It’s common for breasts to become tender and painful during the days leading up to a menstrual period. This breast tenderness is medically known as mastalgia or mammary pain. Up to 70% of women experience breast pain associated with their menstrual cycles. The pain and tenderness often goes away once your period starts. Here are some key points about breast pain before periods:
- It’s very common and considered a normal part of the menstrual cycle for many women.
- It’s referred to as cyclical breast pain because it’s related to menstrual cycles.
- It often affects both breasts.
- The pain typically occurs in the upper, outer quadrants of the breast.
- The intensity can range from mild to severe.
- It may feel like a dull ache or a sharp, stabbing pain.
- The pain and tenderness often subsides once menstruation begins.
What Causes Breast Pain Before Periods?
Breast pain before periods is linked to hormonal changes that occur during the menstrual cycle. Here’s an overview of what’s happening:
- In the first half of your cycle, estrogen levels rise rapidly. This stimulates the growth of milk ducts in the breasts.
- Approaching ovulation, progesterone levels also begin rising. Progesterone causes the milk ducts to expand.
- If conception doesn’t occur, estrogen and progesterone levels drop abruptly leading up to menstruation. This contraction of the milk ducts leads to breast pain.
So the breast pain seems to be associated with the rise and fall of estrogen and progesterone. The changes in these hormones cause the breast tissue to swell up premenstrually, stretching the ligaments and other tissue supporting the breasts. This leads to pain and tenderness.
Once menstruation begins, hormone levels stabilize and the pain typically subsides.
Other Factors That Can Worsen Pain
Though hormonal changes are the main cause of cyclical breast pain, some other factors can make the pain worse for some women:
- Caffeine: Consuming caffeine appears to exacerbate breast pain in some women due to its stimulant effects.
- Salt: Eating salty foods for several days before a period can cause fluid retention, making breasts more swollen and tender.
- Stress: High stress levels can make breast pain feel more intense.
- Smoking: Chemicals in cigarette smoke may contribute to increased breast pain.
- Tight bras: Bras that dig into the breasts can worsen pain and tenderness.
When Does the Pain Occur During the Menstrual Cycle?
Cyclical breast pain typically begins sometime after ovulation, as progesterone levels start to rise. Pain and tenderness normally increase as you get closer to your period. Many women experience the worst breast pain during the few days right before their period starts. The chart below summarizes the typical timing:
|Menstrual Cycle Phase||Hormone Changes||Breast Pain Timeline|
|After ovulation||Progesterone rising||Pain may begin|
|Week before menstruation||Estrogen/progesterone dropping||Pain/tenderness increases|
|Few days before menstruation||Estrogen/progesterone withdrawal||Worst breast pain|
As shown, breast pain typically starts sometime after ovulation, gets progressively worse as estrogen and progesterone levels fall, and peaks in the final days before menstruation begins.
Breast Pain vs. Breast Tenderness
Breast pain and breast tenderness often go hand-in-hand before periods, but they aren’t exactly the same thing. Here’s the difference:
- Breast pain: This refers to breasts feeling painful or sore. It may feel like a dull ache or stabbing pain. The medical term is mastalgia.
- Breast tenderness: This refers to breasts feeling unusually sensitive and tender to touch. The medical term is mastodynia.
So in summary:
- Breast pain is the actual feeling of pain in the breast tissue.
- Breast tenderness is when the breasts are sensitive and tender, especially when pressed or touched.
Many women experience both breast pain and tenderness before their periods. The tenderness is what makes breasts hurt when they are pressed during this time.
Why Pressing the Breasts Makes Them Hurt More
As explained above, cyclical breast pain is caused by swelling of the breast tissue and stretching of the ligaments before periods. This means the breast tissue becomes more sensitive and tender during this phase.
Pressing, poking, or touching the breasts adds pressure to the already tender breast tissue. This added pressure stimulates more nerve endings, causing pain signals to be sent to the brain.
It’s similar to how pressing on a bruise causes pain – when tissue is already inflamed and tender, adding pressure makes it hurt worse.
In the days leading up to a period when breast tenderness peaks, even normal movements like walking without a supportive bra can cause breast discomfort. Intentionally pressing on the breasts makes the pain more pronounced.
Tips for Relieving Breast Pain Before Periods
Here are some tips that may help provide relief from breast tenderness and pain before periods:
- Wear a supportive bra, including during sleep
- Limit caffeine intake
- Apply a warm compress or take a warm shower
- Use an over-the-counter pain medication like ibuprofen
- Try an evening primrose oil supplement
- Reduce salt intake to avoid fluid retention
- Perform breast self-massage with oil
- Get a premenstrual breast massage
- Practice stress-reducing techniques like yoga and meditation
- Apply a topical pain relief cream
- Place breast pads inside your bra to minimize friction
See your doctor if breast pain:
- Occurs outside your period
- Doesn’t go away after your period starts
- Worsens over time
- Is severe enough to disrupt sleep or daily activities
- Occurs with breast lump(s) or discharge
This can indicate an underlying breast health issue that requires further evaluation.
When to See a Doctor
Occasional mild breast pain or tenderness before your period is normal and not a major health concern. However, you should make an appointment with your doctor or gynecologist if you experience:
- Severe breast pain that interferes with sleep or daily activities
- Breast pain that occurs at unusual times in your cycle, or persists after your period starts
- Increasing severity or duration of breast pain each month
- Breast pain along with nipple discharge, lumps, skin changes, or nipple retraction
- Unilateral breast pain (only occurs on one side)
These can be signs of a health issue requiring further evaluation, such as fibrocystic breast changes, breast infection, or in rare cases breast cancer. It’s important to make an appointment if you notice any unusual or worrisome breast changes before chalking it up to regular premenstrual breast pain.
Tests for Unusual Breast Pain
If you consult your doctor about severe, unusual, or worsening breast pain, they may recommend diagnostic tests including:
- Clinical breast exam – The doctor thoroughly checks your breast tissue with their hands.
- Mammogram – Breast x-rays to look for masses or cysts.
- Breast ultrasound – Uses sound waves to examine breast tissue.
- Breast MRI – Takes detailed images of breast tissue.
- Breast biopsy – Removing a small sample of breast tissue for testing.
Based on your symptoms, risk factors, and the results of initial exams and tests, your doctor will determine if further testing is needed. Most breast pain before periods ends up being normal, but it’s always best to be evaluated if something concerns you.
Medical Treatments for Severe Breast Pain
If your breast pain before your period is severe and doesn’t respond sufficiently to self-care and home remedies, there are some medical treatment options available:
- Hormonal birth control – Birth control pills, patches, rings, or shots can help stabilize hormone levels and reduce cyclical breast pain.
- Danazol – This androgen hormone capsule can shrink breast fibrous tissue and ease breast pain.
- Gonadotropin releasing hormone (GnRH) therapy – GnRH analog drugs switch off estrogen production, stopping cyclical breast pain.
- Antidepressants – Certain antidepressant drugs like selective serotonin reuptake inhibitors (SSRIs) may reduce breast pain.
- Tamoxifen – This anti-estrogen drug is sometimes used off-label to treat severe cyclical mastalgia.
- Pain relief medications – Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are often recommended.
Talk to your doctor about whether any of these treatment options are recommended or medically necessary in your case if self-care measures don’t provide sufficient breast pain relief premenstrually.
When to Seek Emergency Care
In rare cases, breast pain can signal a medical emergency. Seek prompt emergency care if you experience:
- Sudden, severe breast pain
- Breast pain with fever, redness, warmth or swelling
- Painful lump in breast with overlying skin changes
- Bloody or pus-like discharge from the nipple
- Chest pain that radiates to the arm, back, neck or jaw
- Difficulty breathing along with breast pain
These can be signs of a severe infection like mastitis or abscess, angiosarcoma (breast cancer), or a heart attack or pulmonary embolism. Sudden onset of severe pain warrants urgent evaluation, so call your doctor right away or seek emergency care if you experience these warning signs along with breast pain.
When Breast Pain Isn’t Related to Periods
In some cases, breast pain occurs unrelated to the menstrual cycle. Examples include:
- Pregnancy – Hormone changes during pregnancy can cause breast pain.
- Breastfeeding – Engorgement and milk letdown during breastfeeding may be painful.
- Hormone replacement therapy – Estrogen used in HRT can trigger breast pain.
- Breast injury – Trauma from bumps, bruises, burns can cause breast pain.
- Breast infection – Mastitis causes redness, swelling, and breast pain.
- Abscess – A pocket of pus in the breast causes pain and swelling.
- Fatty breast tissue – More susceptible to pain due to minimal support.
Breast pain unrelated to your menstrual cycle warrants medical evaluation to determine the cause and appropriate treatment.
Is Breast Pain Before Periods Normal?
Mild to moderate breast pain occurring in the week before your period is very common and considered a normal part of the menstrual cycle for most women. However, while common, having sore or tender breasts before your period is NOT universal or necessarily “normal.”
Up to 70% of women deal with cyclical breast pain, but 30% don’t experience it at all. Your individual experience is what’s normal for YOU.
- Breast pain related to the menstrual cycle is very common but not universal.
- Mild or moderate pain is usually normal.
- Severe pain or unusual symptoms warrant medical evaluation.
- Unilateral pain (only on one side) is less concerning than bilateral pain.
- Consistent timing with your cycle is reassuring.
- Sudden onset of severe pain can indicate an emergency.
While it may be “typically normal” to have some breast pain before your period, don’t ignore unusual or severe symptoms – always discuss them with your doctor.
Breast Pain vs. Breast Cancer Symptoms
Breast pain is NOT usually a symptom of breast cancer. Cyclical breast pain linked to menstrual hormones is not related to cancer risk in most cases.
However, it’s important to understand how to distinguish common breast pain from potential breast cancer warning signs:
Breast Pain Characteristics
- Generalized soreness and tenderness of breast tissue
- Typically affects both breasts
- Worsens premenstrually due to hormones
- Usually improves once period begins
- Described as “achy” or “tender”
Breast Cancer Symptoms
- Localized pain in one area of breast
- Usually only affects one breast
- Persistent, doesn’t follow menstrual cycle
- Described as “sharp” or “burning”
- May occur with lump, skin changes, nipple discharge
As shown above, the nature, timing, and pattern of breast pain compared to breast cancer symptoms are quite different. However, it’s always best to discuss any unusual breast symptoms with your doctor to determine appropriate next steps.
Breast pain and tenderness before your period is a common complaint. It’s typically caused by normal hormonal fluctuations linked to the menstrual cycle. In most cases, the discomfort is mild to moderate and subsides once menstruation begins.
However, severe or unusual breast pain warrants medical evaluation to rule out potential health issues. While breast pain is not usually a sign of breast cancer, it’s important to monitor your breasts and discuss any concerning changes with your doctor promptly. With proper evaluation, treatment is available to help manage troublesome premenstrual breast pain when necessary.