7 Ways to Manage Premenstrual Breast Pain

Do your breasts get very painful and swollen every month before your period? If you experience these symptoms, you may be suffering from a condition called cyclic mastalgia.

Woman rubbing her chest
Rob Gage / Getty images

Understanding Cyclic Mastalgia

The exact cause of the breast pain and swelling is not known, but it is likely related to the normal hormonal changes of your menstrual cycle. In some women, these normal hormonal fluctuations likely trigger additional hormone changes or imbalances that result in the swelling and pain of the breast tissue.

The symptoms will begin in the luteal phase of your menstrual cycle or the time between your ovulation and the first day of your period. The symptoms should go away within the first couple of days of your period. For some women, these symptoms are very severe.

Sometimes cyclic mastalgia may be a woman's only premenstrual luteal phase complaint. But for some women breast pain and swelling are only one of several premenstrual symptoms. In fact, cyclic mastalgia is one of the criteria used to make the diagnosis of premenstrual dysphoric disorder (PMDD).

Understandably, one of the biggest concerns you may have if you experience painful and swollen breasts is the possibility that you may have breast cancer.

Pain and/or swelling in both of your breasts that comes and goes with your menstrual cycle is very unlikely to be a sign of breast cancer. In fact, breast pain, in general, is very rarely a sign of breast cancer.

It is important to discuss your symptoms with your healthcare provider. A breast exam is warranted. Your healthcare provider may recommend additional testing if you have a palpable mass that is concerning or if you are due for recommended breast cancer screening based on your age and family history.

Natural Approaches

If you experience breast pain in tandem with your periods and don't want to use drugs, there are a few natural options you can try:

  • Wear a different bra. If the volume of your breasts has increased due to swelling, your usual bra may be too tight and the underwire may be quite uncomfortable. You may want to choose a very supportive soft cup. Don't force your swollen breasts into your usual bra.
  • Limit your caffeine intake. In general, it is recommended that women with mastalgia limit their caffeine intake. It is unclear how much caffeine influences cyclic breast pain, although studies suggest that the risk increases in tandem with the amount of caffeine you consume.
  • Add flaxseed to your diet. Some evidence suggests that dietary supplementation with ground flaxseed daily can help to reduce cyclic breast pain. A 2014 study suggested that whole wheat bread containing 30 grams of flaxseed significantly reduced cyclic mastalgia pain in 181 women with PMDD.
  • Supplement with chaste berry. There is some evidence to suggest that chaste berry (Vitex agnus-castus) supplements can help to reduce the symptoms of cyclic mastalgia. The typical dose of chaste berry used in studies was between 20 to 40 milligrams (mg) daily.
  • Take vitamin E. The effectiveness of Vitamin E supplementation is controversial. There is some evidence that taking 200 IU of Vitamin E per day may help alleviate the intensity of cyclic mastalgia pain. Other studies have found no benefit.
  • Try evening primrose oil. Similar to Vitamin E, the evidence for the benefit of evening primrose oil (EPO) is poor. A 2010 study in the Alternative Medicine Review suggested that a daily 3,000-mg dose of evening primrose oil can help reduce the severity of cyclic breast pain.

Medical Treatment Options

If these first-line interventions are not helping, your healthcare provider may suggest these additional medications:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Hormonal medications such as danazol, tamoxifen, or bromocriptine.

If your symptoms do not respond to any of these treatment options you may need to consider surgical management although this is, of course, your very last treatment option.

Also, be sure to discuss the use of any herbal supplement with your healthcare provider before you start, as serious interactions with medication or worsening of health problems can occur.

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