Post-surgical tightness or scarring that no one mentioned was treatable. Fatigue that won't go away even after a good night's sleep. Many of these experiences are common. But that does not make them normal. Common simply means many people experience them. It doesn't mean they should be dismissed. **RESEARCH SNAPSHOT** Across more than 21,000 emergency department visits in two countries, women were consistently less likely than men to receive prescriptions for pain relief, even at the same reported pain levels, and regardless of the physician's sex. Source: [Guzikevits et al., *Proceedings of the National Academy of Sciences*, 2024](https://www.pnas.org/doi/10.1073/pnas.2401331121). #### **2. Emotional Pain: The Feelings We Keep Carrying** Not all pain is physical. Sometimes it's: • carrying grief you haven't had time to process • feeling overwhelmed on more days than not • anxiety that never seems to fully go away • feeling disconnected from yourself • constantly putting on a brave face For some women, this includes experiences of trauma, sometimes recent, sometimes decades old. You don't have to name it, explain it, or have words for it at all for it to be part of what you're carrying. Many women have become so accustomed to carrying emotional pain that it just feels like part of who they are now. That's not something any woman should have to keep accepting. #### **3. Mental Pain: That Weight We Carry Every Day** ![Mental Load](https://sephirahealing.ca/images/Blogs/Sep-Blog3.png)Mental pain is another kind of pain that often goes unnamed. Some people call it the mental load. Either way, it's a lot. And it's a heavy weight no one else can see. It's remembering appointments. Managing schedules. Checking on aging parents. Supporting children. Keeping work moving. Making hundreds of small decisions every day. None of it looks like pain from the outside. But in my treatment room, I hear it, I see it, and I can feel it. When I check in with a client partway through a treatment, she'll often have missed what I said completely. And then it's: *"I'm sorry, I was going through what we need from the grocery store in my head."* *"I'm sorry, I just remembered it's picture day Thursday and I was trying to figure out where my daughter's dress shoes are."* *"I'm sorry, I'm planning my best friend's bachelorette party and I was thinking about the invitation list."* *"I'm sorry, I was rehearsing a hard conversation I have to have at work tomorrow."* *"I'm sorry, I was thinking about how my dad sounded on the phone last night."* Research consistently links this kind of ongoing caregiving and household responsibility with chronic stress, disrupted sleep, and exhaustion in women ([BMC Public Health, 2025](https://pmc.ncbi.nlm.nih.gov/articles/PMC11977012/)). When your mind never gets a real break, the nervous system stays on duty. I can see your shoulders up by your ears and feel the tension in your neck. I can see how shallow you're breathing and how tight your jaw is from clenching your teeth. And I see it on intake forms every single week: anxiety, stomach aches or headaches that keep coming back, and feeling exhausted or low energy even after a full night's sleep. These are not things that should become a permanent part of your life. Being tired all the time should never become something we simply accept without asking why. And the women carrying the most are usually the last to ask for help. #### **4. Self-Silencing: The Needs We Put Last** Psychologists have had a name for this, self-silencing, since the 1980s. Researcher Dana Jack first documented the pattern, the constant caretaking, the pleasing, the holding back of what you actually feel and need, and linked it to depression. The research since then has gone further: self-silencing has been connected to physical illness too, and even to a higher risk of premature death ([TIME, 2023](https://time.com/6319549/silencing-women-sick-essay/)). **It can be dangerous not to ask for what you need.** But too often I hear women saying things like: *"It's probably nothing."* *"I don't want to waste anyone's time."* *"I'm not really the breadwinner... I can't really justify spending that on myself."* *"I'll deal with it later."* *"Someone else needs it more than I do."* Here's what strikes me about these women: they are not people who neglect health. They book their kids' dental checkups, their mom's specialist appointments, their husband's physio. Every calendar in the house is managed. And their own referral has been sitting on the fridge for eight months. But can you blame them? A systematic review spanning 86 studies and more than 20,000 women found that shame, embarrassment, normalizing of symptoms, and the expectation that clinicians would trivialize their concerns were the most consistent reasons women delayed seeking help for pelvic health symptoms, even when those symptoms were affecting their daily lives ([Jouanny et al., BMC Women's Health, 2024](https://link.springer.com/article/10.1186/s12905-024-03063-6)). When that's what women have learned to expect, why would they respond any differently? ### **We need to do better.** **~** Self-silencing doesn't make pain disappear. It just forces us to live with pain longer than we should. And here's what I want to say to the woman who doesn't feel she can justify the cost of her own care: you are not a lower priority than everyone else on that calendar. Caring for yourself is not taking something away from your family. It's how you keep having something to give them. --- ## **What Does Masking Pain Actually Cost?** Most women I meet have an unspoken threshold: "I'll do something about it when it gets bad enough to justify it." Here's the problem with that threshold. It keeps moving. When discomfort has become your everyday baseline, "bad enough" gets measured against a bar that is already set too high. And waiting isn't neutral. It costs. **It costs your body.** Pain that goes unaddressed rarely stays contained. You adjust how you hold your shoulders, how you breathe, how you move, and over time those compensations become their own sources of tension and restriction. Scar tissue and lymphatic congestion are treatable, but they don't resolve on their own. **It costs your nervous system.** An unresolved signal takes energy to manage, all day, every day. That's energy no longer available for sleep, focus, patience, and recovery. It's part of why "tired all the time" and "sore all the time" so often show up together. **And it costs your self-knowledge.** When you've been overriding your body's signals long enough, you lose track of your own baseline. Your baseline is one of the most valuable health tools you have, because knowing what's normal for you is how you notice when something changes. That's not something an annual appointment can do for you. It has to be maintained. And the good news is, it can be rebuilt. --- ## **Finding the Right Kind of Support** ![Pam Fichtner-Sephira Healing](https://sephirahealing.ca/images/Blogs/Sep-Blog4.png)One of the most important things I've learned over the years is that there isn't one solution for every type of pain. Different experiences call for different kinds of support. If you're carrying chronic stress or overwhelming life experiences, a gentle, trauma-aware approach like **Somatic Experiencing®** could help you work through it (without having to retell your story or relive anything). If you're dealing with chest tightness, scar tissue, lymphatic concerns, or changes after surgery, **Breast and Chest Massage Therapy** could be where your care begins. If it's headaches that keep coming back, persistent tension, or an overloaded nervous system, a light-touch approach like **Craniosacral Therapy** could help things finally settle. If it's an upset stomach, abdominal tightness, or restrictions that are limiting your mobility and how you move, **Visceral Manipulation** works with those deeper patterns. And if you can't remember the last time you truly rested, **Reiki or Energy Balancing** may be the gentlest place to start: an hour where nothing is asked of you. Clients often describe deep, uninterrupted rest and leaving feeling lighter and more like themselves. But the first step isn't deciding which therapy is right for you. It's deciding to stop minimizing, normalizing, and living with your pain. --- ## **When Pain Should Be Checked by a Healthcare Provider** Body awareness is not health anxiety. The goal of paying attention to your body is not to create fear. It's to know yourself well enough that you notice when something is different from your normal. And I'll say this plainly: I work alongside doctors, not instead of them. Some of the most important work I do is telling a client, "that one is for your physician, and soon." **For breast and chest tissue**, see a healthcare provider if you notice: • A new lump or change that doesn't follow your usual cycle or doesn't resolve • Skin dimpling, puckering, or texture changes • Nipple discharge that is new, unexpected, or blood-tinged • One-sided swelling, redness, or warmth that persists or worsens **For the rest of your body**, see a healthcare provider if you notice: • Swelling in an arm or leg that's new, one-sided, or doesn't go down • A headache that's sudden, severe, or unlike any you've had before • New numbness, tingling, or weakness • Digestive changes that persist for more than a few weeks • New or worsening back pain in midlife, or a fracture from a minor fall or bump, both worth a bone health conversation • Any pain that is severe, sharp, or significantly interferes with daily function • And if the emotional weight you're carrying is starting to feel unmanageable, that deserves care too. Your doctor or a mental health professional is the right place to start. Trust your instincts. You know your body better than anyone else does. That knowledge is worth protecting, and it is worth acting on. --- ## **You Don't Need to Earn Support by Suffering Longer** ![Woman Heart Hands](https://sephirahealing.ca/images/Blogs/Sep-Blog5.png)You don't need to be in crisis to deserve care. You don't need to justify your symptoms to access support. And you don't need to reach some threshold of suffering before your discomfort finally counts. The most consistent thing I hear from new clients is, "I should have come sooner." It's not that their situation was dire but they spent years tolerating something that could have been addressed much earlier. If you want one small place to start, try this: once a week, place your hands on your chest, take a few slow breaths, and just notice. Not an exam. Not a hunt for problems. Familiarity. Being the person who would notice if something changed, because you know what's normal for you. And if something has been bothering you for weeks, months, or even years, here's the question I'd ask you to sit with this month: #### *"What have I been dismissing, and is it time to understand it better?"* **~** Sometimes, that's the very place healing begins. --- ### Frequently asked questions **Is it normal to cry during a massage therapy treatment?** Yes, and it's more common than most people realize. When the nervous system finally settles, emotion sometimes comes with it. You don't need to apologize, explain, or hold it together in my treatment room. It's a normal response, and you're safe to let it happen. **What should I expect at my first breast and chest massage therapy appointment?** A conversation before anything else. We talk about what's going on, what you're comfortable with, and what the treatment will involve, and nothing happens without your consent. You're draped the way you would be for any massage therapy treatment, only the area being worked on is uncovered, and you can pause, adjust, or stop at any point. We go at your pace, every single time. Most new clients tell me the appointment felt far more ordinary, and far more comfortable, than they expected. **Is breast and chest massage therapy actually a real, professional treatment?** Yes. It's within the regulated scope of practice for Registered Massage Therapists, with specific post-graduate training behind it. I trained in it in British Columbia, I've taught it to other RMTs, I co-authored professional writing on it, and I'm a court-recognized expert witness in breast massage therapy in Saskatchewan. If it feels strange to ask about, that's not you. That's how little we were all taught. There are no silly questions in my treatment room. **Can I book massage therapy during cancer treatment?** Yes, this is one of my specialties. Oncology massage therapy is adapted care: gentler, informed by your treatment stage, and coordinated with what your care team advises. I've spent decades making sure people living with and beyond cancer aren't turned away from safe, comfortable hands-on care. If you're in treatment, mention it when you reach out and we'll plan around it. **Is massage therapy covered by insurance benefits?** Many extended health benefit plans cover treatments from a Registered Massage Therapist. Coverage varies by plan, so check yours for massage therapy or RMT services, and you'll receive a receipt for your treatments to submit. If cost is a factor, tell me. We'll figure out where to start. **Do you only work with women?** No. Every body is welcome here, regardless of gender identity, body type, surgical history, or diagnosis. You won't have to educate me before you can receive care, and you won't have to explain your body to be treated with respect in this space. **What if I can't get to the clinic?** There are options. I offer home visits, including lymphatic drainage massage therapy at home, which matters for people in treatment, recovering from surgery, or with limited mobility. Somatic Experiencing sessions are also available virtually, so distance doesn't have to be the reason you wait. **What is Somatic Experiencing, and is it right for me?** Somatic Experiencing is gentle, present-moment work with your nervous system's stress responses. There's no requirement to retell your story or relive anything. If you feel like your body is stuck in high alert, or you can't fully relax even when things are calm, it may be worth exploring. Sessions are available in person and online. **Can massage therapy actually help with stress-related pain?** It can. Tension patterns from sustained stress, tight shoulders, jaw clenching, shallow breathing, and headaches respond well to hands-on care, and treatment also gives your nervous system a rare stretch of genuine rest. If pain persists or worsens, I'll always encourage you to see your doctor as well. **How do I know if my pain is normal or something worth investigating?** Normal pain has a clear cause, is time-limited, and improves. Normalized pain is discomfort that's been around long enough that it no longer registers as a problem, even though it is. A useful question to sit with: when did I last feel genuinely comfortable in this part of my body? If you can't remember, that's worth paying attention to. The goal isn't to hunt for problems. It's to know your normal well enough that you'd notice a change. **How is preventative care different from waiting until something goes wrong?** Preventative care means addressing discomfort, tension, and imbalance before they reach crisis level. It means coming in when things feel off, not when they're unbearable, and building enough body familiarity to catch small changes early instead of big changes late. In my experience, people who care for themselves this way spend less time in pain overall, not more time in appointments. **What services at Sephira Healing help with chronic pain and body awareness?** Several. Breast and chest massage therapy addresses tissue tenderness, congestion, and lymphatic concerns. Manual lymphatic drainage supports fluid movement and chronic swelling. Scar care works with post-surgical restriction that keeps contributing to tightness and pain. Somatic Experiencing and craniosacral therapy work with the nervous system's role in chronic tension. And if you'd rather start by learning at home, the Healthy Breast Foundations program and my online self-care workshop are built exactly for that. **Is breast and chest discomfort always hormonal?** Hormonal changes are one common cause, but not the only one. Lymphatic congestion, scar tissue, muscle tension, and postural patterns can all contribute. "It's just hormonal" is often used to close a conversation that deserves to stay open. And hormonal doesn't mean untreatable. **How do I book a first appointment?** If you're a new client, email me at This email address is being protected from spambots. You need JavaScript enabled to view it. or text 306-230-7407 first, and tell me a little about what's going on and what kind of treatment you're interested in. I'll let you know when I can get you in and help you figure out the right starting point. **I'm not sure which service I need. Does that matter?** Not at all. Tell me what you're carrying, and we'll figure out the rest together. Many appointments are integrated sessions that combine approaches based on what your body needs that day. --- ### **Work with me** Sephira Healing Pam Fichtner, BA, RMT Saskatoon, SK This email address is being protected from spambots. You need JavaScript enabled to view it. · 306-230-7407 New clients: please email or text before booking so we can find the right fit for what you're carrying. --- ### **About the author** Pam Fichtner, BA, RMT is an educator, speaker, Registered Massage Therapist, mom of two, and founder of Sephira Healing in Saskatoon. With 30 years of clinical experience, she specializes in breast and chest massage therapy, lymphatic drainage, oncology massage therapy, craniosacral therapy, and trauma-aware somatic bodywork. Pam holds a Bachelor of Arts in Sociology and Women's Studies and trained at the West Coast College of Massage Therapy; her early work in social services and crisis intervention inspired her path into massage therapy. She is a national conference speaker, a court-recognized expert witness in breast massage therapy in Saskatchewan, and has consulted on breast cancer related research initiatives. --- **Sources** 1. Guzikevits, M., et al. (2024). "Sex bias in pain management decisions." Proceedings of the National Academy of Sciences, 121(33). Women were less likely to receive pain-relief prescriptions in emergency departments even after adjusting for reported pain scores, across both male and female physicians. 2. Harvard Health Publishing (2025). The dangerous dismissal of women's pain. Women's pain is more often minimized by clinicians; nearly a quarter of American women live with chronic pain (CDC), a higher proportion than men. 3. NBC News (2023). Bindi Irwin shares endometriosis diagnosis after 10 years of dismissed symptoms; 37 lesions found at surgery. 4. TIME (2023). How Silencing Ourselves Makes Women Sick. Dana Jack's self-silencing research and its links to depression, physical illness, and premature death. 5. BMC Public Health via PubMed Central (2025). On caregiving burden, chronic stress, and exhaustion in women. 6. Harvard Health Publishing (2017). Women and pain: Disparities in experience and treatment. Historical source for the 70% / 80% research-gap figures. 7. Nurofen Gender Pain Gap Index Report, 4th edition (2026). One in six women (17%) waited more than a year for a diagnosis vs one in ten men (10%). [https://eu-assets.contentstack.com/v3/assets/blt73c3051f4cacd5b5/blt654c281afb20be25/69fb0db21d1c51a523ec3174/FINAL\_Nurofen\_GPG\_Report\_Design.pdf](https://eu-assets.contentstack.com/v3/assets/blt73c3051f4cacd5b5/blt654c281afb20be25/69fb0db21d1c51a523ec3174/FINAL_Nurofen_GPG_Report_Design.pdf) 8. Jouanny, C., Abhyankar, P., & Maxwell, M. (2024). "A mixed methods systematic literature review of barriers and facilitators to help-seeking among women with stigmatised pelvic health symptoms." BMC Women's Health, 24. 86 studies, 20,000+ women: stigma, shame, normalizing, and expected trivialization were the most consistent barriers to seeking help. *This article is general wellness education and is not a substitute for individual medical advice. If you have new, persistent, or worsening symptoms, please see your doctor. Massage therapy services are provided by a Registered Massage Therapist within her scope of practice.* - Posted in: - [Blog](https://sephirahealing.ca/the-hub/my-blog/category/blog.html) - Tagged with: - [breast tenderness](https://sephirahealing.ca/the-hub/my-blog/tag/brest-tenderness.html), - [rmt saskatoon](https://sephirahealing.ca/the-hub/my-blog/tag/rmt-saskatoon.html), - [sephira healing](https://sephirahealing.ca/the-hub/my-blog/tag/sephira-healing.html), - [lymphatic drainage](https://sephirahealing.ca/the-hub/my-blog/tag/lymphatic-drainage.html), - [womens pain](https://sephirahealing.ca/the-hub/my-blog/tag/womens-pain.html), - [pain awareness month](https://sephirahealing.ca/the-hub/my-blog/tag/pain-awareness-month.html), - [chronic pain women](https://sephirahealing.ca/the-hub/my-blog/tag/chronic-pain-women.html), - [mental load](https://sephirahealing.ca/the-hub/my-blog/tag/mental-load.html), - [burnout symptoms](https://sephirahealing.ca/the-hub/my-blog/tag/burnout-symptoms.html), - [chest tightness](https://sephirahealing.ca/the-hub/my-blog/tag/chest-tightness.html), - [body awareness](https://sephirahealing.ca/the-hub/my-blog/tag/body-awareness.html), - [somatic experience](https://sephirahealing.ca/the-hub/my-blog/tag/somatic-experience.html), - [craniosacral therapy](https://sephirahealing.ca/the-hub/my-blog/tag/craniosacral-therapy.html) - By [Pam Fichtner](https://sephirahealing.ca/the-hub/my-blog/author/sephira-sasktel-net.html) - On May 28 2026 - 9 min read [ ](#)- [ Print](https://sephirahealing.ca/the-hub/my-blog/print/heat-hormones-summer-body-stress-why-you-feel-more-swollen-sensitive-and-overheated-during-perimenopause.html "Print") - [ Subscribe](https://sephirahealing.ca/javascript:void(0) "Subscribe") ## [ Heat, Hormones & Summer Body Stress: Why You Feel More Swollen, Sensitive, and Overheated During Perimenopause ](https://sephirahealing.ca/the-hub/my-blog/heat-hormones-summer-body-stress-why-you-feel-more-swollen-sensitive-and-overheated-during-perimenopause.html) [ ![Heat, Hormones & Summer Body Stress: Why You Feel More Swollen, Sensitive, and Overheated During Perimenopause](https://sephirahealing.ca/images/Blogs/July-Blog.png?nocache=6a9a68cd1072f) ](https://sephirahealing.ca/the-hub/my-blog/heat-hormones-summer-body-stress-why-you-feel-more-swollen-sensitive-and-overheated-during-perimenopause.html) Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan **TL;DR** Perimenopause and summer heat can be a brutal combination. Hot flashes, swollen breasts, tight rings, irritated skin, exhaustion, sensory overload, and feeling uncomfortable in your own body are all common experiences during this stage of life that many women are never warned about. This article explains: • Why hot flashes and heat intolerance happen • Why breast tenderness and swelling get worse in summer • Why your rings, ankles, and body suddenly feel puffier • Why your skin becomes more sensitive and reactive • Why noise, crowds, heat, and busy days suddenly feel overwhelming • What actually helps support your body during this transition --- Heat feels more intense during perimenopause. You’re hotter. Your breasts ache more. Your rings are tighter in the afternoon. Your skin is reacting to things it never did before. You’re more tired, more sensitive, more easily overwhelmed — and you can’t quite explain it to anyone who isn’t living it. ![Pam Fichtner RMT](https://sephirahealing.ca/images/Blogs/Jul-Blog1.png)I’m Pam Fichtner, a Registered Massage Therapist and a breast and chest educator and speaker. I’m the founder of Sephira Healing in Saskatoon and I’ve spent nearly 30 years working with the bodies of people navigating hormonal transitions, and every summer I see a surge of clients coming in and telling me about a new pain or symptom. I’m going to explain what really happens when perimenopause meets the heat, and what can genuinely help. ## Why Heat Feels More Intense During Perimenopause If you feel like you can’t tolerate the heat like you used to, there’s a physiological reason, and it starts in the brain. Estrogen affects the part of the brain that controls your body temperature. When estrogen levels are unstable during perimenopause, your body becomes more sensitive to heat and temperature changes. The result is hot flashes: a sudden surge of heat, often accompanied by flushing, sweating, and sometimes a chill afterward. Research suggests hot flashes affect an estimated 50–80% of people going through the menopause transition. Night sweats are the nighttime version of hot flashes, and disrupted sleep can make heat intolerance even worse the next day. ## Why Your Breasts and Chest Feel More Tender, Swollen, or Sensitive ![Woman having a hot flash and holding above swollen breast](https://sephirahealing.ca/images/Blogs/Jul-Blog3%201.png)Breast tenderness is one of the most common and least-discussed symptoms of perimenopause. Research from the Centre for Menstrual Cycle and Ovulation Research (UBC) found that approximately one in three women in early perimenopause experience breast tenderness. This is because breast tissue contains receptors that are sensitive to both estrogen and progesterone. During perimenopause, estrogen levels don’t simply decline. They spike unpredictably before eventually tapering off. These estrogen surges can cause breast ducts to enlarge and tissue to hold more fluid. Progesterone, which normally helps balance estrogen’s effects, is often lower during this phase, making the breast tissue more sensitive, swollen, and tender. **What you might feel:** • Aching, burning, or stabbing sensations in one or both breasts • Generalized tenderness or a sense of fullness that doesn’t follow your usual cycle • Nipple sensitivity that feels new or heightened • Breast tissue that feels lumpier, denser, or more fibrocystic than before • Swelling that worsens before a period, in heat, or seemingly at random In summer, this often gets worse. Heat increases fluid buildup in the tissues, and if the lymphatic system is already slowed down by hormone changes, that extra fluid does not drain as easily. The result can be more swelling, heaviness, and tenderness. ***What to watch for:** tenderness and cyclical swelling are common in perimenopause and are usually benign. However, a new lump that feels different from surrounding tissue, skin dimpling, nipple discharge, or one-sided symptoms that don’t go away, are important to get checked out by your healthcare provider. Get to know what your normal is so you can recognize changes quickly.* ## Why Swelling Gets Worse in Hot Weather You notice it around your ankles at the end of a long day. Your rings are tighter by midafternoon. Your sleeves may feel tighter on one side than the other. Summer swelling is a real thing, and in perimenopause, it’s often worse. Two things are happening at once. First, hormones. Fluctuating estrogen can cause the body to hold onto more fluid. It’s the same reason many women feel swollen before a period. During perimenopause, estrogen levels can spike unpredictably, so the swelling can feel random too. Second, heat. Hot weather causes blood vessels to widen, which pushes more fluid into the surrounding tissues. Your lymphatic system is responsible for moving that fluid back out, but it does not have a pump. It relies on movement, muscle contraction, and deep breathing to keep fluid moving. Heat can slow that process down even more. The combination of hormone-related fluid retention and slower lymphatic drainage is why summer swelling during perimenopause can feel so intense. **What helps?** • Gentle movement and walking • Staying hydrated • Elevating your legs • Avoiding long periods of sitting or standing in the heat • Manual lymphatic drainage for more ongoing or significant swelling ## Why Your Skin Suddenly Feels More Sensitive in Summer Estrogen plays a big role in keeping skin strong, hydrated, and resilient. As estrogen levels become more unpredictable during perimenopause, many people notice their skin becoming drier, thinner, more sensitive, and more easily irritated. ![Womans chest and breast sensitivity with a flower](https://sephirahealing.ca/images/Blogs/Jul-Blog2.png)**You may notice:** • Itching or prickling that seems to come from nowhere (a condition sometimes called pruritus) • Increased sun sensitivity or faster burning • Chafing and under-breast irritation from heat and sweat, worsened by tissue sensitivity • Rashes or heat rashes appearing where they didn’t before • Products, fabrics, or detergents that previously caused no reaction now causing irritation The skin under and between breast tissue is especially vulnerable because heat, sweat, friction, and moisture all build up there quickly. **WHAT CAN HELP** • Loose, breathable, moisture-wicking clothing • Proper bra fitting to reduce friction and pressure under the breasts • Barrier creams for irritated or chafed skin • Gentle, fragrance-free products during times of increased sensitivity • Avoiding tight bra bands and synthetic fabrics during hot weather ## Why Summer Can Feel More Overstimulating and Exhausting This is the symptom most often dismissed, and the one I hear about often from clients. You used to be able to handle a busy day, a hot afternoon, a social event, or a crowded space. Now those same things can feel overwhelming. You come home depleted in a way that rest doesn’t fully fix. You’re more irritable, less patient, and more sensitive to noise, heat, and sensory input. Hormone changes during perimenopause affect the nervous system too. Sleep becomes disrupted, stress feels harder to recover from, and summer heat adds even more strain to a body that is already working harder than usual. *“Perimenopause is largely neurological in nature. Neurological symptoms that emerge during perimenopause are indicative of disruption in multiple estrogen-regulated systems, including thermoregulation, sleep, circadian rhythms and sensory processing.” — PMC, 2015* This is all treatable. Your body responds to nervous system support, body-aware care, rest, and reducing stress on the body. ## What Actually Helps With Summer Body Stress During Perimenopause There is no single fix. But there are some practical strategies grounded in physiology that can make a real difference. #### For heat and hot flashes • Layer clothing so you can adjust quickly when a flash hits • Keep a cold water bottle or cooling cloth accessible, particularly at night • Lower the thermostat or use a fan at night — sleep environment temperature matters significantly for hot flash frequency • Avoid known triggers where possible: alcohol, caffeine, spicy foods, and warm rooms can all lower the threshold • Cold water on the wrists and neck provides rapid cooling when a flash is building #### For breast and chest tenderness and swelling • Choose bras with soft, wide bands and no underwire during periods of heightened tenderness — compression worsens congestion • Moisture-wicking, breathable fabrics reduce under-breast irritation • Gentle self-lymphatic massage supports fluid movement — this is something I teach clients directly • Cold compresses can temporarily reduce acute tenderness • Breast and chest massage therapy addresses tissue congestion directly and is one of the most underutilized supports for this symptom #### For general swelling and fluid retention • Move regularly — even short walks support lymphatic circulation • Stay well-hydrated; dehydration paradoxically worsens fluid retention • Elevate legs during rest periods • Avoid prolonged sitting, particularly in heat • Manual lymphatic drainage is clinically effective for significant or persistent swelling #### For nervous system overload and sensory overwhelm • Reduce load deliberately: you don’t have to earn rest • Slow, diaphragmatic breathing activates the parasympathetic nervous system and is one of the fastest tools for nervous system regulation available to you right now • Somatic bodywork and craniosacral therapy support the nervous system’s ability to shift out of chronic activation — not by talking about stress, but by working directly with the body’s response to it • Prioritize sleep environment above almost everything else: temperature, light, and noise control matter more during this transition than at most other times in life • Stop explaining your capacity to people who aren’t experiencing what you’re experiencing. This is real, and it warrants real accommodation. ## When Symptoms Should Be Checked by a Healthcare Provider Most of what’s described in this blog is uncomfortable but not dangerous. Perimenopause is a biological transition, and many of these symptoms are common during this stage of life. However, some symptoms should be checked out: • A new lump in the breast or chest that feels different from surrounding tissue or that doesn’t change with your cycle • One-sided breast swelling, redness, or warmth that persists and worsens • Nipple discharge that is new, unexpected, or blood-tinged • Skin dimpling, puckering, or changes in texture on the breast or chest • Swelling that is severe, sudden, or significantly asymmetrical • Hot flashes or night sweats severe enough to significantly disrupt daily functioning or sleep over an extended period — these are treatable, and you don’t have to manage them alone • Any symptom that feels new, unusual for you, or simply wrong in a way you can’t explain ## You Are Not Imagining It Perimenopause can make us feel almost crazy at times. We doubt ourselves. We downplay things. And it doesn’t help when we’re told these symptoms are “just part of getting older.” I want to say this clearly. The heat sensitivity is real. The breast tenderness is real. The swelling, exhaustion, and overstimulation are real too. Perimenopause affects more than hormones. It can affect body temperature, the nervous system, fluid retention, breast tissue, and skin sensitivity all at once. Summer heat can make all of it feel worse. Understanding what’s happening in your body matters because it helps you support your body differently instead of fighting against it. If you’d like help navigating swelling, tenderness, or nervous system overwhelm, I’d love to explore some treatment options with you. --- ## Frequently Asked Questions About Perimenopause and Summer Body Changes **Why am I so hot all the time lately?** If you’re in your late 30s to early 50s and have noticed increased heat sensitivity, you may be in perimenopause. Estrogen plays a direct role in the brain’s temperature regulation system. As estrogen levels become erratic, the hypothalamus becomes hypersensitive to small temperature changes — triggering disproportionate heat responses even in mild warmth. It’s not your imagination, and it’s not “just” hot flashes. It’s a shift in how your nervous system processes temperature. **Why do my breasts hurt more in summer?** Summer heat increases circulation and encourages fluid to move into surrounding tissues. If your lymphatic system is already working harder due to hormonal changes, that fluid has less efficient pathways out. Combine this with the erratic estrogen spikes of perimenopause — which cause breast tissue to retain fluid and become more sensitive — and summer can significantly amplify existing breast tenderness. Breast and chest massage therapy and gentle lymphatic drainage are among the most effective hands-on supports for this. **Is the swelling I notice in summer related to perimenopause or just the heat?** Both. Heat dilates blood vessels and pushes fluid into tissues. But perimenopause adds a hormonal layer: high estrogen levels encourage fluid retention independently. If you notice that your summer swelling is more pronounced than it was in previous years, perimenopause is likely contributing. The combination of the two — thermal and hormonal — is why it can feel so disproportionate. **Why do I feel so easily overwhelmed and exhausted in summer now?** Perimenopause affects the nervous system directly — estrogen and progesterone both play regulatory roles in how the brain handles stress, sensory input, and recovery. When their levels fluctuate, the nervous system becomes more reactive and less resilient. Summer adds additional physiological load: heat stress, disrupted sleep from night sweats, and constant thermoregulatory effort. The result is a system working at or near capacity before the day has even started. This is real, it’s documented, and it warrants real rest and support. **Can massage therapy actually help with perimenopause symptoms?** Yes, for several specific symptoms. Manual lymphatic drainage is clinically supported for reducing swelling and fluid retention. Breast and chest massage therapy can address tissue congestion, tenderness, and the discomfort of fibrocystic changes. Craniosacral therapy and somatic bodywork support the nervous system’s ability to regulate — particularly relevant when perimenopause is producing the kind of exhaustion and overwhelm described above. Massage therapy is not a hormonal treatment and won’t stop perimenopause. But it can meaningfully address several of the physical symptoms that make it harder to live in your body during this transition. **When should I see a doctor about breast changes during perimenopause?** Cyclical tenderness, swelling, and density changes are common in perimenopause and are usually benign. See a healthcare provider if you notice: a new lump that doesn’t change with your cycle, skin dimpling or puckering on the breast, unexpected nipple discharge, one-sided swelling that persists, or any change that feels unusual for your body. Trust your instincts. You know your normal better than anyone. Pam Fichtner, RMT | Breast and Chest Health Educator | Founder, Sephira Healing | Saskatoon, Saskatchewan --- #### Sources & References Bhatt DL, et al. (2025). Effects of menopause on temperature regulation. Temperature (Taylor & Francis). Brinton RD, et al. (2015). Perimenopause as a neurological transition state. PMC. Prior JC. (2014). Progesterone for symptomatic perimenopause treatment. PMC. Bjelland J. (2025, October). Survey results: Perimenopause and menopause in sensitive and neurodivergent women. Cleveland Clinic. (2024, January). Does menopause cause breast pain? HealthyWomen. Perimenopausal breast tenderness. Healthline. (2024, April 3). Menopause breast pain and tenderness: Causes and treatment. Bonafide Health. (2025, July 16). Hot weather and menopause. National Sensory Network. Understanding sensory processing and menopause. A.Vogel. (2024). Sensory overload: What causes it during perimenopause and menopause. - Posted in: - [Blog](https://sephirahealing.ca/the-hub/my-blog/category/blog.html) - Tagged with: - [breast health saskatoon](https://sephirahealing.ca/the-hub/my-blog/tag/breast-health-saskatoon.html), - [breast and chest massage therapy](https://sephirahealing.ca/the-hub/my-blog/tag/breast-and-chest-massage-therapy.html), - [perimenopause](https://sephirahealing.ca/the-hub/my-blog/tag/perimenopause.html), - [perimenopause symptoms](https://sephirahealing.ca/the-hub/my-blog/tag/perimenopause-symptoms.html), - [perimenopause summer](https://sephirahealing.ca/the-hub/my-blog/tag/perimenopause-summer.html), - [hot flashes](https://sephirahealing.ca/the-hub/my-blog/tag/hot-flashes.html), - [breast tenderness perimenopause](https://sephirahealing.ca/the-hub/my-blog/tag/breast-tenderness-perimenopause.html), - [sore breasts menopause](https://sephirahealing.ca/the-hub/my-blog/tag/sore-breasts-menopause.html), - [breast swelling menopause](https://sephirahealing.ca/the-hub/my-blog/tag/breast-swelling-menopause.html), - [fuid retention menopause](https://sephirahealing.ca/the-hub/my-blog/tag/fuid-retention-menopause.html), - [menopause fatigue](https://sephirahealing.ca/the-hub/my-blog/tag/menopause-fatigue.html), - [menopause anxiety](https://sephirahealing.ca/the-hub/my-blog/tag/menopause-anxiety.html), - [nervous system perimenopause](https://sephirahealing.ca/the-hub/my-blog/tag/nervous-system-perimenopause.html), - [pymphatic drainage saskatoon](https://sephirahealing.ca/the-hub/my-blog/tag/pymphatic-drainage-saskatoon.html), - [rmt saskatoon](https://sephirahealing.ca/the-hub/my-blog/tag/rmt-saskatoon.html), - [sephira healing](https://sephirahealing.ca/the-hub/my-blog/tag/sephira-healing.html) ### ![Sephira Healing](https://sephirahealing.ca/components/com_sppagebuilder/assets/images/lazyloading-placeholder.svg) ![Saskatchewan flag](https://sephirahealing.ca/media/com_sppagebuilder/placeholder/flag_of_saskatchewan.png) ![Pride flag](https://sephirahealing.ca/media/com_sppagebuilder/placeholder/pride_flag.jpg) ##### Follow Me — - [fa fa-facebook](https://www.facebook.com/SephiraHealing) - [fab fa-instagram](https://www.instagram.com/sephirahealing/) - [fab fa-linkedin](https://www.linkedin.com/in/pam-fichtner-96847b20/) ##### — Address 201-611 9th Street East Saskatoon, SK S7H 0M4 ##### — Contact Phone: (306) 230-7407 Email: sephira@sasktel.net © 2026 Sephira Healing. 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