Can peri-menopause cause changes?

I am 46 years old and had an ablation with Mirena inserted in 2018. I haven't had a period for probably close to a year. I have been having what I believe are hot flashes all spring and summer.

Then, in early-Mid-August, I kind of felt "off" one day and noticed I was spotting. This went on for a few days then stopped. Two weeks later I got an actual period out of the blue. Around this time I felt like my breasts were "puffy." The period ended a few days later and I forgot about it.

About two weeks ago I started noticing discomfort in my right breast, in the right upper quadrant. At first it was just soreness, but then it morphed into more of a thick feeling, and then it got REALLY painful, culminating in sharp stinging/stabbing pains and a general lumpiness and engorgement. I think what made me notice it most was that I was suddenly more aware of it and it felt bigger than normal.

I was quite worried about this but didn't want to be a hypochondriac and gave it a few days and then it settled down. Almost immediately after the breast stopped being so horribly painful, I started another period. So, now the breast is almost back to normal. No longer really sore, but slightly so. But it does have lumpiness/firmness on the outer quadrant. I'm still having this period, but it's more spotting. I don't think the timing is coincidental and assume they are related.

About ten years ago I had a very similar experience where I went to bed thinking I was having hot flashes and woke up with a jagged, hard and horribly painful lump protruding from my left breast which turned out to be a cluster of cysts inside a fibrous area that had ruptured into my milk duct. I developed another painless and enormous cyst two years later in the same breast.

I am hopeful that this new issue with my right breast is a result of fibrous and cystic changes because of a bizarre hormone surge.

Has anyone experienced anything similar around peri-menopause and can ease my mind? I am calling my GP on Monday to see if she can get me in prior to my physical which is scheduled for October 8.