Is It Perimenopause, or Could Your Breast Implants Be Part of the Problem?
Fatigue, brain fog, joint pain and anxiety are often blamed on hormones. Sometimes the picture is more complicated.
A woman in her forties walks into a doctor’s office feeling exhausted.
She cannot concentrate. Her joints ache. Her hair is thinning. She is anxious, sleeping poorly and gaining weight despite doing everything “right.”
The explanation often comes quickly:
It is probably perimenopause.
And it might be.
But for women with breast implants, there may be another factor worth investigating.
Not because every woman with implants will become sick. Most will not develop unexplained systemic symptoms.
But enough women have reported them that the FDA now includes systemic symptoms in its breast implant safety information.
What is breast implant illness?
Breast implant illness, commonly called BII, is the name patients and some clinicians use for a collection of symptoms reported after breast augmentation or reconstruction.
Commonly reported symptoms include:
Persistent fatigue
Brain fog or difficulty concentrating
Joint and muscle pain
Hair loss
Rashes
Anxiety or depression
Sleep disruption
Weight changes
Headaches
Dry eyes and mouth
These symptoms have been reported with silicone and saline implants, as well as smooth and textured implants. They may begin shortly after surgery or many years later.
BII is not currently recognized as a formal medical diagnosis. There is no single blood test, scan or diagnostic criterion that can confirm it. Researchers have also not established one definitive biological mechanism explaining why some women develop symptoms while others do not.
That uncertainty is important.
It does not mean the symptoms are imaginary.
It means the science has not completely caught up with what some patients are experiencing.
The midlife overlap
This is where the conversation becomes especially relevant for women in perimenopause.
Perimenopause itself can cause trouble sleeping, joint and muscle discomfort, forgetfulness, difficulty concentrating, mood changes and irritability.
Those symptoms look remarkably similar to the symptoms reported by women who believe their implants are affecting their health.
A woman may be experiencing hormonal changes.
She may be experiencing an implant-related problem.
She may be experiencing both.
Or the real cause may be something entirely different, such as thyroid disease, anemia, an autoimmune condition, medication effects, chronic stress or a sleep disorder.
The problem begins when every midlife symptom is automatically dismissed as “just hormones.”
Perimenopause should not become a diagnostic junk drawer.
What the FDA reports show
The FDA reviewed medical device reports submitted between January 2008 and June 2024 involving unexplained systemic symptoms in people with breast implants.
After removing identified duplicates, it found 10,318 reports.
Among reports containing age information, the average patient age was 42.6 years. When timing information was available, symptoms began an average of 5.6 years after implantation.
The most frequently mentioned symptoms included fatigue, joint problems, anxiety, brain fog, hair loss, depression, rashes and weight changes.
But these numbers require context.
Medical device reports cannot tell us how common breast implant illness is. They may include incomplete information, duplicate reports and unverified assumptions that an implant caused the symptoms.
They are a safety signal, not proof of causation.
Do women improve after removing their implants?
Many do report improvement.
A 2025 systematic review evaluated 33 studies involving 6,048 women with an average age of 46. Approximately 82 percent reported some symptom improvement following explantation, or implant removal. Fatigue, joint pain and muscle pain were among the most frequently reported symptoms.
That finding deserves attention, but it should not be oversimplified.
Most of the available studies are observational. Patients know they have had their implants removed, symptoms are often self-reported and the women choosing explantation may not represent everyone with implants.
Improvement after surgery does not automatically prove that the implants caused every symptom.
It also does not guarantee that every woman will improve after removal.
The most honest conclusion is this:
Some women experience meaningful improvement after explantation, but medicine still cannot reliably predict who will improve or why.
There are other established implant risks
Systemic symptoms are only one part of the breast implant safety conversation.
Breast implants are not lifetime devices. The risk of rupture, capsular contracture, pain, displacement and additional surgery increases over time.
There are also rare implant-associated cancers.
Breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL, is a lymphoma that develops in the scar tissue and fluid surrounding an implant. It has been most strongly associated with textured implant surfaces.
As of June 30, 2024, the FDA had received 1,380 medical device reports involving BIA-ALCL and reports of 64 deaths. These reports cannot be used to calculate an individual woman’s risk because of incomplete reporting and unknown numbers of exposed patients.
The FDA has also documented rare cases of squamous cell carcinoma and other lymphomas developing in the capsule surrounding breast implants. The incidence and risk factors remain unknown.
These cancers are rare. Their existence is not a reason for every woman to panic or immediately remove her implants.
They are a reason to understand what is inside your body and pay attention to changes.
What women with implants should know
1. Find your implant information
Locate your implant device card or surgical records.
Know:
The manufacturer
Implant model
Whether the implant is saline or silicone
Whether the surface is smooth or textured
The date it was placed
Whether you have had previous implants
Do not assume your current implant is your only relevant implant history.
2. Do not blame every symptom on one cause
Unexplained fatigue, brain fog, pain or anxiety deserves a complete medical evaluation.
Hormones may be involved. So may thyroid function, iron levels, sleep, medications, autoimmune disease, nutrition, infection or other medical conditions.
Implants should be included in the conversation, not automatically blamed and not automatically ignored.
3. Keep up with rupture screening
For women without symptoms who have silicone gel implants, FDA labeling recommends the first ultrasound or MRI five to six years after surgery, followed by imaging every two to three years.
An MRI is recommended when symptoms suggest rupture or when an ultrasound result is uncertain.
A normal-looking breast does not necessarily rule out a silent silicone rupture.
4. Seek care for new breast changes
Contact a qualified clinician promptly for:
Persistent swelling
A new breast or underarm mass
Increasing pain
Sudden asymmetry
Fluid accumulation
Skin discoloration
New or worsening hardening around an implant
These symptoms usually have causes other than cancer, but they still require evaluation.
5. Approach explantation as a medical decision
Implant removal is surgery. It carries risks, costs and possible cosmetic consequences.
The decision should be made with a board-certified plastic surgeon who is willing to review your symptoms, implant history, imaging and realistic expectations.
No responsible clinician should promise that removing your implants will cure every health problem.
The larger issue
Women should not be frightened into removing their implants.
They also should not be told that unexplained symptoms are all in their heads.
The answer is not panic.
It is better informed consent, appropriate monitoring and clinicians who are willing to consider the entire picture.
Especially in midlife, when multiple biological changes may be happening at once.
Sometimes it is perimenopause.
Sometimes it is something else.
And sometimes the body is asking us to stop accepting the easiest explanation.
This article is for educational purposes and is not a substitute for individualized medical advice. New or worsening symptoms should be evaluated by a qualified healthcare professional.
References
U.S. Food and Drug Administration: Medical Device Reports for Systemic Symptoms in Women With Breast Implants.
U.S. Food and Drug Administration: Risks and Complications of Breast Implants.
U.S. Food and Drug Administration: Breast Implant Rupture-Screening and Labeling Recommendations.
U.S. Food and Drug Administration: Breast Implant-Associated Anaplastic Large Cell Lymphoma Reports.
U.S. Food and Drug Administration: Squamous Cell Carcinoma in the Capsule Around Breast Implants.