A healthy living blog from Marshfield Clinic

Breast pain: Is it hormonal or something more?

Breast pain is a common complaint among women of all ages. Paying attention to your symptoms and timing of breast pain is important so you can let your doctor know if something changes.

“Whenever a patient tells me she has breast pain, I take a detailed history,” said Dr. Henny Liwan, a Marshfield Clinic OB-GYN physician. “I want to know if the patient is pre- or post-menopause, if the pain happens in cycles or is constant, and if she has a family history of breast cancer.”

Liwan said most causes of breast pain are benign, and there may be things you can do at home to find relief.

Breast pain usually is related to hormonal changes

Woman feeling her breast - Breast pain

Most breast pain is caused by hormones related to a woman’s menstrual cycle.

Most breast pain is the result of normal hormonal changes during a woman’s menstrual cycle. Women describe the pain as breast aching, tenderness, heaviness and swelling in the outer upper quadrants of both breasts. It tends to start a week before your period begins and improves soon after your period starts.

Breast pain caused by early pregnancy hormones may be confused with premenstrual breast pain before a woman knows she is pregnant. For most women, the pain improves after the first trimester.

Women undergoing hormone replacement therapy during menopause sometimes feel breast tenderness and heaviness. Hormonal birth control can cause a similar feeling.

“Ice packs and ibuprofen, or Tylenol if you’re pregnant, can provide some relief from breast pain,” Liwan said. “If you have large or heavy breasts, try a more supportive bra.”

You may have a breast infection

Women who are breastfeeding are susceptible to painful clogged milk ducts. A warm compress to improve milk flow or a cold compress may relieve the pain. Sometimes bacterial growth in the milk duct causes a breast infection, or mastitis. Mastitis causes swelling, tenderness, redness and fever.

“Breast infections need to be treated with antibiotics,” Liwan said. “If the infection gets worse, it can become an abscess that needs to be drained.”

Women who aren’t breastfeeding can get mastitis, but it’s less common.

Sometimes the pain isn’t coming from the breast

Pain in the chest wall, rib cage or upper back can feel like breast pain. The culprit may be a pulled muscle, an infection or in the most serious cases, a heart attack. Call your doctor if you’re concerned about the source of your pain.

Breast pain rarely is breast cancer

“Breast cancer usually doesn’t present with pain, but it can happen,” Liwan said.

Inflammatory breast cancer shares some symptoms with mastitis, such as redness and swelling. Nipple discharge, skin changes such as a rash that feels like an orange peel, and single-sided pain could be signs of breast cancer that your doctor should check.

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