Breast pain, also known as mastalgia, can cause a lot of anxiety, and many women
worry that they may have breast cancer. You may find it helpful to know that breast pain alone is not usually a sign of breast cancer. We hope the information will help you understand more about breast pain and reassure you.
Types of breast pain
Breast pain is very common in women of all ages, for example, approximately two out of three pre-menopausal women will experience it at sometime in their lives.
There are two main types of breast pain. Breast pain that is part of a woman’s normal menstrual cycle is known as cyclical breast pain. Women may experience it as discomfort and lumpiness in their breasts a week or so before their period. The pain can vary from mild to severe and breasts can also be tender and sore to touch. It often goes away once the period starts.
Other women can have lasting pain felt in the breast that is not related to their menstrual cycle or is actually coming from elsewhere in the body. This is known as non-cyclical breast pain.
Both types of breast pain can be treated, so if you have breast pain that is severe or long lasting and affecting your daily life, you may want to talk to your GP.
Cyclical breast pain
Cyclical breast pain is linked to the menstrual cycle and affects women who haven’t been through the menopause (change of life). Normal hormonal changes take place throughout the menstrual cycle. These make the breast tissue oversensitive, which in turn can cause breast pain. You may experience a burning, prickling, stabbing or drawing-in pain. It can affect either one or both breasts and can spread to the armpit, down the arm and to the shoulder blade.
This type of pain often stops after the menopause when the ovaries stop working.
However, women who are taking hormone replacement therapy (HRT) after their menopause can also experience breast pain. This is because the HRT keeps them in a pre-menopausal state.
What causes cyclical breast pain?
The exact causes of cyclical breast pain are not known. Research has shown that low levels of an essential fatty acid called gamolenic acid (GLA) can contribute to cyclical breast pain. Pain can also be associated with starting to take the contraceptive pill, certain anti-depressant drugs and herbal remedies, or stress.
1. Diet and Lifestyle Changes
- In many cases your doctor will be able to reassure you that what you are experiencing is a perfectly normal part of your monthly cycle. In the first place, s/he may suggest simple things you can try, such as reducing your intake of caffeine, chocolate and red wine and increasing the amount of fresh fruit and vegetables you eat.
- You may also be advised to wear a correctly fitting and well supporting bra day and night. Some women have found relaxation therapy, such as relaxation tapes, useful in reducing the symptoms of cyclical breast pain.
- If your pain started when you began taking the contraceptive pill, changing to a low-dose pill or a different brand may help.
- Evening Primrose Oil: You may find evening primrose oil helpful as it contains GLA. To get the recommended daily dose of GLA (240 milligrams) you will probably need to take about three grams. You will usually need to take evening primrose oil for about six months. If your pain improves during this time you may be able to halve the dose. Evening Primrose Oil generally causes few side effects, but you may experience nausea, an upset stomach or headaches. It is not advisable to take it if you are pregnant, trying to get pregnant or if you have epilepsy.
2. Anti-inflammatory medicines
Research has shown that non-steroidal anti-inflammatory painkillers, such as ibuprofen, can help this type of pain. These are particularly effective if applied directly to the affected area, but can also be taken in tablet form.
3. Hormone drugs
If your pain is severe and prolonged and hasn’t improved with any of the suggestions you’ve read about so far, your doctor may want to consider starting you on a hormonal drug. The drugs used to treat breast pain are danazol, bromocriptine, tamoxifen and goserelin. These drugs do have side effects so they are only suitable for use following a thorough discussion of the benefits against the potential risks.
- Danazol works by blocking certain hormones produced during the menstrual cycle. It is given as a tablet and you take 100-200mg daily. Like all drugs it can have side effects, including weight gain, acne, absence of periods (amenorrhoea), facial hair growth and changes to the voice. It is important to remember that you may not experience any of these.
- Sometimes bromocriptine may be considered. It works by lowering the level of the hormone prolactin. It is also given as a tablet and you take 2.5mg daily. Due to its potential side effects (which can include nausea, vomiting, dizziness, headaches and constipation) bromocriptine is only usually prescribed in very specific circumstances. Its side effects can be reduced by starting at a low dose of 1.25mg and gradually increasing to the full dose.
- Both danazol and bromocriptine need to be taken for two to four months for effects to be seen. After this time it may be possible to gradually reduce the dose. Both danazol and bromocriptine make the contraceptive pill less reliable, so if you are on the pill you should use another method of contraception. You should not take these drugs if you are pregnant, as they are harmful to the unborn baby.