Breast Pain

Breast pain, also called mastalgia, can feel like tenderness, throbbing, sharp, stabbing, burning, or tightness in the breasts. This pain can be constant or happen only sometimes, and it can affect anyone – men, women, and transgender people.

Breast pain comes in different levels of intensity. It can happen:

• Around your period: Some women experience mild to moderate pain in both breasts for a few days before their period. This is common and usually nothing to worry about.
• Throughout your cycle: For some women, the pain is more intense and lasts a week or longer, starting before their period and sometimes continuing into the next cycle. This pain might be moderate to severe and affect both breasts.
• All the time, unrelated to your period: If you have breast pain that's not linked to your menstrual cycle, it's important to pay attention.

Why do men get breast pain?

In men, breast pain is often due to gynecomastia. This means there's an increase in the breast gland tissue. This is usually caused by a hormonal imbalance, with the levels of estrogen and testosterone not being balanced. Gynecomastia can affect one or both breasts and may not affect them equally.

Why might transgender people experience breast pain?

In transgender women, hormone therapy can cause breast pain. For transgender men, breast pain might be due to any remaining breast tissue after a mastectomy (breast removal surgery).

When to see a doctor:

Most breast pain is caused by harmless conditions. Breast cancer is rare as a cause of breast pain. However, if you have unexplained breast pain that doesn't go away after a couple of menstrual cycles, or if the pain continues after menopause, or if the pain doesn't seem related to hormonal changes, it's essential to see a doctor for evaluation. Don't delay; early diagnosis is important for any health concern.

Breast pain can be categorized into two main types: cyclic and noncyclic.

Cyclic breast pain follows a regular pattern, closely linked to your menstrual cycle and changing hormone levels. This type of pain is often described as a dull, heavy, or aching sensation. You might also experience breast swelling, fullness, or tenderness. The pain typically affects both breasts, especially the upper outer areas, and sometimes spreads to your armpit. It usually gets worse in the two weeks before your period and then subsides. Women in their 20s, 30s, and sometimes 40s going through perimenopause (the transition to menopause) are more prone to this type of pain.

Noncyclic breast pain isn't tied to your menstrual cycle. The feeling can vary, described as a tight, burning, stabbing, or aching sensation. This pain may be constant or come and go. It usually affects just one breast, often in a specific spot, but can sometimes spread more broadly. Women experiencing noncyclic breast pain are most often postmenopausal.

Sometimes, pain that seems to originate in the breast tissue actually comes from somewhere else. This is called "extramammary" pain. "Extramammary" means outside the breast. For example, a strained chest muscle or costochondritis (inflammation of the cartilage connecting the ribs to the breastbone) can cause pain that radiates to the breast area. This pain might feel like it starts in the breast, but its true source is in the chest wall or rib cage.

If you're experiencing breast pain, it's important to pay attention to certain signs. See your doctor if the pain:

• Persists daily for more than a few weeks. This means the pain isn't just occasional or temporary.
• Is focused in one specific spot in your breast. If the pain is all over your breast, it's less likely to be a serious issue.
• Is getting progressively worse. If the pain is getting stronger or more intense over time, it warrants a doctor's visit.
• Makes it hard to do your usual daily activities. For example, if the pain is severe enough to affect your work, exercise, or other routines.
• Keeps you awake at night. Pain that disrupts your sleep is a significant concern.

While breast pain is rarely a sign of breast cancer, it's crucial to have your doctor evaluate it, especially if you notice these specific patterns. If your doctor recommends a check-up, it's important to schedule an appointment and follow through. This is a standard part of taking care of your health.

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Hormonal shifts can affect the milk ducts and glands in your breasts. These changes can lead to breast cysts. Cysts are fluid-filled sacs that can be uncomfortable and are a frequent reason for breast pain that comes and goes with your menstrual cycle (cyclic breast pain). Other types of breast pain, which aren't linked to your period (non-cyclic breast pain), might be caused by things like injuries, past breast surgeries, or other medical issues.

Sometimes, doctors can't pinpoint the exact cause of breast pain. However, some things might make it more likely to happen, like your age, certain medical conditions, or lifestyle choices.

Breast pain is a common problem, especially for people who haven't gone through menopause, but it can happen after menopause too. Men can also experience breast pain, often due to a condition called gynecomastia. Transgender people undergoing gender transition may also experience breast pain.

Several things can increase the chance of breast pain:

• Breast size: Larger breasts can sometimes cause pain, especially non-cyclical pain (pain that isn't related to a menstrual cycle). This pain can be connected to the weight and pressure of the breasts, and it may be accompanied by pain in the neck, shoulders, or back.

• Breast surgery and scars: If you've had breast surgery, some pain or discomfort around the surgical scars might linger even after the incisions have healed.

• Fatty acid imbalance: If there's a problem with the types of fats in your cells, it can affect how your breast tissue reacts to hormones in your body.

• Medications: Certain medications can cause breast pain. This includes some fertility treatments, birth control pills, and hormones like estrogen and progesterone (often used after menopause). Some antidepressants, like SSRIs, as well as blood pressure medications and some antibiotics, can also be linked to breast pain.

• Caffeine: While more research is needed, some people find that cutting back or eliminating caffeine helps reduce breast pain.

If you're experiencing breast pain, it's a good idea to talk to your doctor. They can help figure out the cause and recommend the best treatment options.

Breast pain can be a common problem. While more research is needed to confirm these methods, here are some things you can try to help prevent or manage breast pain:

• Hormone Therapy: If possible, avoid hormone replacement therapy (HRT) or birth control pills, as these can sometimes cause or worsen breast pain in some people.

• Medications: Be mindful of any medications you're taking. If you're experiencing breast pain, talk to your doctor about whether any of your medications might be contributing to the problem. Avoid any medications known to cause breast pain or make it worse.

• Proper Bra Fitting: Wearing a well-fitting bra, especially a supportive sports bra during exercise, can make a difference. A bra that's too tight or too loose can irritate the breast tissue and cause discomfort.

• Stress Management: High levels of stress and anxiety can sometimes contribute to breast pain. Relaxation techniques, such as deep breathing exercises, meditation, or yoga, may help manage these feelings.

• Caffeine: Some people find that reducing or eliminating caffeine intake can help with breast pain, but the effect of caffeine on breast pain and related premenstrual symptoms isn't fully understood. If you think caffeine might be a factor, try cutting back and see if it helps.

• Heavy Lifting: Try to avoid lifting heavy objects for extended periods, as this can put strain on your muscles and potentially contribute to breast pain.

• Diet: A healthy diet might help. A low-fat diet, with more complex carbohydrates (like whole grains), may be beneficial. Talk to your doctor or a registered dietitian about a diet plan that might work for you.

• Pain Relief: Over-the-counter pain relievers like acetaminophen (like Tylenol) or ibuprofen (like Advil) can help with the discomfort. However, these should only be used as directed by your doctor. Long-term use of these medications can increase your risk of side effects, such as liver problems, so it's important to follow your doctor's advice. Don't take more than recommended, and be sure to talk to your doctor first.

Important Note: These suggestions are for general information only and should not be considered medical advice. If you are experiencing breast pain, it's essential to consult with a healthcare professional for a proper diagnosis and treatment plan. They can help determine the underlying cause of your pain and recommend the best course of action for you.

To figure out what's causing your breast pain or changes, your doctor might use these tests:

1. Physical Exam: Your doctor will examine your breasts and the lymph nodes in your neck and underarm. They'll also listen to your heart and lungs and check your chest and stomach. This helps see if the pain might be from something else. If the exam doesn't show anything unusual, you might not need more tests.

2. Mammogram: If your doctor finds a lump, thickening, or a specific painful area in your breast during the physical exam, they might order a mammogram. A mammogram is an X-ray of your breast that focuses on the area of concern. This is called a "diagnostic mammogram."

3. Ultrasound: An ultrasound uses sound waves to create pictures of your breasts. It's often done together with a mammogram. Even if the mammogram looks normal, an ultrasound might be needed to look closer at a specific painful area.

4. Biopsy: If a lump, thickening, or something unusual shows up on the mammogram or ultrasound, a biopsy might be necessary. During a biopsy, your doctor takes a small piece of breast tissue from the suspicious area. This tissue sample is sent to a lab for testing to help your doctor make a diagnosis.