​Why Do My Breasts Hurt? Understanding the Causes of Breast Pain (Mastalgia) & Tips to Help by Dr. Constance Chen

Women's Health
3 years ago

​Why Do My Breasts Hurt? Understanding the Causes of Breast Pain (Mastalgia) & Tips to Help

Most women suffer some form of breast pain at some point in their lives. It may be mild or severe, constant or intermittent. It may be in the form of soreness, sharp burning pangs or tightness. Breast pain, or mastalgia, is usually straightforward to diagnose and treat. While it is seldom a sign of something serious, pain that doesn't go away after one or two menstrual cycles or that persists in women after menopause should be evaluated by a doctor.

Cyclical Breast Pain

Most breast pain is cyclical – linked to hormonal fluctuation associated with the reproductive cycle. Women describe cyclical breast pain as the breasts feeling heavy, tender, swollen and achy. It is caused by increases in estrogen and progesterone that occur before the menstrual period and cause the breasts to swell. Cyclical breast pain generally affects both breasts, intensifies in the week or two leading up to the menstrual period, then recedes. It most often affects women during their childbearing years and as they are approaching menopause. Breast tenderness can be eased with over-the-counter pain relievers and by reducing salt, fats and caffeine in the diet. Birth control pills – or switching to a different formulation – can also help.

The breasts may remain tender during the first trimester of pregnancy in response to increased hormone levels and that continuing breast soreness often accompanies a missed menstrual period as an early sign of pregnancy.

Fibrocystic breast disease, also triggered by hormones, is characterized by dense, lumpy breast tissue that may become painful in response to the monthly cycle. The lumps are fluid-filled cysts and can be clearly differentiated from more dangerous lumps composed of a solid mass of cells that may signify a benign or malignant tumor. Cysts may resolve on their own but any lump in the breast must be evaluated by a doctor via mammogram, ultrasound or aspiration – drawing fluid from the cyst.

Non-cyclical Breast Pain

Non-cyclical breast pain – unrelated to reproductive hormones – most often occurs in one breast and in a localized area though the pain may spread throughout the breast. There are several causes:

  • Mastitis is most common in breastfeeding women (lactation mastitis) but can occur at any time. It is characterized by inflammation of the breast tissue that causes swelling, redness, pain and warmth and sometimes fever and chills. During lactation, mastitis is usually caused by a blocked milk duct or by bacteria entering the breast through an opening in the skin or a cracked nipple. It is generally treated with antibiotics.
  • Injury to the breast can be from a previous surgery, from an accident or from sports. There may be a sharp pain at the time of the trauma followed by tenderness for days or weeks. A doctor should be seen if pain doesn't subside or if there is redness and warmth, which could indicate the presence of infection, if there is severe swelling, or if there is a bruise that doesn't go away.
  • Support issues are most often experienced by women with large, heavy breasts but poor support can cause the ligaments to stretch and cause pain in breasts of any size, particularly after exercise. Pain may also affect the neck, back and shoulders. A properly fitted, supportive bra should be worn at all times and a sports bra when exercising.
  • Medications can cause breast pain as a side effect. Hormonal therapies used in infertility treatment, birth control pills and hormonal replacement after menopause can cause breast tenderness. Some psychiatric medications and those used for coronary disease can also have this effect.

Many women worry that breast pain might be a sign of breast cancer. While this is unusual, it's not impossible. Inflammatory breast cancer, which accounts for 1 percent to 5 percent of breast cancers does cause pain as well as redness, swelling and thickened or dimpled skin. The important thing for women to know is that while most breast pain isn't dangerous, any condition that doesn't resolve over the course of the menstrual cycle or a week or two should be evaluated by a doctor. In the vast majority of cases, treatment will be rapid and effective.

The content on 30Seconds.com is for informational and entertainment purposes only, and should not be considered medical advice. The information on this site should not be used to diagnose or treat a health problem or disease, and is not a substitute for professional care. Always consult your personal healthcare provider. The opinions or views expressed on 30Seconds.com do not necessarily represent those of 30Seconds or any of its employees, corporate partners or affiliates.

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Elisa Schmitz
This is so helpful, Dr. Constance Chen . I have had mastitis before and it was so painful. I attribute most tenderness to hormones, but now will be more aware, thank you!
I always worry when I feel pain in my breast. Thanks for this. 🙏🏼

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