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Breast Pain before Periods: Causes and Management

Breast pain, breast soreness or Mastalgia is defined as any pain or discomfort in the breast and/or in the underarm region.

Breast pain can be an indication that a woman is close to getting her periods. Breast pain can be severe before periods and decrease after the onset or post periods. Pain is usually felt in one or both the breasts, all over the breast or a part of the breast, extending to the armpit area. Having pain in the breast is not a sign of cancer.

Breast Pain before Periods: Causes and Management

Causes:

  • Hormones: ‘Oestrogen’ and ‘progesterone’ are responsible for initiating the menstruation. These hormones enlarge the breast ducts and breast lobules (milk glands) during menstruation leading to pain in breasts. Few studies claim that high levels of prolactin, a hormone associated with breastfeeding is also responsible for inducing breast pain.
  • Stress: Stress causes hormonal imbalance leading to breast pain.
  • Hormone replacement therapy (HRT): As HRT causes breast-tissue cells to multiply rapidly, women undergoing HRT may develop breast pain.

Other causes are:

  • Excessive consumption of caffeine (in coffee, tea, cola, chocolate and energy drinks). There is no direct relation between breast pain and caffeine. However, it is seen that caffeine intake may lead to hormonal imbalance leading to pain in the breast.
  • Weight gain can make the breasts heavy and cause pain.
  • Injury to the breast (scar resulting from surgery).
  • Breast cysts or fibroadenomas are small lumps in the breast. These lumps become tender before periods leading to pain.
  • Wearing a bra that is not supportive enough leads to pain.
  • Excessive physical activity like weight lifting which puts a strain on the chest, shoulder or pectoral muscles.
  • Few medical conditions like costochondritis or cervical spondylitis etc. which affect the chest wall, ribs or muscles that lie underneath the breasts.

 Management:

  • Avoid: Caffeine (coffee, tea, and chocolate) 1 to 2 weeks before your period starts.
  • Reduce: Food rich in fat.
  • Increase: Physical activity – walking, exercise.
  • Medication: It is always safe to consult a physician before taking any medication.

Supplemental hormones and hormone blockers are prescribed to treat breast pain. They include:

  • Birth control pills
  • Bromocriptine (which blocks prolactin in the hypothalamus)
  • Danazol, a male hormone
  • Thyroid hormone
  • Tamoxifen, an oestrogen blocker.

One can use pain relievers (ibuprofen) or apply ointments on the breast to reduce pain.

 Others:

  • Wear a supportive, well-fitted brassiere.
  • Some studies suggest the use of evening primrose oil which is rich in anti-inflammatory omega-3 fatty acids. It is advisable not to use evening primrose oil if you are diagnosed with epilepsy.
  • Do relaxation techniques to overcome stress.
  • Use of hot pack on the breasts or having a hot shower will relieve mastalgia.

Is it a sign of cancer?

Many women worry that breast pain could be an indication of breast cancer. Well, breast pain is ‘not a sign of cancer’ and it does not put you at any increased risk of breast cancer. You should do a breast self-examination for the presence of any lumps or swellings.

Visit your physician if you notice any changes in your breast such as:

  • Lumps in your breast
  • Discharge from nipple
  • If you are above 40 and, have not undergone a mammogram.
  • Your symptoms are interfering with your sleep and medications/diet/ exercises are not helping.

Your doctor may ask you to get mammogram or breast ultrasound done based on the history and physical examination,

To conclude, breast pain is normal before periods and one need not worry much about it. Resort to simple measures. In case you are not finding relief, consult your physician without delay.

Consult a top Gynaecologist

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References

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  • Teens health. http://kidshealth.org/en/teens/breasts-period.html. Accessed on May 16,2016.
  • Healthy women. National Women’s Health Resource Center. Ask the expert. http://www.healthywomen.org/content/ask-expert/1288/breast-tenderness-period. Accessed on May 16,2016.
  • Premenstrual breast changes. Medline Plus. https://www.nlm.nih.gov/medlineplus/ency/article/003153.htm. Accessed on May 16,2016.
  • Breast Pain. The Society of Obstetricians and Gynaecologists of Canada (SOGC). http://sogc.org/publications/breast-pain/.Accessed on May 16,2016.

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