Breast pain: 8 main causes and what to do


Breast pain, known as mastalgia, is a common symptom that affects about 70% of women, and can be caused by common hormonal changes related to premenstrual syndrome (PMS), menstruation, or menopause, but in some cases it can  be related to other more serious situations such as mastitis during lactation, the presence of cysts in the breast, or even breast cancer.


Breast pain: 8 main causes and what to do



Breast pain can be controlled with homemade solutions such as the use of warm compresses, massages during the bath and with the use of comfortable clothing and bras, the use of medications being very rare. If the pain and discomfort remain for more than 15 days and if it seems that it is not related to menstruation or menopause, you should go to the gynecologist for an evaluation, and if necessary, perform tests.


The pain can occur in only one breast or in both at the same time, and can even radiate into the arms. This breast pain can be mild, being considered normal, but it can also be severe, preventing the performance of daily tasks. Here are the most common causes:


1. Beginning of puberty


Girls between the ages of 10 and 14 who are entering puberty may have little pain or discomfort in their breasts that are beginning to grow, and they become more sore.


What to do: No specific treatment is necessary, but a warm bath can ease the discomfort. In this phase it is also important to wear a bra that is good support and is suitable for the size of the breasts.


 2 . PMS or menstruation


Before and during menstruation, hormonal alterations can cause breast pain in some women, not being serious, despite causing discomfort every month. It can cause stitches and tenderness in the breasts or nipples. When the pain is mild or moderate and lasts 1 to 4 days, it is considered normal, but when it lasts more than 10 days and radiates to the arms or armpits, it should be evaluated by a gynecologist or mastologist.


What to do: Medication is rarely necessary, but continuing to take birth control pills can help relieve symptoms with each menstrual period. When the pain is very bothersome, the gynecologist may indicate the intake of Bromocriptine, Danazol and Tamoxifen. You can also indicate as natural options Agnus-Castus, Evening primrose oil or vitamin E, which should be taken for 3 months to then evaluate the results.


3. Menopause


Some women when they are entering menopause may experience breast pain or a burning sensation, in addition to other typical symptoms of menopause, such as hot flashes, night sweats and mood changes, for example.


Breast pain occurs due to the alteration of estrogen and progesterone levels in the body, which tend to vary greatly during the first phase of menopause, affecting the breast tissue and causing discomfort.


What to do:  No specific treatment is necessary, but wearing a supportive bra, reducing the amount of caffeine, and applying warm compresses to the breasts are simple strategies that can reduce pain.


4. Pregnancy


The breasts can be especially sensitive in early and late pregnancy, due to the growth of the mammary glands or the production of breast milk. If you suspect you may be pregnant.


What to do : Putting on warm compresses can help relieve discomfort, as can taking a warm bath and massaging the region. In pregnancy it is recommended to use special bras for breastfeeding, as they provide better support for the breasts.


5. Pain in the breasts during lactation


During breastfeeding when the breasts are full of milk, the breasts can become hard and very sore. A sharp pain can also occur, located in the nipple, this may indicate the existence of a crack, which causes intense pain and even bleeding.


Another more serious situation that can occur during lactation or even a few days before childbirth is that breast milk stagnates and clogs the ducts through which it comes out, which can cause an infection called mastitis, which generates intense pain in the breasts, in the areola or nipple, and is usually accompanied by other symptoms such as redness, lumps that are palpable and warmth of the affected area.


What to do:  If the breast is full of milk, the best strategy is to give the baby a feed or express the milk with a manual or electric pump. If the nipples are sore, the area should be closely watched to see if there are any plugged ducts or cracks where the pain occurs. So if there is a problem with breastfeeding, your obstetric nurse or pediatrician can personally tell you what to do to solve this problem. 


6. Use of medications


Taking certain medications such as Methyldopa, Spironolactone, Digoxin, Oxymetholone and Chlorpromazine have breast pain as a side effect.


What to do: the doctor should be informed about the appearance of this symptom and also its intensity. The doctor can check the possibility of indicating the taking of another medicine that does not cause mastalgia.


7. Cysts in the breasts


Some women have irregular breast tissue called fibrocystic breasts, which can cause pain mainly before menstruation. This type of problem is not linked to cancer, but it also causes lumps to form in the breasts that can grow or disappear on their own.


What to do: in cases where the pain is not related to menstruation, medications such as Paracetamol, Aspirin or Ibuprofen can be used, under medical indication.


8. Change of contraceptive pills


When starting to take or change contraceptives, breast pain may arise, which can be mild or moderate and generally affects both breasts at the same time, and there may also be a burning sensation.


What to do: Bathing massage and wearing a comfortable bra can be a good solution while the body is not adjusting to the birth control pill, which can take 2 to 3 months.


In addition to these causes, there are many others, such as trauma, physical activity, thrombophlebitis, sclerosing adenosis, benign tumors or macrocysts, which can be diagnosed by the gynecologist or the mastologist. So if the pain in the breasts continues, even carrying out the home solutions that we indicate here, a consultation is recommended so that the doctor can make the diagnosis and indicate the most appropriate treatment for each situation.


Other possible causes 

In addition to these causes, there are also many other situations such as trauma, physical activity, thrombophlebitis, sclerosing adenosis, benign tumors or macrocysts, which must be diagnosed by a specialist doctor.


In case the pain in the breasts continues despite treatment and home remedies, you should go to the gynecologist or mastologist for an evaluation to diagnose what the problem is and indicate the most appropriate treatment.


When pain can be a sign of cancer

Breast pain is rarely a sign of cancer, as malignant tumors usually do not cause pain. In the case of breast cancer, other symptoms must be present, such as discharge from the nipple, presence of a groove in the breast, among others.


Women with the highest risk of breast cancer are those with a family history of this type of cancer, who are over 45 years old, and those who have previously had some type of cancer. Young women who breastfed with only benign lesions, or even those who had benign cysts, are not at increased risk for breast cancer.


In any situation, if breast cancer is suspected, a gynecologist should be seen to assess the signs and symptoms and indicate a mammogram from the age of 40 to verify if it is really cancer or some other disease.


When to see a doctor


You should see a doctor when breast pain is severe or lasts more than 10 consecutive days, or if it appears in conjunction with other symptoms such as:


Clear or bloody discharge from the nipple;

Redness or pus in the breasts;

Fever;


A lump or lump in the breasts that disappears after the menstrual period.

In addition to this, it is important to go to the gynecologist at least once a year to perform gynecological and breast control examinations, as a way to prevent and identify alterations or diseases in time.


The doctor normally evaluates the breasts by observing the place of pain, if there are alterations such as asymmetry or retraction of the breast at any point, and also looks for swollen or sore nodes in the armpits or in the clavicles to verify if there is a need to request tests such as mammography or breast ultrasound, especially if there is a family history of cancer.



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