Sudden breast swelling and pain with dark-colored menstruation after 4 years of menopause may be due to medication factors or due to gynecological diseases combined with breast diseases. Sudden breast swelling and pain with dark-colored menstruation after 4 years of menopause, first need to consider the drug factor. If a woman takes estrogen-containing drugs for a short period of time, it can lead to endocrine dysfunction and disorders, and therefore breast swelling and pain and menstruation may occur. If a woman suffers from cervical cancer, uterine fibroids, endometrial cancer, it will also lead to menstruation 4 years after menopause. When gynecological diseases are combined with breast diseases, such as breast hyperplasia and breast cancer, it can cause sudden breast swelling and pain at the same time. There are many reasons for sudden breast swelling and pain with dark-colored menstruation after 4 years of menopause, so it is recommended that patients go to the hospital in time and take standardized treatment according to the doctor’s instructions, rather than treating the patients indiscriminately in order to avoid causing adverse consequences.