Mastalgia

Common Causes of Mastalgia

• Hormonal Fluctuations: Changes in estrogen and progesterone levels during the menstrual cycle are a common cause.

• Pregnancy: Hormonal changes during early pregnancy can cause breast tenderness.

• Breast Cysts: Fluid-filled sacs in the breast may cause localized pain.

• Medications: Certain drugs, such as hormone replacement therapy (HRT), oral contraceptives, and some antidepressants, can cause breast pain as a side effect.

• Poorly Fitting Bras: Wearing an ill-fitting or unsupportive bra can lead to breast discomfort.

• Breast Infections (Mastitis): Commonly seen in breastfeeding women, infections in the breast tissue can cause pain, redness, and swelling.

• Chest Wall Pain: Conditions affecting the muscles, joints, or ribs may lead to breast pain.

• Stress: Emotional stress can sometimes trigger breast pain.

Diagnosis

Your doctor will start with a thorough medical history and physical examination of the breasts. In some cases, further tests may be needed to rule out other conditions:

• Breast ultrasound or mammogram to check for lumps or abnormalities.

• Hormonal tests to identify imbalances.

• Fine-needle aspiration or biopsy in cases of lumps.

Types of Mastalgia

1. Cyclic Mastalgia
   This type of breast pain is related to the menstrual cycle and tends to occur in the days leading up to your period. Hormonal changes cause breast tissue to swell, resulting in pain or tenderness. Cyclic mastalgia typically affects both breasts and subsides once menstruation begins.

2. Non-cyclic Mastalgia
   This pain is not linked to the menstrual cycle and can occur at any time. It may be constant or intermittent and usually affects one breast. Non-cyclic mastalgia may be caused by factors such as breast trauma, infections, or underlying conditions unrelated to the breast.

3. Extramammary Pain
   Sometimes, breast pain can originate from another part of the body, such as the chest wall, muscles, or ribs, but is felt in the breast. This is called referred pain.

Symptoms

• A dull, heavy ache or sharp pain in one or both breasts.

• Tenderness or soreness, especially when touched.

• Swelling or lumpiness in the breast.

• The pain may worsen during certain times of the menstrual cycle (cyclic mastalgia).

When to See a Doctor

You should seek medical advice if:

• The pain is severe, persistent, or worsening over time.

• There is a new lump in the breast or other changes such as redness, swelling, or nipple discharge.

• Breast pain is unrelated to the menstrual cycle and does not improve with self-care.

• You have signs of a breast infection, such as warmth, redness, or fever.

Treatment Options

Mastalgia often resolves on its own, especially in cyclic cases. However, several treatment options are available to relieve pain:

1. Self-Care and Lifestyle Changes

• Supportive Bra: Wearing a well-fitted, supportive bra can help reduce breast discomfort, especially during physical activity.

• Cold Compresses: Applying a cold pack to the affected area may relieve soreness.

• Pain Relievers: Over-the-counter medications like ibuprofen or acetaminophen can help reduce pain and inflammation.

• Dietary Changes: Reducing caffeine and fatty foods may help some women with cyclic mastalgia.

• Vitamin Supplements: Some women find relief with vitamin E or evening primrose oil, although the effectiveness is not guaranteed.

2. Medications

• Hormonal Therapy: In some cases, your doctor may recommend adjusting hormone-based medications (such as birth control or HRT) to reduce symptoms.

• Prescription Medications: Severe or persistent pain may be treated with prescription medications such as tamoxifen, danazol, or bromocriptine, though these are typically used in severe cases.

3. Managing Non-Cyclic Mastalgia

For non-cyclic mastalgia, treatment depends on the underlying cause. Managing infections, reducing physical strain, or addressing muscular or joint problems may be necessary.