Shannon, 41, from Los Angeles, knows all too well the discomfort of painful breasts. “During my period, my breasts feel extremely heavy, especially at night. Sometimes I wear a bra when I go to sleep to give them some extra support. If not, I often have to cradle them before I roll over in bed, or else the movement feels like little bowling balls swinging by a tether.”
What Causes Breast Pain?
Sadly, Shannon isn’t alone in her suffering. Breast tenderness and pain, known in the medical world as mastalgia, affects nearly 70 percent of women under 55. About 45 percent of women will suffer from painful or tender breasts at some point in their lives, and about 25 percent will live with moderate-to-severe pain that lasts for more than five days.
There are two types of breast pain. The first is known as cyclic pain, coming and going each month in tandem with your menstrual cycle. The second type, non-cyclic, may not follow any pattern at all.
Breast Pain During Your Period: Cyclic Breast Pain
Monthly breast pain is very common, especially in women who haven’t reached menopause, and is most often caused by a progesterone peak during ovulation or about a week before your period. You’ll typically feel pain in both breasts, and you’ll notice that the pain is most intense right before your period when you're having PMS. What’s happening is that your breasts are being stimulated by both estrogen and progesterone, which makes them swell and become lumpy or tender. When your period arrives, your breasts simply reabsorb the extra fluid instead of discharging it, and then, like magic, the pain usually goes away.
Though this pain can be really uncomfortable, it may help to know that you are not alone. “High progesterone states can lead to breast pain, tenderness and soreness, and this hormonal spike often happens right before a period. It’s a perfectly common, albeit unpleasant, cyclical pattern," says Stella Jones, M.D., who practices in Bethesda, Maryland.
How to Treat Breast Pain
If you suffer from cyclical breast pain, certain things may help to relieve the discomfort. While the remedies below have all been studied extensively, it helps to keep in mind that there’s still some conflicting evidence around the efficacy of all of them; that's why it’s important to talk to your doctor before trying any remedy for the first time.
Breast Pain and Caffeine
There's a growing body of evidence that reducing or eliminating caffeine from your diet can significantly decrease the amount of breast pain you’re experiencing. In several recent studies, women with breast pain who substantially decreased caffeine intake for a year had decreased pain or complete relief.
Breast Pain and Vitamin E
Try a vitamin E supplement. This is the most commonly used vitamin prescribed for the treatment of breast pain. Vitamin E is often prescribed in tandem with evening primrose oil in order to treat severe breast pain, though the evidence for evening primrose oil being taken on its own as a remedy for breast pain is weak.
Breast Pain and Diet
One thing that could help? Changing your diet by cutting the fat — especially animal fat. Reducing the amount of fat in your diet has been shown in studies to reduce breast density and this has, in many studies, been associated with less severe instances of breast pain.
Consuming soy as part of your daily diet has been shown in several studies to help reduce breast pain.
Non-Cyclic Breast Pain
This type of breast pain is most common in women between 30 and 50, and it usually occurs in only one breast. Typically, this pain is nothing to worry about and can occur for a number of reasons. One factor is stress, as feeling tense, anxious, or under pressure can exacerbate breast pain. In fact, exercise, healthy eating, and reducing stress have all been shown to have a minimizing effect on this type of breast pain.
Breast Pain in Pregnancy
The hormone surge you feel right before your period is exaggerated when you’re pregnant; your breasts might become so tender that you may not want to wear your regular bra or be touched. This can begin as early as three weeks into pregnancy, and sensitive, tingling, or sore breasts can be among the first tell-tale signs that you have a baby on the way, even before you take a pregnancy test.
The good news is that breast pain usually decreases after the first trimester, once surging hormones have settled down. You may find that wearing a maternity cotton bra helps relieve the discomfort, and you may find you need to be fitted for a new bra several times during your pregnancy as your breasts grow and change.
Breast Pain and Your Bra
If a bra is too tight, it can irritate your skin and breast tissue and cause you pain. Sports bras don’t always give the support that you need and can cause or contribute to your pain, too. Additionally, underwired bras may interfere with lymph flow. Many breast care practitioners recommend that women with painful breasts don’t buy underwired bras.
Breast Pain and Perimenopause
For women in their 40s, breast pain can sometimes be one of the first signs of perimenopause. “When I was about 48, my breasts were so sore all of a sudden, so tender — soreness that I hadn’t had since I was in my 20s hit me like a ten-ton truck,” says Anna Shwartz, of Austin, Texas. “I knew this wasn’t normal for me, and sure enough, my period had completely disappeared a few years later. That was the beginning.”
Other Breast Pain Causes
Hormone medications: Birth control pills and HRT pills can both cause breast pain. The amounts of either estrogen or progesterone (or both) may not be right for you, or your breasts may be reacting to the additives in the pill.
Other drugs: Some anti-depressants or other psychiatric meds may increase breast pain. Also, some cholesterol-lowering and heart medications can cause breast changes.
Cysts: These fluid-filled sacs in the breast are common, especially before menopause. They can swell and recede, sometimes causing pain in the process. Sometimes breast cysts actually go away on their own, and if not, you can see your doctor about options, which often include draining the fluid from the breast.
If you’re having non-cyclical breast pain which has lasted longer than a few months, it’s a good idea to get a full medical checkup in order to find out what’s going on. And, of course, while breast pain is only very rarely a symptom of breast cancer, it’s worth having a breast thermography exam or mammogram just to be on the safe side.
"With both cyclical and non-cyclical breast pain, it’s simply a case of finding the best remedy for you," says Stella Roper, M.D., who practices in London, England. "For women with severe cyclical pain, sometimes taking a birth control pill which stops menstruation can relieve symptoms significantly. But this isn’t for everyone; sometimes birth control pills actually exacerbate breast pain. Some women find that lymphatic massages or even rubbing castor oil into their breasts can help. And, of course, adopting a healthy lifestyle and minimizing stress is always the first place to begin.”
This article was written by Amy Schreibman Walter.