What is premenstrual breast pain?

Premenstrual breast pain refers to cyclical breast pain that occurs before menstruation. It is very common in women and is related to hormonal changes during the menstrual cycle. The pain is usually mild and disappears after menstruation begins.

Which department should I visit for premenstrual breast pain?

English names: premenstrual breast pain, premenstrual mastalgia, premenstrual mastodynia, cyclic breast pain.

Other names: premenstrual breast tenderness, menstrual breast pain, cyclical breast pain.

Departments to visit: Breast Surgery, Thyroid and Breast Surgery, Gynecology, General Surgery.

What causes premenstrual breast pain?

Premenstrual breast pain is related to hormonal changes during the menstrual cycle. The rise in estrogen and progesterone levels around ovulation stimulates the proliferation of breast glandular tissue, leading to breast pain. After menstruation begins, the levels of these hormones decrease, reducing the stimulation and relieving the pain.

Who is most likely to experience premenstrual breast pain?

Premenstrual breast pain is common in women of reproductive age. Additionally, postmenopausal women undergoing hormone therapy for menopausal symptoms may also experience similar discomfort.

What are the symptoms of premenstrual breast pain?

Premenstrual breast pain typically occurs about one week before menstruation and subsides once menstruation begins. The pain is usually diffuse and bilateral, with the upper outer quadrant of the breast often being the most tender.

During a breast examination, there is no redness, skin changes, or bloody nipple discharge. If these symptoms appear, breast cancer should be suspected.

However, if breast pain persists after menstruation or is localized to one breast or a specific area, it is not considered premenstrual breast pain and may indicate other underlying conditions.

How is premenstrual breast pain diagnosed?

For women seeking medical attention for premenstrual breast pain, doctors can make a diagnosis by taking a detailed medical history and performing a breast examination.

Tests such as breast ultrasound, mammography, or MRI are usually unnecessary unless suspicious signs (e.g., breast lumps, peau d'orange skin, dimpling, or bloody nipple discharge) are found during the examination.

How is premenstrual breast pain treated?

For women with severe pain that significantly affects their quality of life and does not improve after reassurance, further treatment may be needed.

Non-drug treatments, such as warm or cold compresses and gentle breast massage (avoiding excessive pressure), can be tried first.

If these methods are ineffective, oral or topical nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac gel or acetaminophen, may be used.

If symptoms persist after six months, medications like tamoxifen or danazol may be considered for 1–3 months, though they may have significant side effects.

Can premenstrual breast pain resolve on its own? What are its main risks and prognosis?

For 70–80% of women, breast pain significantly improves or no longer causes distress after being reassured by a doctor that there is no malignant breast disease.

Some women may experience spontaneous relief, though the pain may recur. Pregnancy or menopause may also lead to spontaneous resolution.

Severe premenstrual breast pain can negatively affect sexual activity, physical activities, social interactions, and school performance.

How can premenstrual breast pain be prevented?

Wearing underwire bras during the day can reduce breast sagging, while soft supportive bras at night may improve sleep. Sports bras can minimize breast movement during exercise. Women with asymmetrical breasts may use bra pads to prevent excessive pressure on the larger breast.

Postmenopausal women on hormone therapy who experience significant cyclical breast pain should consider discontinuing hormone replacement therapy.

Additionally, a low-fat diet and reduced intake of caffeine-rich foods (e.g., coffee, cola, tea, chocolate) may help alleviate pain.