What is Cyclical Breast Tenderness?

Do you know what time of the month it is because of breast tenderness?

Do you ever feel like you can’t exercise, lie on your stomach or wear certain clothes because your breasts are sore?

Or do you need to remind your partner or kids to be gentle when giving you a hug because it’s too painful?

You’re not alone. Approximately 60-70% of menstruating women experience some level of breast pain at some point in their life, and it’s one of the common symptoms of PMS.

What is breast tenderness?

Cyclical breast pain, medically known as cyclical mastalgia, is the most common type of benign (harmless) breast pain and is related to the menstrual cycle.

Cyclical breast tenderness starts 1-2 weeks prior to your period, can continue until the start of your period and will stop by the end of your period. Breast tenderness can range from mild to moderate and is felt throughout both breasts. It can feel sore, heavy, tender, dull or achy and can radiate to the armpit or upper arms.

If your breast pain differs from this description or is concerning to you, schedule an appointment with your doctor for a thorough evaluation.

What causes breast tenderness before my period?

Hormonal changes, beyond what normally occurs during the menstrual cycle, can contribute to breast tenderness before your period. This includes estrogen excess (increased estrogen in relation to progesterone) or increased prolactin.

Other factors thought to be related with cyclical breast pain include:
• irregular menstrual cycles
• medication side effect (oral contraceptives, hormone therapy, antidepressants and SSRIs)
• psychosocial factors
• emotional stress
• smoking or nicotine consumption
• nutritional factors including caffeine and alcohol consumption and high-fat diets

These other factors have been implicated in contributing to cyclical breast pain, though the research isn’t conclusive.

What can you do to improve breast tenderness?

You don’t have to suffer with cyclical breast tenderness every month. The good news is that there are things you can do to help.

Keep in mind that hormonal imbalances don’t change overnight, so you may not notice changes in breast tenderness in the same menstrual cycle. Give yourself at least 6-8 weeks and note any improvements after two menstrual cycles.

Top 5 tips to improve cyclical breast tenderness

1. Healthy Estrogen Balance

  • Liver foods

    • Eat 4-5 servings (or 2-3 cups) of liver supporting foods each week. These foods contain nutrients important for the liver’s role in processing estrogen once it’s no longer needed.
    • Examples include broccoli, broccoli sprouts, cauliflower, kale, cabbage, Brussels sprouts, turnip, rutabaga, beets, artichoke, dandelion greens and watercress.

  • Fibre

    • Aim for at least 25-30 grams daily (from vegetables, fruit, beans/legumes, whole grains as tolerated).
    • Fibre helps maintain regular bowel movements and eliminate waste.

 

2. Nutrients for healthy hormones

  • Certain nutrients, such as magnesium, vitamin B6 and vitamin E can be helpful for reducing PMS symptoms, including breast tenderness.
  • Foods containing these nutrients include:
    • almonds, sunflower seeds, hazelnuts, spinach, swiss chard, sweet potato, avocado, salmon, chicken breast, figs and dark chocolate.

 

3. Avoid inflammatory foods and caffeine

  • Avoid or reduce top inflammatory foods, which include sugar, processed foods, refined flour-based products, processed vegetable oils (soybean, corn, canola, safflower), artificial sweeteners and dairy.
    • Inflammation contributes to hormonal imbalance and PMS symptoms, including breast tenderness.
  • Consider avoiding or reducing caffeine consumption.
    • While the research is mixed on the effect of caffeine on cyclical breast tenderness, some studies have shown that reducing caffeine (from coffee, tea, chocolate, colas) can be effective for reducing breast tenderness.
  • If you cannot commit to avoiding caffeine or more inflammatory foods, intend to commit to at least reduce some of these for the 2 weeks before your period.

 

4. Relaxation

  • As I’m sure we all know, stress can make our symptoms worse, and cyclical breast tenderness is no exception. Stress can impact our hormones, aggravating existing hormonal imbalance.
  • Doing something that you enjoy or that you find relaxing, even taking a few deep breaths, can positively impact the stress response.

 

5. Go bra less!

  • I realize this seems counterintuitive since there can be discomfort with movement of the breasts. However, tight-fitting bras (especially those with underwire) impede circulation of blood and lymph in the chest area.
    • Premenstrually, women can experience not only breast tenderness but breast enlargement, due to water retention. Even gentle or slight movement of the breasts is important for circulation.
  • So, even if you don’t feel comfortable going completely braless or need to wear a bra because of breast size or back problems, there are still options:
    • Avoid constant or long durations spent in bras with an underwire or bras that are really constricting (if you see marks left on your chest/torso after removing your bra, this is likely too constricting)
    • Get properly fitted for a bra so that you’re still getting the support you need while reducing health risks
    • Wear a comfortable bra more often and save the fancy stuff for special occasions
    • Go bra less when you can, especially overnight

 

If you experience cyclical breast tenderness related to your menstrual cycle which is bothersome or is persisting after making adjustments on your own, it may be time to see Dr. Haarsma to assess potential causes, decrease your discomfort and get you back to activities you enjoy, like hugs!

Schedule your appointment here.

 

 

References

Eren, T., Aslan, A., Ozemir, I. A., Baysal, H., Sagiroglu, J., Ekinci, O., & Alimoglu, O. (2016). Factors Effecting Mastalgia. Breast Care, 11(3), 188-193. doi:10.1159/000444359.

Idiz, C., Cakir, C., Ulusoy, A. I., & Idiz, U. O. (2018). The Role of Nutrition in Women with Benign Cyclic Mastalgia: A Case-Control Study. European Journal of Breast Health. doi:10.5152/ejbh.2018.3827.

Kataria, K., Dhar, A., Srivastava, A., Kumar, S., & Goyal, A. (2013). A Systematic Review of Current Understanding and Management of Mastalgia. Indian Journal of Surgery, 76(3), 217-222. doi:10.1007/s12262-013-0813-8.