Cyclical and Noncyclical Breast Pain

Symptoms, Causes, and Treatment Options

Breast pain, or mastalgia, is very common, especially for women who are 20-50 years old. Researchers have found that around two-thirds of women have breast pain at some point in their lives. The type and severity of pain vary from person to person. Breasts may be tender, achy, throbbing, or even have sharp pain.

Breast pain is divided into two basic groups. Cyclical breast pain comes and goes regularly related to the menstrual cycle (monthly period). Noncyclical breast pain is unrelated to the menstrual cycle and may occur in women (and men) who are not having menstrual periods.

This article will discuss cyclical and noncyclical breast pain, as well as other causes of pain in the breast area. 

There are a number of different medical terms used to describe breast pain, including mastodynia, mastalgia, and mammalgia.

Cyclical Breast Pain

Cyclical Breast Pain and Menstrual Cycle

Verywell / Pam Stephan

Cyclical breast pain typically varies during the phases of the menstrual cycle. Hormone fluctuations are believed to cause the pain that arrives before the menstrual period starts.

Premenopausal women may experience cyclical breast pain on a regular schedule. Most often, breast discomfort happens before the menstrual period. Breasts may feel:

  • achy
  • heavy
  • tender
  • full
  • swollen

Most of the time, the pain is in both breasts (bilateral), but it may not be equal. The pain is often spread across the breast tissue, and may also include the armpit or upper arms.

Breast pain is often one of the components of premenstrual syndrome (PMS). Symptoms of PMS also include fatigue, irritability, and abnormal hormone levels.

The discomfort often begins a few days before your period starts and may continue until your period has stopped, though it often decreases in severity as time goes on.

Associated Conditions

Cyclical breast pain may also be due to benign (non-harmful) breast conditions. There are three such conditions commonly seen by healthcare providers:

  • Fibrocystic breast changes can make breasts feel lumpy. These harmless breast changes include fluid-filled sacs (cysts) and scar (fibrotic) tissue. Breasts can also feel tender or thick because of the changes. An ultrasound machine can be used to look at the breast tissue. Your doctor may use a fine needle biopsy to remove a small sample and to diagnose the condition.
  • Mammary duct ectasia is another benign breast condition. The milk ducts inside the breast become clogged and then widen and thicken. This happens more often in people approaching menopause. It often causes tenderness in the nipple and areola.
  • Oral contraceptive breast pain is a common and mild side effect of hormonal birth control (birth control pills). People taking combination pills are more likely to experience breast pain than those who take the mini-pill.

Cyclical breast pain may be considered normal but, nevertheless, be severe enough to interfere with your quality of life. If faced with this level of cyclical breast pain, do not hesitate to see a healthcare provider as soon as possible.

Noncyclical Breast Pain

Noncyclical breast pain is unrelated to the cycle of your menstrual period. In some people, it occurs after menopause.

There are many causes of breast pain, including injury, weight gain, prior breast surgery, or breastfeeding. Wearing an ill-fitting bra can lead to increasing levels of breast pain. Pain that is from bras that are not supportive enough often gets worse over time. 

Several drugs are also known to cause breast pain in some women, including:

Noncyclical breast pain may occur in both breasts or only one breast. You may have pain in one specific area, or it may be generalized. The pain can vary in intensity or be constant.

Managing Breast Pain

You may be able to figure out if your pain is cyclical or noncyclical. If you are premenopausal, keep a chart of your cycle and track your pain. Journaling can also help you discover what is triggering your breast pain. These records assist your healthcare provider to establish a diagnosis.

Your healthcare provider may recommend certain treatments to help alleviate breast pain:

  • Medications: Cyclical and noncyclical breast pain may benefit from over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen). Sometimes, prescription NSAIDs like Topricin (diclofenac) can be helpful. Some doctors prescribe hormonal treatments such as Parlodel (bromocriptine) or Danocrine (danazol).
  • Support bras: A bra fitting may go a long way toward reducing breast pain, and a supportive bra may be beneficial in people with larger breasts. A sports bra during exercise is essential.
  • Caffeine avoidance: Some studies suggest that drinking more than two cups of coffee per day increases the risk of mastalgia.
  • Smoking cessation: Similarly, smoking more than five cigarettes a day increases the risk of mastalgia by more than tenfold compared to non-smokers.

For severe, persistent pain, breast reduction surgery or even mastectomy may be considered. Unfortunately, these surgeries are not always successful. According to a 2014 review of studies, around 50% of such procedures will not improve pain.

When Breast Pain Isn’t

Your breasts rest on the chest wall muscles and ribs just above your heart, lungs, and other structures of the thorax. Within your breasts are a rich supply of nerves, blood vessels, and connective tissues. These make the breast very sensitive to touch, pain, or pressure from the rest of the chest.

Sometimes, you will feel pain in the breast area that is caused by referred pain from another structure or is caused by a health condition. Nearby body parts and some medical issues can cause pain which can easily be mistaken as breast pain. 

Some causes of pain in or around the chest that are not caused by breast tissue (sometimes called extramammary, or outside of the breast) are:

Reach out to your healthcare provider if you have pain in your breasts. They will be able to provide a breast exam to figure out the cause of your pain and recommend the appropriate treatment.

Is It Breast Cancer?

Most breast cancers do not cause pain. But in some cases, pain may be the first symptom of cancer.

A 2017 study reported that more than one in five women with breast cancer experience pain in the three months leading to their diagnosis. Some forms of breast cancer, such as inflammatory breast cancer, typically start with pain.

If your breast pain is persistent or worsening, you should see your healthcare provider about having a clinical breast exam. Certainly, if you notice a lump, changes in your skin such as redness, thickening, or an orange peel appearance, you should see your healthcare provider right away.

Summary

Breast pain is very common, especially for premenopausal women during certain parts of the menstrual cycle. A medical professional can help determine if you have cyclical breast pain or if there is another cause.

There are multiple ways to prevent, relieve, and treat breast pain. See your healthcare provider for any new or worsening pain symptoms.

A Word From Verywell

With breast cancer affecting roughly one in eight people in the United States, any symptom related to the breasts can understandably cause significant anxiety. This is especially true if you have a family history of breast cancer.

One way to reduce those fears is to adhere to breast cancer screening guidelines issued by the Centers for Disease Control and Prevention. Screening can start as early as age 40, with recommendations varying based on your age and risk factors. Speak with your healthcare provider to discuss your screening options.

Frequently Asked Questions

  • What helps ease breast pain?

    The best treatment for breast discomfort depends on what is causing your pain. Many women report that breast pain decreases their quality of life, and there are things that can help with the pain. Your healthcare provider can recommend treatments based on the cause of your pain, the symptoms, and your other health conditions.

  • What helps cyclical breast pain?

    There are no universal treatments for breast pain, but there are several approaches that often help. Symptoms can be managed with medications, diet adjustments, a cool or warm compress, and wearing a supportive bra. Your doctor can discuss other pain management with you if these strategies are not successful.

  • How do I know if my breast pain is serious?

    New or worsening breast pain should always be evaluated by your healthcare provider. You should also have your breast evaluated if you have a new or different lump, nipple discharge, or skin changes on your breast.

  • Can back and shoulder pain cause breast pain?

    Lifting or exercising can cause muscle strain or spasms. Pulled or irritated muscles in your chest wall, back, or shoulder can cause sharp pain in your breast area. Any new or worsening breast pain concerns should be shared with your healthcare provider.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
Originally written by
Pam Stephan
Pam Stephan is a breast cancer survivor.
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