Hi, Thanks for the query. During perimenopausal some amount of hormonal fluctuation can be seen. That can lead to breast pain sometimes. But as you are having severe pain other possible causes like periductal mastitis etc should be considered. Because of the inflammation of the lactiferous ducts and surrounding tissue breast pain can occur. Periductal mastitis is somewhat more common in elderly age. So, once consult gynecologist or general surgeon and get examined. By examination the possible cause for the problem can be identified. If your doctor suggests once go for sonomammography. This can help in ruling out any possible masses in the breast. Then treatment can be taken according to the examination and investigation findings. In case of simple mastitis, antibiotics, analgesic and anti inflammatory drugs are sufficient. Take care.