Do you have breast pain before your period? After menopause? Learn about the hormonal, structural and cancerous causes of breast pain on the right or left side.
9 most common cause(s)
Breast pain symptoms
The breasts are composed of tissue, fat, and glands that develop due to increases in hormones such as estrogen during puberty. Breast pain, or mastalgia, is a common condition among women of childbearing age; however, it is commonly described as cyclical or non-cyclical.
Common characteristics of breast pain
Breast pain can differ from woman to woman, but common breast pain symptoms often include:
- Tenderness
- Sharpness or burning
- Tightness around the breast tissue
Cyclical breast pain
Women in their early 20s and 30s are most likely to experience symptoms related to cyclical breast pain. Cyclical breast pain often involves both breasts and includes symptoms such as the following.
- Occurring in close relation to your menstrual cycle: It may begin a few days before the start of your cycle
- Sensation of fullness or heaviness in the breasts
- Breast swelling
- Radiating pain: Pain that radiates to the underarm or upper and outer portions of the breast
- Self-resolving: Improves during your menstrual cycle and resolves on its own when the menstrual cycle is over
Non-cyclical breast pain
Women in their 40s to 50s who are transitioning or experiencing menopause often experience non-cyclical breast pain symptoms. Non-cyclical breast pain usually involves one breast and includes symptoms such as the following.
- Burning or soreness of the breast
- Constant pain: Pain will last throughout the month that is unrelated to the menstrual cycle.
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Breast pain causes
Fortunately, the majority of breast pain causes are limited and not life-threatening. However, it is still important to follow-up on your breast pain symptoms with your physician in order to get an appropriate diagnosis and care.
Hormonal causes
Types of breast pain are divided into cyclical and non-cyclical causes because cyclical pain is associated with hormonal fluctuations in estrogen and progesterone. The breasts are extremely sensitive to these hormone changes and often worsen as women get older due to increased sensitivity of the breasts.
Breastfeeding-related causes
Breastfeeding can result in pain due to the latching of the infant itself. If your baby is latching improperly you will experience breast pain symptoms. Moreover, you may experience breast pain due to problems associated with breastfeeding below:
- Infection: Infection of the milk ducts of the breast is known as mastitis. Mastitis can result in cracked, burning or blistering nipples that may also cause red streaks on the breast. Though painful, this condition is common among women breastfeeding.
- Engorgement: When the breasts become too full of milk, they enlarge and press against the skin, resulting in a tight, painful sensation.
Structural causes
Structural causes of breast pain may include the following.
- Size: Women with breasts that are larger or not proportional to their frames can experience breast pain that is related to pain in their neck and shoulder pain.
- Extramammary: Pain or irritation of the chest, arms, or back muscles due to exercises and activities such as rowing, waterskiing, raking or shoveling can radiate to and affect the breasts.
Cancerous causes
Though less common, breast pain can signal cancerous conditions. Be on alert and make an appointment with your physician immediately if you notice breast pain, especially if the pain is associated with other symptoms, such as:
- A new, fixed lump in the breast
- Changes in size or shape of the breast
- Changes other characteristics: Such as in the color (redness, inflammation) or texture of the skin (wrinkling, puckering or dimpling)
- Rash, crusting of nipple discharge
10 breast pain conditions
The list below shows results from the use of our quiz by Buoy users who experienced breast pain. This list does not constitute medical advice and may not accurately represent what you have.
Premenstrual syndrome
Premenstrual syndrome, or PMS, refers to a set of symptoms experienced by some women just before the start of a menstrual period.
The exact cause of PMS is uncertain, but changing hormone levels are always involved. Ongoing depression will make the symptoms worse and may be connected to low levels of the brain chemical serotonin, which influences mood, food cravings, and sleep patterns.
Symptoms include irritability, mood swings, insomnia, difficulty concentrating, weight gain, fluid retention, bloating, abdominal discomfort, food cravings, and breast tenderness.
PMS normally fades within a day or two of start of the menstrual period. If the symptoms are interfering with activities of daily living, a medical provider may be able to help. Some symptoms can be treated for improved quality of life.
Diagnosis is made through patient history.
Treatment primarily involves making lifestyle improvements in diet, exercise, and stress management. Nonsteroidal anti-inflammatory drugs can address the physical discomfort, and diuretics will help with fluid retention. Hormone-based contraceptives can regulate the cycle and ease symptoms. In some cases, antidepressants are helpful.
Premenstrual dysphoric disorder
Premenstrual dysphoric disorder (PMDD) describes a set of severe, debilitating symptoms that appear seven to ten days before a woman's menstrual period begins.
It may be caused by an abnormal reaction to the natural female hormone changes, creating a deficiency in the mood-regulating brain chemical serotonin.
Risk factors include a personal or family history of PMDD, postpartum depression, and/or general depression, as well as cigarette smoking.
Physical symptoms include headaches, abdominal pain and bloating, back pain, and breast tenderness. Psychological symptoms include severe depression, anxiety, and irritability.
Because symptoms tend to get worse over time, medical help should be sought so that quality of life can be improved.
If symptoms persist for a year or more, a diagnosis of PMDD may be made.
Treatment includes improving the diet, adding vitamin and mineral supplements, and getting regular exercise (get those steps in!).
Birth control pills to regulate the menstrual cycle may be prescribed, along with anti-inflammatory medicines such as ibuprofen. Antidepressants in the selective serotonin reuptake inhibitor class (SSRI) are helpful in some cases.
Rarity: Common
Top Symptoms: fatigue, stomach bloating, anxiety, depressed mood, abdominal cramps (stomach cramps)
Symptoms that always occur with premenstrual dysphoric disorder: impaired social or occupational functioning, symptoms of depression, anxiety and emotional lability
Symptoms that never occur with premenstrual dysphoric disorder: constant sadness, disapearance of periods for over a year
Urgency: Primary care doctor
Possible pregnancy
The earliest sign of a pregnancy is typically a missed period, but many women do experience symptoms shortly after conception:
- Implantation bleeding may occur after six to twelve days, when the fertilized egg implants itself into the lining of the uterus. This can cause mild cramping with light bleeding or spotting.
- Fatigue and increased desire to sleep may happen within a week.
- Breast tenderness can start as soon as one to two weeks.
- Nausea ("morning sickness") can occur after two to eight weeks.
If pregnancy is suspected, testing should be done so that proper prenatal care can begin. It's important to avoid some behaviors during pregnancy, such as drinking alcohol or using certain drugs or medications, so an early diagnosis should be made.
Over-the-counter home pregnancy tests are available at any drugstore. A positive test is almost certainly correct, but a negative test in the face of other symptoms may be a false negative and should be tried again after a week.
Rarity: Common
Top Symptoms: fatigue, nausea or vomiting, stomach bloating, bloody vaginal discharge, vaginal bleeding
Symptoms that always occur with possible pregnancy: missed period
Symptoms that never occur with possible pregnancy: painful urination, severe abdominal pain
Urgency: Self-treatment
Non-specific breast pain
Nonspecific breast pain, also called mastalgia or mastodynia, refers to tenderness or pain in the breast with no obvious cause. It almost always proves to have a benign (non-cancerous) cause.
Breast pain is most common in women aged 35 to 50 and still experiencing menstruation. Fibrocystic changes are common in this age group, where tiny, fluid-filled sacs form within breast tissue and might be felt as small, tender, but non-cancerous lumps.
Birth control pills, hormone replacement therapy, caffeine, and soy can cause breast tenderness in women of any age. A breast infection can cause painful lumps.
A medical provider should be seen, in order to rule out any serious condition and get treatment for the discomfort.
Diagnosis is made through patient history; physical examination; mammogram or breast ultrasound; and sometimes biopsy.
A breast infection will be treated with antibiotics. Large, painful cysts may have the fluid drained or be surgically removed. Lifestyle improvements regarding diet and exercise are often helpful, as well as adjustments to birth control pills or hormone therapy.
Rarity: Common
Top Symptoms: breast pain, breast swelling, armpit pain
Symptoms that always occur with non-specific breast pain: breast pain
Urgency: Primary care doctor
Fibrocystic breast changes
Fibrocystic change is a generalized term used to describe a variety of benign changes in the breast. Symptoms of this condition are breast swelling or pain, as well as nodules, lumpiness, or nipple discharge.
You should visit your primary care physician to evaluate the lump. Diagnosis typically just involves a physical exam and imaging. A biopsy would be needed in case scarier things need to be ruled out, but it's not always necessary. Treatment of a cyst involves aspirating the contents of the cyst, a mass just needs a biopsy with no further treatment, and nipple discharge doesn't require treatment.
Rarity: Common
Top Symptoms: breast lump, hard breast lump, nipple discharge, rope-like breast lump
Symptoms that always occur with fibrocystic breast changes: breast lump
Urgency: Primary care doctor
Fibroadenoma
Fibroadenomas are solid, noncancerous breast tumors that occur most often in adolescent girls and women under the age of 30. You might describe a fibroadenoma as firm, smooth, rubbery or hard with a well-defined shape.
You should visit your primary care physician to confirm the diagnosis and discuss treatment options.
Breast infection (mastitis)
Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness of the breast. Mastitis most commonly affects women who are breast-feeding (lactation mastitis), although sometimes this condition can occur in women who aren't breast-feeding.
You should visit your primary care physician to confirm the diagnosis and discuss treatment options, such as antibiotics.
Rarity: Uncommon
Top Symptoms: fatigue, nausea, breast pain, signs of breast inflammation like redness, swelling or fever, fever
Symptoms that always occur with breast infection (mastitis): breast pain, signs of breast inflammation like redness, swelling or fever
Urgency: Primary care doctor
Breast cyst
A breast cyst is a fluid-filled sac (like a tiny balloon) inside the breast. Breast cysts are common in women. They might cause a little pain, but they are usually benign (not cancerous).
You should visit your primary care physician within the next 24 hours to evaluate the lump. Diagnosis typically just involves a physical exam and imaging. Sometimes a biopsy is needed to rule out other causes. Treatment of a cyst involves aspirating the contents of the cyst (sucking the stuff out).
Rarity: Common
Top Symptoms: breast pain, breast lump, painful breast lump, movable breast lump
Symptoms that always occur with breast cyst: breast lump
Symptoms that never occur with breast cyst: armpit lump, fever
Urgency: Primary care doctor
Breast cancer
Breast cancer has several names, depending on the part of the breast where it starts:
- Lobular carcinoma affects the milk glands.
- Ductal carcinoma affects the milk ducts.
- Sarcoma affects the connective tissue.
- Paget's Disease affects the nipple and areola.
Women over age 50 with a family history of the disease, and/or certain genetic factors, are most at risk, but anyone can get breast cancer at any age. It is rare in men but does occur.
Symptoms include a lump, thickening, or pain anywhere in the breast or armpit; red, flaky, or irritated breast or nipple skin; nipple discharge; and any area of irregular skin or misshapenness.
Many harmless conditions can cause similar signs, so it is important to see a medical provider about any of these symptoms.
Diagnosis is made through physical examination; imaging such as ultrasound, mammogram, or MRI; and sometimes biopsy.
Treatment involves a combination of surgery, radiation therapy, and chemotherapy.
The best prevention is a combination of screening mammograms as recommended by the medical provider, and monthly self-examination.
Rarity: Uncommon
Top Symptoms: breast pain, armpit lump, breast mass or retraction, breast lump, nipple discharge
Urgency: Primary care doctor
Breast abscess
Breast abscess is a complication of mastitis, which is an inflammation of the breast tissue. An abscess is a pocket of pus that forms within the breast, usually just under the skin.
Most susceptible are women who are breastfeeding. Bacteria can be transferred into the milk ducts from the skin or from the infant's mouth. Women not breastfeeding can be infected through a sore nipple or from a nipple piercing.
If a milk duct is blocked through trauma, compression, or incomplete emptying, bacteria can gain a foothold and an abscess can form.
The abscess forms a hot, reddened, painful lump in the breast. There will be flu-like symptoms of fever, chills, fatigue, and body aches.
Diagnosis is made through physical examination and sometimes a milk sample.
Treatment is with antibiotics along with rest, fluids, and over-the-counter pain relievers. Unless otherwise directed by the medical provider, it is safe to continue nursing the baby. If the abscess persists, it may be drained under local anesthesia with a needle and syringe.
Breast pain treatments and relief
At-home treatments
Luckily, cyclical breast pain can be treated at home with simple lifestyle changes such as the following.
- Choose the right bra: Invest in a supportive and comfortable bra that you can wear when your pain is at its worst.
- Pain medication: Take over-the-counter medications such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) in order to relieve breast pain symptoms.
- Heat or ice: Use hot or cold compresses on the breast to reduce swelling and pain.
- For breastfeeding: If your pain is related to breastfeeding, try pumping your breast milk to prevent engorgement and see a lactation specialist to help train your baby in proper latching.
When to see a doctor
Make an appointment with your physician if your breast pain:
- Persists for a long time: More than a couple of weeks
- Is localized: Is limited to only one specific area of your breast
- Is worsening over time despite at-home remedies
- Begins to interfere with everyday activity
Medical treatments
To address cyclical breast pain symptoms, doctors may also prescribe oral contraceptives or estrogen blockers to control your hormone levels. Doctors will provide antibiotics if your breast pain is related to mastitis.
FAQs about breast pain
Here are some frequently asked questions about breast pain.
Why do I only have breast pain in one breast?
There are many causes of pain in one breast and not the other. Usually, this type of pain is not associated with a menstrual cycle. If it is associated with a menstrual cycle, it is more likely to be caused by cyclical changes in breast tissue. Non-cyclical causes include things like diet and lifestyle, such as smoking, having larger breasts, or wearing poorly fitted bras. Ductal ectasia, when the ducts of the breast dilate, may also lead to breast pain on one side. Infections of breastfeeding mothers like mastitis can also lead to swelling, warmth, and one-sided breast pain.
Why do I have breast pain before my periods?
You likely have breast pain before your period because of fibrocystic breast changes. These changes occur as your hormones prepare you to menstruate and cause changes in your breast tissue, resulting in tenderness.
What causes breast pain after menopause?
Breast pain after menopause is caused most frequently by hormone replacement therapy, as female hormones cause increased sensitivity of the breast tissue. This may spontaneously resolve over time if you continue to take your medications regularly.
Can stress and anxiety cause breast pain?
No, stress and anxiety generally do not cause breast pain. Severe physical stress among individuals who are undergoing situations, like starvation or a severe bodily injury, may cause menstruation to stop as well as cyclical pains associated with menstruation.
What does it feel like when your breasts are tender?
If a breast is tender, it may mean that the entire breast hurts and is sensitive to touch. This sort of tenderness may indicate a problem with the skin, such as an infection or other cause of inflammation. Tenderness can also occur at the nipple or within the breast tissue when pressed upon. This can be caused by natural changes associated with aging, a menstrual period, a benign cyst, or even more dangerous issues such as infections or malignancies.
Questions your doctor may ask about breast pain
- Do your symptoms occur or worsen before or during your period?
- Any fever today or during the last week?
- Have you given birth to any children?
- When was your last menstrual period?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
- Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A systematic review of current understanding and management of mastalgia. Indian J Surg. 2013;76(3):217-222. NCBI Link
- Breast pain. Breast Cancer Care. Updated November 2018. Breast Cancer Care Link
- Newman A. How to tackle mastalgia - Medical Observer. Jean Hailes. Published October 6, 2017. Jean Hailes Link
- Marshall SA, Husney A, Romito K, Jones K, eds. Mastitis while breastfeeding. University of Michigan: Michigan Medicine. Updated September 5, 2018. UofM Health
- Simon S. Breast cancer symptoms: What you need to know. American Cancer Society. Published September 27, 2018. American Cancer Society Link
- Duct ectasia. American Cancer Society. Published September 20, 2017. American Cancer Society Link