MASTALGIA ( Breast Pain )

What is Mastalgia?

Breast pain or Mastalgia is a very common condition experienced by two out of three women at some time in their life.

Your breasts go through many changes that begin when you reach puberty and continue as you get older through to menopause.

The breast tissue responds to the hormones produced by the ovaries and the pituitary gland. There are two types of mastalgia, cyclical and non-cyclical.

In severe cases the breast pain can interfere with the quality of life and limit some of your daily activities.

By keeping a pain chart for two to three months it will enable you and your Doctor to determine which kind of breast pain you are suffering.


What is Cyclical Mastalgia?

This mastalgia relates to the monthly your menstrual cycle, typically breasts feel heavy, swollen and tender for several days before each period; that is quite normal. It is believed to be related to the sensitivity of breast tissue to the changes in the hormones, it is not a reflection of hormonal imbalance. Keep a record of your breast pain in relation to your menstrual cycle and you can be assured if there is a clear relationship present.

In  a few women the pain can last for days after the start of their period. Pain can vary in severity from one period to the other, and may travel to the upper arm. The breast can feel lumpy during this time but there should not be a single definite lump forming.

Sometimes the pain or tenderness can be severe and interfere with your normal activities. Often all that is needed is reassurance from your doctor that this is not due to cancer. For some women though, the pain may be so severe that they require some sort of treatment.


What is persistent or intermittent non-cyclical mastalgia?

This is often described as a burning or drawing sensation. It is not related to the cycles and more common in women over 40 years of age. The cause of this pain is not well understood.

Continuing breast pain, whether cyclical or non-cyclical, must always be investigated. It is important to determine if there is a lump associated with the pain or not. The pain can result from breast infections, abscess formation or could be related to the chest wall rather than the breast.

Breast pain without a lump is rarely a sign of cancer.


Hints to help you relieve breast pain

In many women the pain is mild and all that is required is reassurance and simple pain relief tablets, often the pain goes away after few months,. Occasionally it comes back later on, and  can again last for few months.

Some of the measures below can be helpful:

  1. Supportive Bra – Some women find it helpful to wear a properly fitted supportive bra at all times, even in bed. Wearing a bra at night (e.g. sports bra) is especially helpful if your breasts are heavy and painful. Try to avoid excessive exercises that cause breast movement like jogging.

  2. Pain Relief – Simple pain relief (e.g. Paracetamol tablets 500 mgs x 2 tablets four times a day) may also help if your breasts are particularly painful.

  3. Voltaren Emugel – This is a non-steroidal anti-inflammatory cream that you can obtain from the chemist. Try applying the cream to the painful area of the breast and massage into the skin.

  4. Non-Steroidal medication (e.g. Voltaren, Ibuprofen) – These medication can be used but make sure it is taken after meals and not for a prolonged periods. Do not use these if you have a history of stomach or duodenal ulcers.

  5. Caffeine – Cutting down on caffeine in tea, coffee, Coca Cola and chocolate can help to relieve breast pain.

  6. Stop smoking and reduce Alcohol intake – High alcohol intake can be associated with increased pain. Avoid excessive intake of alcohol especially when in pain.

  7. Nutrition – Symptoms of breast pain are made worse by being overweight. If you are overweight your GP will be able to help you plan a low fat reduction diet.

  8. Stress – Stress is known to affect breast pain. Learning to relax and take time out from a busy schedule is helpful.

  9. Evening Primrose Oil Capsules - These capsules are available without a prescription from chemists, supermarkets and health shops. They can be effective in relieving breast pain. There are usually no obvious side effects. You need to take the capsules for a few weeks before you will notice any improvement. Try taking 3 grams daily for three months, and if effective you can carry on for few more months before reducing the dose. If it is not helpful after 3-4 months then it is not going to be effective

  10. Anti-Hormone medications such as Danazol, Bromocriptine and Tamoxifen – These can be prescribed for severe breast pain. It is a hormone treatment and it does have side effects, like increasing facial hair if used for prolonged periods of time. It is not used as a first choice of treatment. It would require a doctors’ prescription.

  11. Flaxseed in muffins and bread, Some people find this natural remedy very helpful.

Who you can ask for further advise?

If you have any further questions please contact your doctor. Some of the medications listed above would need your GP to prescribe.

Falah El-Haddawi