Table of Contents
12 Common Causes of Breast Pain During Periods
1. Normal Levels of Hormones
Breast pain which is associated with menstrual cycle or periods is also known as cyclical breast pain or cyclical mastalgia. Cyclical breast pain can occur normally during periods in some women. The pain may occur repeatedly before periods and usually tapers down with menstruation. It is the most common type of breast pain and usually involves both the breasts. In these women, hormone levels are usually normal. The pain ranges from mild tenderness in the breasts to moderate pain. This pain usually subsides during or after menstruation. The heaviness or soreness in breasts may radiate to the armpit and arm.
2. Premenstrual Syndrome
It is a group of symptoms that occur in a women typically between ovulation and periods, causing mood swings, irritability, anxiety, breast pain, lower abdomen pain, acne etc. These symptoms can begin as early as on 14th day of cycle and may lasts upto completion of menstrual cycle. It usually occurs due to changes in the levels of estrogen and progesterone during the menstrual cycle. Premenstrual syndrome is commonly seen in women with mood disorders, postpartum depression, physical or emotional trauma, domestic violence, substance abuse and schizophrenia.
3. Prolactin Hyper- responsiveness
Prolactin hormone promotes milk production in mammals usually females. Some studies have found that breast pain during periods occur due to increased responsiveness of prolactin hormone to thyrotropin releasing hormone. Higher levels of sex hormone was also present, probably contributing to the exaggerated response. This hyper- responsiveness results in soreness and tenderness of breasts during periods.
4. Premenopausal Women and Psychological Distress
Approximately 8-10% of premenopausal women experience moderate to severe perimenstrual breast pain or cyclical breast pain, monthly. This type of breast pain can occur regularly for years until menopause. It can interfere with usual activities, and is usually associated with elevated utilization of mammography among young women. According to a study done by DN Ader et al 1999, although by definition cyclical breast pain is associated with menstrual cycle but it can be a chronic pain disorder in some women. It may be associated with psychological distress and other disease processes. Psychological factors influence susceptibility and severity of breast pain.
5. Fatty acid Imbalance
Elevated saturated fatty acids and abnormal metabolism of essential fatty acids in the body results in exaggerated effects of normal levels of hormone. This in turn can cause soreness, tenderness and pain in the breasts especially before and during the periods. So, one must take balanced diet and cut down in fat intake to prevent this problem.
6. Fibrocystic Changes in Breasts
Fibrocystic changes in the breasts is a benign or non- cancerous condition that give a breast lumpy or rope-like texture. This condition can occur due to hormonal changes during the menstrual cycle affecting the breast tissue. Fibrocystic changes in the breasts cause tenderness, pain, swelling and lumpy or rope- like texture before and during the periods. This condition is most common in women in their 30s to 50s. Although this condition is not dangerous or harmful but medical evaluation is required from time to time for new changes. Low salt intake, mild pain relieving medication and vitamin supplements help in reducing breast pain in women with fibrocystic breast changes.
7. Breast Fibro-adenomas
Fibro-adenoma is a non- cancerous breast tumour and occurs most often in young women. Although the exact cause of fibro-adenoma is not known but the reproductive hormones may play a part in their formation. Use of oral contraceptive pills before the age of 20 has been associated with a higher risk of developing fibro-adenomas in the breasts. This tumour feels like a firm, smooth and rubbery lump in the breast. It is usually painless but may cause mild tenderness in the breasts. This condition is not life- threatening but it needs proper medical treatment.
8. Breast Cysts
Fluid- filled sacs or cysts can develop in breasts of some women. They may or may not cause pain. These cysts typically increase in size during the menstrual cycle. They are not cancerous and usually go away with the onset of menopause. Breast cysts are common in women in their fourth and fifth decade. Usually treatment is not required but if the cyst is large in size or causing discomfort then drainage of the cyst is indicated.
Some medications can contribute to breast pain before and during menstruation. Medicines affecting the reproductive hormones, psychiatric medications, and some cardiovascular medicines are linked to breast pain. These medicines include oral contraceptive pills or birth control pills, post- menopausal estrogen and progesterone preparations (hormone therapy), antidepressants, antipsychotic medications, diuretics, infertility treatments, and some steroids. Alternative methods of contraception may help in women using birth control pills. Post- menopausal women taking hormone replacement therapy may experience breast pain and they have an increased risk of developing breast cancer.
Infection of the breasts can cause painful breast. This condition is most common in breast- feeding women due to a clogged milk duct. It can happen both during menstruation and at other times. This causes pain, swelling, redness in the breasts and may also cause fever and tiredness. The pain and inflammation subsides with proper antibiotic treatment.
11. Improperly fitted clothes
Too tight or too loose brasserie can compress the breasts or leave them with improper support causing discomfort and pain in the breasts. So, proper fitting of clothes is necessary for adequate support and comfort of the breasts.
12. Relationship to Breast Cancer
Although breast cancer is not considered as a cause of breast pain during periods, but premenstrual breast tenderness has a potential association with breast cancer. Premenopausal women with premenstrual breast pain and tenderness are at a higher risk of developing breast cancer than the premenopausal women without cyclical breast pain.