Breast Pain – Symptoms and Causes
What You Should Know About Breast Pain
Breast pain, also called mastalgia, affects people of all genders and can feel like tenderness, throbbing, or sharp pain in breast tissue. The pain varies from mild to severe and can happen in different patterns.
Common Patterns of Breast Pain:
- Short-term pain in both breasts for 2-3 days before menstruation
- Longer episodes lasting a week or more, starting before and continuing through periods
- Constant pain not connected to menstrual cycles
Breast Pain in Different Groups:
| Group | Common Causes |
|---|---|
| Women | Often hormone-related, connected to menstrual cycles |
| Men | Usually caused by gynecomastia (increased breast tissue from hormone imbalance) |
| Transgender women | May result from hormone therapy |
| Transgender men | Can occur in remaining breast tissue after mastectomy |
Gynecomastia happens when men have an imbalance between estrogen and testosterone. This condition can affect one or both breasts and sometimes develops unevenly.
When to Seek Help:
- Pain that doesn’t go away after one or two menstrual cycles
- Pain that continues after menopause
- Breast pain not clearly connected to hormonal changes
It’s important to know that breast pain rarely signals cancer. Most cases point to non-cancerous (benign) breast conditions. However, unexplained or persistent pain should be checked by a healthcare provider to determine the cause and proper treatment.
Types of Breast Discomfort
Breast pain comes in two main types: cyclic and noncyclic. Each type has different patterns and feelings.
Cyclic breast pain follows your menstrual cycle due to hormone changes. It usually feels dull or achy and often comes with swelling or lumpiness.
This pain typically affects both breasts, especially the upper outer areas, and may spread to the underarm. It gets worse in the two weeks before your period starts and then gets better.
People in their 20s and 30s experience this most often, as well as those in their 40s approaching menopause.
Noncyclic breast pain doesn’t relate to menstrual cycles. It feels tight, burning, or stabbing and can be constant or come and go. This pain usually affects one specific area in one breast but might spread.
It’s more common in women after menopause.
| Type | Pattern | Sensation | Location | Timing |
|---|---|---|---|---|
| Cyclic | Related to periods | Dull, heavy, aching | Both breasts, upper outer parts | Worse before period |
| Noncyclic | No regular pattern | Tight, burning, stabbing | Usually one breast, specific area | Constant or irregular |
Pain Outside the Breast
Pain that seems to come from your breast might actually start elsewhere. Pulled chest muscles can cause pain that spreads to the breast area. Arthritis in the chest cartilage (costochondritis) can also create this sensation.
When the pain source is outside the breast, doctors call it “extramammary” breast pain.
When To Contact Your Doctor
Call your doctor if your breast pain:
- Lasts daily for more than two weeks
- Stays in one specific spot in your breast
- Gets worse over time
- Disrupts your daily life
- Wakes you up from sleep
While breast cancer rarely causes pain as the main symptom, it’s important to get checked if your doctor recommends it.
Causes
Breast pain can stem from changes in hormone levels. These hormonal shifts affect milk ducts and glands, sometimes creating painful breast cysts. This is typically what causes cyclic breast pain that follows your menstrual cycle.
Noncyclic breast pain has different origins. It may result from:
- Physical injury to the breast
- Previous breast surgical procedures
- Other medical factors
For many women, the exact cause remains unknown. However, certain risk factors may increase the likelihood of experiencing breast pain, though these specific factors vary from person to person.
Risk Factors
Several factors may increase your chances of experiencing breast pain. This discomfort happens more often in people who haven’t gone through menopause, though it can also occur afterward.
Men with enlarged breast tissue (gynecomastia) and transgender individuals undergoing gender reassignment may also experience breast pain.
Having larger breasts can lead to non-hormonal breast pain, often accompanied by discomfort in the neck, shoulders, and back due to the extra weight.
Previous breast surgeries can cause lingering pain even after the surgical wounds have healed completely.
Your body’s balance of fatty acids may play a role. When these become unbalanced, your breast tissue might become more sensitive to normal hormone fluctuations.
Medications that may cause breast pain:
- Hormonal birth control pills
- Fertility treatments
- Hormone replacement therapies (estrogen and progesterone)
- Certain antidepressants, especially SSRIs
- Some high blood pressure medications
- Particular antibiotics
Some people find that reducing caffeine consumption helps relieve breast pain, though more research is needed to confirm this connection.
Ways to Prevent Breast Pain
Several steps may help reduce breast pain, though more studies are needed to confirm how well they work.
Avoiding hormone therapy when possible can make a difference for many women. If you take medications that cause breast discomfort, talk to your doctor about alternatives.
Proper support matters. Wearing a correctly fitted bra daily and a sports bra during exercise can significantly reduce discomfort.
Managing stress through relaxation techniques helps some women who experience severe breast pain related to anxiety.
Some dietary changes might help:
- Reducing or eliminating caffeine
- Following a low-fat diet
- Eating more complex carbohydrates
Physical precautions can prevent pain from worsening:
- Avoid heavy lifting for extended periods
- Consider over-the-counter pain relievers like acetaminophen or ibuprofen
Important note: Before starting regular use of pain medications, consult with your doctor about appropriate dosages, as long-term use may affect your liver and cause other side effects.
