Breast pain

Breast pain is a common symptom experienced by most women. It is most commonly minor or moderate and is accepted as part of the normal changes of the menstrual cycle. Sometimes it may not be related to the menstrual cycle. A small proportion of women however have more significant symptoms.

The most common type of breast pain is cyclical mastalgia, where both breasts become tender or painful, and possibly swollen or lumpy, before your menstrual cycle. These symptoms tend to improve after your menstrual cycle has ended.

Cyclical mastalgia is most common between ages 20-45, and can also occur in women after menopause, especially if they are taking hormone replacement therapy. Most women will experience relief from their breast pain with treatment, which are multi-fold.

Non-cyclical mastalgia tends to occur in older women. Symptoms vary according to the pathology as pain may arise from part of the chest wall, be referred from elsewhere or arise diffusely within the breast. In cases where the pain appears to be truly arising from the breast, it may be possible to find localised areas of tenderness and such areas may act as triggers, causing pain elsewhere in the breast.

TREATMENT

Dietary Changes

Some women find if they eliminate caffeine from their diet it can help reduce breast tenderness. However, it may take a few weeks to months or more for you to feel the difference in your breasts. Caffeine can be found in coffee, tea, cola, and chocolate as well as some over-the-counter drugs. Oestrogen is linked to breast pain and eating a low-fat diet, especially low in saturated fats, can decrease oestrogen levels and improve breast pain and lumpiness. Avoid meat and eat more fish, tofu, and non-fat dairy. Stop eating all dairy foods for at least one month as a trial run. If it hasn’t helped after one month, then you can add dairy foods again. All these measures should relieve your symptoms to a great deal if not cure them.

Keep a log of the foods and activities that may be associated with either the onset of breast pain, or worsening the pain, and try avoiding them.

Lifestyle

  • Exercise has been shown to decrease oestrogen levels and improve breast tenderness.
  • A well-fitting, supportive bra can often greatly relieve breast pain.
  • Quitting smoking.
  • Applying warm compresses to the breast may also be helpful.

Nutritional Supplements

  • Evening primrose oil contains polyunsaturated fatty acids that may help to reduce the symptoms of breast pain. Many doctors recommend taking 3 grams per day for at least 6 months.

Medications

  • Over the counter pain relievers such as Ibuprofen and aspirin can often be helpful in relieving breast pain. A topical pain-relieving gel such as diclofenac sodium gel may help to reduce breast pain with less likelihood of side effects than with oral pain medications.
  • Oral contraceptives can be helpful, although they tend to increase breast tenderness initially. It may take up to 3-6 months to see any positive changes.
  • Tamoxifen is an anti-oestrogen that is used to treat breast cancer and is effective in reducing breast tenderness. However, it has significant risks and side effects, and so is used only in the most severe of cases.
  • Danazol and Bromocriptine have been used in the past, however in most cases the side effects are considerably worse than the symptoms, and they are rarely used today.

Last updated: July 17, 2019