We can all admit that some bodily pains are more worrisome than others. A stabbing sensation in your foot? Meh. It’ll probably go away. But breast pain? Most of us will be sent into a panic, especially if it doesn’t go away quickly. We are here to tell you that you do not need to have an anxiety attack. There are, as you’ll see, a gazillion reasons for breast pain, and most are totally benign. The most important thing you can do for your breasts is to keep an eye on them by performing regular breast exams and scheduling your yearly trips to the gynecologist for a comprehensive checkup. A good rule of thumb is to start scheduling annual mammograms as soon as your doctor says it’s time (usually around 40). You should always schedule an appointment if you think something feels (or looks) off. You know your body better than anyone, so take charge of your own health and get it checked out—it could save your life.
How common is breast pain?
Pretty common, and it can vary wildly in intensity. Some women feel mild discomfort—swelling, a little lumpiness, or tenderness—before or during their periods, and some feel it quite acutely. Anywhere between 50 and 70 percent of women experience breast pain, usually related to the changing hormone levels associated with their menstrual cycles. If you’re concerned about pain in your breasts, begin by tracking when and where the pain occurs. If it seems to come and go with your menstrual cycle, this is generally normal.
Why do I have breast pain?
“There are 900 reasons you can have breast pain,” explains Kerry Price, MD, an OB-GYN in Laguna Hills, California. “There are so many layers of tissue in and around the breasts—skin, glands, muscle, cartilage, rib. Right behind your breasts are internal organs and tons of nerves and lymph nodes.” In other words: There’s a lot going on around there, and it is not necessarily your boob that’s hurting you. The most important thing to remember, though, is that the vast majority of breast pain is totally benign. Some common reasons for breast pain?
PMS or Menstruation
Changes in hormone levels impact how the breasts feel. Swelling, pain, and lumpiness are the most common sensations before and during your period. These should abate when your period actually begins or very soon after it starts. Note that this type of breast pain tends to increase as you age.
Pregnancy, Especially During the First Trimester when Breasts Are Growing and Changing at a Rapid Rate
First trimester breasts are no joke—the pain is only rivaled by the pain of growing breasts during puberty.
Breastfeeding
This deserves its own category because breastfeeding pain—especially in the first few weeks—is real, often horrendous, and usually a sign that something is wrong, whether it be the baby’s latch or a sign of infection. (In other words: breastfeeding, when done properly, should not hurt.) Most breast pain from breastfeeding, however, is concentrated on the nipple, or associated with engorgement or blocked ducts. Which leads us to…
Mastitis
This is an infection that can develop during breastfeeding. It most commonly occurs in the first six to 12 weeks, but can occur later and in rare cases can happen unrelated to breastfeeding. The breast becomes red, swollen, hot, and painful. Many women report feeling like they have the flu.
Medications
Birth control pills, fertility drugs, and some SSRIs and antidepressants list breast pain among their side effects.
Too Much Caffeine
According to Michelle Brunnabend, DO, MPH, at the Mercy Clinic in Oklahoma City, some women can experience breast pain with caffeine consumption, so if you’re drinking loads of coffee, cut back and see how your boobs feel after a week or two.
Cysts
Small pockets of fluid that can be seen on an ultrasound may cause discomfort.
Breast Surgery
Occasionally, scars on your breasts can cause pain even after you’ve healed from breast surgery.
Why do I only have breast pain on one side?
“Breasts are kind of like hands and feet,” Price explains. “They are always a tiny bit different.” Unlike many parts of the body, though, breasts are composed of muscle and granular tissue and respond to how you move. So let’s say you’re a softball pitcher: You might have more pain on your dominant side. Or conversely, you might have pain on the side that’s less active. Start paying attention to your daily activities and whether you can trace any relationship between your breast pain and how you’re moving your body.
What’s the difference between concerning and non-concerning breast pain? (And when do I see a doctor?)
This is sometimes also referred to as “clinical” and “non-clinical” breast pain, but Price prefers the terms “concerning” and “non-concerning.” Non-concerning breast pain comes and goes on its own, is infrequent, and is associated with a particular activity. For example, if your breast pain crops up every time you play softball, or comes and goes with your menstrual cycles, Price would categorize it as non-concerning. Concerning breast pain is persistent. It doesn’t get better with anything you try, and it is not associated with your menstrual cycle. It might be getting worse with time, and it is always present. “Breast pain in the absence of a mass or skin changes is rarely of concern,” says Brunnabend. “Know your own breasts and feel them consistently at the same time during your cycles so that you will know if a change occurs.” Symptoms that are concerning? Along with pain, you are experiencing bloody or clear discharge from your nipple; a new lump that doesn’t go away after your period; local redness, pus or a fever; dimpling, or nipple inversion. Remember: Breast cancer is usually not painful, so even if you’re experiencing concerning symptoms accompanied by breast pain, you aren’t necessarily experiencing the symptoms of breast cancer. If you have concerning breast pain, though, it is definitely worth seeing your doctor.
Are there certain age ranges in which breast pain is more common?
Brunnabend say this is variable, but it most often occurs in women in their childbearing years.
Where does breast pain typically occur?
It most commonly occurs in the outer quadrants of the breast and armpit region.
What are fibrocystic breasts?
Fibrocystic breasts are very common. According to Price, up to 40 percent of women have them. These breasts have more glands, so the tissue is more granular and more hormonally sensitive. The little lumps women might feel in their breasts are fluid-filled cysts rather than a mass of cells. During pregnancy and the postpartum period, these cysts can feel more tender. The good news? The fibrocystic nature of the breast does not mean women with fibrocystic breasts are more susceptible to breast cancer, it just means that breast exams can be harder to do, so these women really need to get to know their breasts, getting to know what feels normal and what’s new or unusual. Which brings us to…
How do I conduct a breast self-exam?
Breast exams are vital, whether you have breast pain or not. They are your primary way of monitoring what’s happening with your boobs and whether any unexpected changes are occurring. And more importantly, it’s a way for you to get to know the unique feel and consistency of your breasts. This is how you will really know if something new seems to have appeared that wasn’t there before. “There is no one correct way to do an exam,” explains Brunnabend, “but you should be consistent each time. You should be looking for lumps, bumps, skin texture, or color changes.” Pick a system and stick with it: in the shower, lying down with a pillow under your shoulder, or in front of a mirror. If you’re examining the left breast, the left arm should be overhead. Use the pads of your right fingers to palpate around the whole breast, from the outside to the center in a circular motion. You’re looking for anything hard or unfamiliar, and you can use a fair amount of pressure to really get in there. When you’re done, squeeze the nipple to check for discharge. If you’re breastfeeding, you will eject milk, so don’t worry about that. If you feel anything unusual, schedule an appointment with you doctor. But don’t freak out: According to the National Breast Cancer Foundation, eight out of 10 lumps are not cancerous.
How often should I perform a breast self-exam?
“You should definitely do a breast exam at least once a month,” Price says. The best time? Right after your period, because right before your period your breasts can be very tender. “Stick to the same time of your cycle, not the same day on the calendar, so you can establish a true baseline.” In other words: Do it the second or third day after your period ends, not on the second or third day of the month.
How can I relieve the pain?
The most important thing to do with breast pain that will not go away is to see your doctor ASAP. Here are some smaller changes that can possibly make a difference for non-concerning breast pain (or between now and your doctor’s appointment):
- Reduce your salt intake and increase water consumption.
- Wear a supportive bra, even to bed (your most comfortable option is likely a sports bra!).
- Increase your intake of fruits and veggies, and try to stick to a lower fat diet.
- Reduce your caffeine intake.
- Exercise regularly.
- Take Tylenol or ibuprofen.
- Take calcium supplements.
We know that breast pain can be frightening, but it is usually nothing to be too concerned about. And remember: If something seems suspicious, call your doctor and ask them what’s going on. They’re your breasts. Take good care of them.
