|AGE Most common between the ages of 15 and 50||GENDER|
|LIFESTYLE Risk factors depend on the cause||GENETICS Risk factors depend on the cause|
Pain or discomfort usually affecting one or both breasts is often experienced around the time of a woman's periods, but may have other causes.
Breast pain is an extremely common problem. In most women, the pain is cyclical, varying in severity in response to the hormonal changes of the menstrual cycle. This cyclical pain is usually most severe before periods and tends to affect both breasts.
Cyclical breast pain affects as many as 1 in 2 women and is commonly a long-term problem. Women who experience cyclical breast pain frequently also have generalized breast lumpiness, which tends to become worse before a period. The pain may be aggravated by stress and by caffeine in certain drinks.
In some women, breast pain is not related to menstruation. One cause of noncyclical breast pain is muscle strain. Rarely, pain is caused by a breast cyst or breast cancer. Breast pain may also be due to a short-term problem, such as inflammation of the breast tissue caused by an infection (see Mastitis) or engorgement of the breasts with milk after childbirth (see Breast engorgement). Sometimes, the cause of breast pain is not known. If you have large breasts, you are more likely to suffer from both cyclical and noncyclical breast pain.
What might the doctor do?
Your doctor will ask you about your breast pain to see if there is a pattern. He or she will examine your breasts to look for an underlying cause, such as a breast cyst, or any tender areas in the surrounding muscles. If it is apparent from the consultation and examination that you do not have an underlying disorder, your doctor may ask you to keep a record of when you experience breast pain to help to confirm that the pain is cyclical. If your doctor suspects that an underlying disorder may be causing the pain, he or she will probably refer you to a breast clinic for mammography or ultrasound scanning to look for any abnormalities in the breast tissue.
Mild cyclical pain does not normally require treatment. However, in about 1 in 10 women, the pain is so severe that it can interfere with everyday life. Taking large doses of evening primrose oil may reduce the response of the breast tissue to female sex hormones. However, if this treatment is ineffective or the pain is severe, your doctor may prescribe danazol, a drug that reduces the effects of female sex hormones acting on the breast (see Sex hormones and related drugs). Although this drug is effective in relieving pain, it can sometimes have side effects such as acne and weight gain. Cyclical breast pain tends to diminish following the menopause. If you are taking hormone replacement therapy, the pain may continue after the menopause, but it often improves after a few months.
If your breast pain is noncyclical, the cause will be treated if necessary. Cysts are usually drained (see Aspiration of a breast lump), and antibiotics can be used to treat infection. Nonsteroidal anti-inflammatory drugs may help to relieve muscle pain.
What can I do?
Breast pain may be eased by wearing a bra that supports your breasts properly. If your breasts are heavy and the pain is severe, you may need to wear a bra at night. Cyclical pain may be relieved by cutting down on caffeine, stopping smoking, practising relaxation exercises to help to control stress, and losing weight to reduce the size of the breasts. Some women find vitamin E supplements helpful, but this effect has not been scientifically proven.
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