BREAST PAIN (MASTALGIA) – Causes, Treatment And All you need to know

Dr Rooma Sinha, MD, DNB
Sr. Consultant Gynecologist & Laparoscopic Surgeon
Apollo Health City, HYDERABAD

What is mastalgia?

Breast pain also known as mastalgia (in medical terminology) may affect close to 70% of women in their lifetime. It is normal for women to have pain for 2-3 days before their menstrual period or may last for more than 5 days. It can be so bad it is not comfortable to wear a dress or to be hugged. Pain can be in one breast or both or may be not related with periods at all. In about 8% of these women the pain will be severe and interfere with their normal activities

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Three main types of breast pain –

• Cyclical – pain is related to menstrual period and may start before the onset of bleeding (premenstrual mastalgia). This may reduce with onset of bleeding or may continue for the duration of periods.
• Non-cyclical – The pain does not change with the menstrual period. It may be there all the time or it may come and go without a pattern.
• Chest wall pain – This is not true breast pain but affects the muscles and other tissues beneath the breast.

Causes

The cause of breast pain is not known but it may be related to

• Hormonal changes
• Excess salt intake- increases swelling by causing fluid retention
• Pregnancy
• Fibrocystic changes in the breast
• Cysts in the breast
• Inflammation of the breast bone and ribs

What to do if you have breast pain?

• Have a complete breast examination.
• Keep track of the breast pain and your menstrual cycle. Keep a daily record of the pain intensity on daily basis.
• Make sure you are wearing the right type and size of bra. The bra should give good support.
• Look for ways to reduce stress and relax.
• You may be advised to undergo mammography

Does hormone treatment or contraceptives increase breast pain?

The birth control pill or hormone therapy may cause breast pain, increase or decrease it. Some women may get breast pain for the first time when they start these medications. Such mastalgia slowly disappears.

Is breast pain related to cancer?

It is very rare for breast pain to be caused by cancer if there is no lump present. Consult a doctor if you are concerned.

What helps?

• Oral contraceptives- mastalgia caused by hormonal fluctuations often diminishes with the use of OCPs.
• Antibiotics- breast pain caused by infection requires antibiotics.
• Low salt diet- Reducing sodium intake is helpful when fluid retention causes breast pain.
• Non Steroidal Anti-inflammatory drugs-such as ibuprofen often provide effective relief from breast pain
• Vitamins E and B6 have been shown to be helpful in the treatment of mastalgia.
• Evening primrose oil. A few studies have shown a dose of 3000 mg a day to be helpful in treating breast pain.
• Flaxseed. Two tablespoons of crushed flaxseed (not flaxseed oil) taken daily for 3 months was found to be effective for cyclical breast pain in one study.