Breast Pain: Causes, What to Do & When to Worry

Medical review: Dr. Sheila Sedicias
Gynecologist
July 2022

Breast pain, which is scientifically known as mastalgia, is a relatively common symptom that can affect about 70% of women. Most of the time, it is caused by strong hormonal changes that occur during menstruation or menopause.

Nonetheless, the pain can also be related to other, more critical conditions, like mastitis from breastfeeding, breast cysts or even breast cancer. Therefore, if the breast pain lasts for over 15 days or if it does not appear to be related to your period or menopause, you should see your doctor for assessment,

Breast pain can occur in just one breast or in both at the same time, and the pain can radiate to the arm on the affected side. It can be mild, which is considered to be normal, but it can also be intense enough to interrupt daily activities.

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The main causes of breast pain include:

1. Start of puberty

Girls between the ages of 10 and 14 that are entering puberty may feel mild pain or discomfort in their breasts when they are starting to grow. This may make the breasts more sensitive.

What to do: No specific treatment is necessary. A warm bath may help to relieve some discomfort. It is also important to use a well-fitting bra that supports the breasts during this phase.

2. PMS or menstruation

Hormonal changes that occur before and during menstruation can cause breast pain in some women. This is not a serious finding, but it can be a monthly inconvenience. In these cases, women may feel some tingling in the breasts or nipples or increased sensitivity. It is considered to be normal if pain is mild to moderate and lasts for up to 4 days. If the pain lasts for longer than 10 days and radiates to the arm or armpit, you should see your doctor for assessment.

What to do: Taking medication is rarely needed, but using a birth control pill may help to relieve symptoms associated with menstruation. When the pain is intolerable, your doctor may recommend taking bromocriptine, danazol, and tamoxifen. Other natural options can include chasteberry, primrose oil or Vitamin E. These natural options should be taken for 3 months before evaluating their therapeutic effect.

3. Menopause

When entering menopause, some women may experience painful breasts or a burning sensation. Other typical symptoms of menopause include hot flashes, night sweats and mood changes.

Breast pain occurs due to changes to estrogen and progesterone hormone levels. These hormones tend to fluctuate greatly during the first phase of menopause, which can affect breast tissue and cause discomfort.

What to do: Specific treatment is not necessary. Some strategies that can help with discomfort include making sure to use a well-fitting bra, decrease caffeine intake, and applying warm compresses on the breasts.

4. Pregnancy

Breasts can become particularly sensitive at the beginning and end of pregnancy. This is due to the growth of mammary glands for the production of breastmilk. If you suspect you are pregnant, read about the most common 10 first symptoms of pregnancy.

What to do: Applying warm compresses on the breast can help to relieve discomfort, as well as a warm bath or a light massage in the affected area. During pregnancy, you should wear a well-fitting nursing bra, as these will help to support the breasts.

5. Breastfeeding

When breastfeeding, the breasts may feel hard and painful if they are full of breastmilk. If the pain is sharp and localized to the nipple, however, this may indicate cracked nipples. These often cause intense pain and even bleeding.

What to do: If the breast is full, then removal of milk with breastfeeding or a breast pump is indicated. If you are also feeling nipple pain, assess the area for a clogged duct or cracked skin. Each of the conditions can lead to mastitis, which is a more serious problem. If you have any breastfeeding difficulties, you should see a lactation consultant for evaluation.

6. Medication use

Some medications, like methyldopa, spironolactone, digoxin, oxymetholone and chlorpromazine can cause breast pain as a side effect.

What to do: You should talk to your doctor about this side effect and about how intense the breast pain is. The doctor may consider prescribing an alternative medication that does not cause breast pain.

7. Breast cysts

Some women may have abnormal breast tissue that is fibrocystic, which may cause breast pain particularly before menstruation. This condition is not linked to cancer, but it can cause the growth of nodules in the breast that may appear and disappear spontaneously.

What to do:  When breast pain is not related to menstruation, you can used medications like acetaminophen, aspirin or ibuprofen as directed by your doctor.

8. Change in contraceptives

When starting a new contraceptive or changing to another kind, breast pain can emerge. It can range from mild to moderate and it generally affects both breasts at the same time. Pain can also feel like a burning sensation.

What to do: Massaging during a shower and using a comfortable bra can help with breast pain while the body is adapting to the birth control. This can take about 2 to 3 months.

Other possible causes

In addition to the above-mentioned causes, other conditions can also be associated with breast pain. These include physical exercise, thrombophlebitis, fibroadenosis, benign tumors or large cysts.

Therefore, if breast pain persists even with the at-home interventions recommended above, you should see a doctor for assessment. He or she will be able to confirm a diagnosis and indicate appropriate treatment.

When pain can mean cancer

Breast pain is rarely a sign of cancer, as malignant tumors are not painful. With breast cancer, other symptoms like nipple discharge or indented breast tissue are usually present.

Women at high risk for breast cancer will usually have a strong family history of it (e.g. mother or grandmother with breast cancer), be over the age of 45, and have already had another type of cancer. Young women who have breastfed and were found to have benign lesions or cysts do not have a higher risk of breast cancer.

In any case, if you suspect your have breast cancer, you should see your doctor to complete a mammogram.

When to go to the doctor

You should see medical attention if the breast pain is intense, if it lasts for more than 10 consecutive days, or if it has other symptoms like:

  • Transparent or bloody nipple discharge
  • Breast redness or pus
  • Fever
  • The appearance of a breast lump that appears after a period

It is also recommended to see your doctor at least once a year for a breast exam and to assess your reproductive health. This can prevent problems and identify any diseases early on. 

The doctor will assess your breasts by inspecting the painful areas and assessing for asymmetry or indentations. He or she will assess for any swollen or painful lymph nodes in the armpits or clavicles and determine whether further exams, like mammogram or ultrasounds, are necessary. These will be likely be ordered if there is a family history of breast cancer.

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Edited by Tua Saude editing team in July 2022. Medical review completed by Dr. Sheila Sedicias - Gynecologist in December 2021.
Medical review:
Dr. Sheila Sedicias
Gynecologist
Physician graduated in Mastology and Gynecology by UFPE in 2008 and member no. 17459 of CRM-PE, Brazil.