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Ease Breast Pain
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What may—and may not—help to lessen the discomfort
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By Natasha Persaud
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April 2009
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 Breast pain is a common complaint among women. Typically, it occurs in response to the normal rise of hormone levels during the menstrual cycle. “When hormone levels peak right before a woman’s period, it stimulates the breast tissue and causes the breasts to become engorged, producing discomfort or pain,” explains Carolyn D. Runowicz, M.D., a gynecologic oncologist and director of the Neag Comprehensive Cancer Center at the University of Connecticut. “This type of cyclic breast pain starts in the late teens or early 20s when a woman starts ovulating regularly, and it typically subsides as she approaches menopause. “I try to reassure women that breast pain isn’t usually associated with breast cancer,” says Dr. Runowicz.
Many remedies have been touted to reduce breast pain associated with a woman’s menstrual cycle including dietary changes, supplements, topical creams and prescription drugs. “However, none of these methods have been shown in randomized clinical trials to be effective and/or safe,” says Dr. Runowicz. “Breast pain will usually subside with time and with proper support.” The two most effective and safe ways to relieve breast pain are also the most simple:
Buy a better bra.
“Contrary to what you might think, your breast size changes during your lifetime due to weight gain, pregnancy, the start of birth control pills and other factors.” If you’re experiencing breast pain, it’s worthwhile to go for a bra fitting to determine your current size. In addition, wear a bra or sports bra, for most of the day to reduce excessive motion, which can worsen breast pain; don’t just throw on a T-shirt. When the pain is severe and it’s waking you up at night, try wearing a bra to bed. It also helps to alter your exercise routine the week before your period to restrict movement of the breasts, says Dr. Runowicz. Instead of running on the treadmill, try walking or doing yoga.
Take this pain reliever.
When you need additional relief, take a low dose of a nonsteroidal anti-inflammatory drug (NSAID), such as over-the-counter ibuprofen or naproxen, which helps reduce the inflammation associated with breast pain, she says. Acetaminophen, such as Tylenol, is less effective. But be very careful not to overdose on these medications. “Taking too many NSAIDs can lead to kidney failure, and some prescription NSAIDs have severe side effects. Don’t take it daily or for more than a week or two,” Dr. Runowicz cautions.
You may have heard of these popular methods to relieve breast pain. Although some of these treatments may be effective, there are often side effects, according to Dr. Runowicz. Here’s the lowdown:
• Caffeine: Cutting back on coffee, tea, soda and chocolate may help reduce pain in some women, but is unproven. Abrupt withdrawal of caffeine may cause headaches and other symptoms in those accustomed to frequent “cups of joe.”
• A low fat, low calorie diet and regular exercise may possibly improve breast pain by helping you lose weight over time.
• Birth control pills: Some women report that taking an oral contraceptive regulates their hormone levels and provides a measure of relief from breast pain. However, the opposite is also likely to occur since birth control pills have high levels of hormones that stimulate breast tissue, which may produce more pain.
• Evening primrose oil: According to some claims, the supplement may improve the balance of fats in the breasts. However, a 2007 meta-analysis showed evening primrose oil performed no better than placebo in treating breast pain.
• Vitamin E: While initially promising, studies have failed to show a benefit to taking the vitamin for breast pain.
• Cold compress and massage: While it can’t hurt to try these methods, it’s unlikely they will provide much relief.
Skin-numbing crèmes, ointments or gels have been approved by the FDA for relief of the pain of mammograms, which may lead some women to believe they’re safe to use for cyclical breast pain. But the FDA warns that anesthetics such as lidocaine, tetracaine, benzocaine and prilocaine carry risks. “When applied too liberally, the medication can be absorbed into the bloodstream causing fainting, irregular heart rhythms, seizures, breathing difficulties, coma and even death,” explains Dr. Runowicz. “The surface area of the breast is large in some women, so it’s possible for excess medication to be applied and absorbed.”
If your pain is unusual—that is, it doesn’t occur monthly in concert with your menstrual cycle, it’s new or localized to one breast or changes in severity--see your gynecologist or a breast specialist. Your doctor will likely order a mammogram and/or sonogram to determine a cause. Common causes of this type of pain include an infection or inflammation. Rarely, these symptoms indicate cancer.
If you’re nursing and you experience breast or nipple pain accompanied by redness and swelling, you may have an infection and, perhaps, an abscess that requires treatment. See your doctor who may prescribe an antibiotic or recommend that an abscess be drained.
Finally, if you’re at high risk of breast cancer, based on a risk assessment tool (such as the Gail Model on the NCI website) or a strong family history and you experience cyclical breast pain, you may want to discuss the use of tamoxifen with your doctor. Studies show it reduces the risk of breast cancer in high-risk women and provides modest relief of breast pain. The drug carries serious side effects, so discuss the risks and benefits with your doctor.
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