Breast pain, or mastalgia, is very common. In fact, some research indicates that nearly 70% of women will experience breast pain at some point in their lives. Breast pain can occur at all ages and stages of life, from the teenage years to the postmenopausal time. It is most commonly seen in young premenopausal women and perimenopausal women.
The majority of the time, breast pain is not a sign of breast cancer or anything concerning. While the exact cause of breast pain is not known, many of the factors likely center around hormonal fluctuations. However, if breast pain is persistent or is accompanied by redness or lumps or other concerning symptoms, you should make an appointment with your health care provider.
I’ve outlined below the two main types of breast pain and some recommended treatments and remedies to alleviate the symptoms.
Types of Breast Pain
Cyclic Pain: This is the most common type of breast pain. It may be caused by normal monthly changes in hormones associated with the menstrual cycle and often appears in both breasts. It is described as a heaviness or soreness that radiates under the arm and is sometimes accompanied by swelling. The duration is extremely variable from woman to woman. For most women, it starts a week or two before her menstrual cycle and starts to go away after the menstrual period ends. For some women, it can extend longer. This pain is most common in younger women and often goes away without treatment. It usually is not experienced after menopause.
One way to tell if your breast pain is related to your menstrual cycle is to keep a calendar of the days you experience pain, including the intensity in relation to your menstrual period.
Non-Cyclic Pain: This type of pain is most common in women ages 30-50. It may occur in only one breast and is usually described as a sharp or burning pain that can be felt in one area of the breast. Sometimes this pain can be related to the appearance of a breast cysts or a benign breast lump called a “fibroadenoma.” Other causes of pain that may feel like they are in the breast but are actually in other structures may be due to pinched nerves, back pain or inflammation of the cartilage between the ribs called “costochondritis.”
You should make an appointment with your doctor if you have breast pain that persists daily for more than a couple of weeks and is seemingly unrelated to your menstrual cycle, your breast pain is localized to one specific area of your breast, the breast pain seems to be getting worse over time, or the pain interferes with your daily activities.
Treatment of Breast Pain
Breast pain can usually be treated by both lifestyle modifications as well as medications.
Lifestyle Modifications
- Breast size/Bra size: Women with large breasts may experience breast pain related to the size of their breasts. This pain may be associated with pain in the neck, shoulders, and back. Regardless of size, wearing a firm support bra may help minimize the pain. Consider a professional bra fitting. For some women, wearing a sports bra during exercise and even while sleeping may help improve breast pain.
- Caffeine: Some women experience an increase in their breast pain when they consume caffeine. Although there are no scientific studies to prove this, some women feel that the pain is decreased when they reduce caffeine intake. (Remember: caffeine sources can include coffee, some teas, cola and chocolate).
- Medications may cause breast pain as a side effect. Some common types include oral contraceptives (birth control pills), infertility medications, hormone replacement therapy, and some types of medications that treat depression and other psychological disorders. Before you consider eliminating these medications, you should have a conversation with the prescribing clinician.
- Diet: Research is somewhat inconclusive on relationships between diet and breast pain, yet some data indicates that women with high-fat diets have higher incidences of breast pain. Decreasing the total dietary fat below 20% may improve breast pain. Sometimes, reducing salt intake can also help if pain is associated with swelling.
- Nicotine has also been associated with increased breast pain.
- Compresses: During times of pain, warm or cold compresses may provide symptom relief
- Exercise in general helps manage stress and pain control. Exercising on a regular basis may therefore help to decrease breast pain.
Medications for treatment
- Acetaminophen (Tylenol)
- Anti-inflammatory Medications: Ibuprofen (Advil or Motrin) or naproxen (Aleve) can be taken orally or used as a gel rubbed into the affected area.
- Evening Primrose Oil: A trial of 1,000 mg capsules 1-3 times a day for a 3-month period may reduce symptoms. Evening Primrose oil is a supplement that may change the balance of fatty acids in the cells and thus reduce breast pain. It should not be taken if you are pregnant.
- Vitamin E: Some women find that 400 IU (International Units) of vitamin E taken one to three times a day for 3 months may be helpful to alleviate breast pain
- Danazol, tamoxifen and bromocriptine are prescription medications that can reduce breast pain but are not commonly used because the side effects often outweigh the benefits.