Why Does Your Breast Hurt? 11 Harmless and Concerning Causes Explained

If you experience persistent breast discomfort for over two weeks, seek medical advice without delay.

Mastalgia refers to pain in one or both breasts and is a common experience for 70% of women. This symptom can indicate various conditions, ranging from benign to serious.

1. Premenstrual Syndrome (PMS) or Ovulation

Breast tenderness and swelling during ovulation or before menstruation are normal hormonal responses. However, cyclic breast pain should not be severe. If the discomfort is intense or persistent, consult a gynecologist promptly.

Typical signs of normal cyclic breast pain include:

• Both breasts hurt, mainly in the upper and central areas near the nipples;
• The breasts feel swollen and firmer to the touch;
• Pain may radiate to the underarm area;
• Symptoms appear no earlier than two weeks before menstruation and subside afterward;
• The individual is within reproductive age.

Management

Mild discomfort during PMS or ovulation is usually tolerable. Over-the-counter pain relievers such as ibuprofen, acetaminophen, or naproxen can help alleviate symptoms.

If breast pain recurs every cycle and becomes bothersome, consult your gynecologist. They may recommend or adjust oral contraceptives to help manage symptoms.

2. Hormonal Imbalance

Mastalgia is often influenced by fluctuations in estrogen and progesterone levels. These hormonal changes commonly occur during:

• Puberty;
• Pregnancy, especially the first trimester;
• Lactation;
• Menopause.

Management

Mild breast pain during these life stages is generally normal and temporary. However, severe pain warrants medical evaluation.

3. Lactation

Milk production can cause breast fullness and tenderness, which is typical for breastfeeding mothers experiencing an increase in breast size by one or two cup sizes.

Management

No treatment is usually necessary as discomfort subsides when the breasts adjust to milk production.

4. Milk Duct Blockage (Lactostasis)

Sometimes, milk ducts become clogged, causing milk to accumulate. This results in localized swelling, firmness, and pain upon touch, often with a palpable lump.

Management

Frequently breastfeed to help clear the blockage. If needed, express milk gently with massage after feeding. Consult a lactation specialist if difficulties persist.

5. Mastitis

Mastitis is inflammation of the breast tissue, often developing from untreated lactostasis. It can also occur from infections entering through skin injuries or bloodstream. Exposure to cold can lower local immunity, increasing infection risk.

Symptoms include:

• Fever of 100.4°F (38°C) or higher;
• Swollen, hard breast with sharp pain on touch;
• Warmth and redness of the skin;
• Fatigue, dizziness, and weakness.

Management

Seek immediate medical care. Mastitis requires prompt treatment with antibiotics to prevent serious complications, including blood infection. Advanced cases might need surgical intervention.

6. Fibrocystic Breast Changes

This benign condition causes the breasts to feel lumpy, with fibrous tissue and fluid-filled cysts. It is linked to hormonal factors and age.

Management

Consult a healthcare provider for diagnosis. Treatment is usually unnecessary. Over-the-counter pain relievers like acetaminophen or ibuprofen can ease discomfort.

7. Medication Side Effects

Certain medications can cause breast pain, including:

• Oral hormonal contraceptives;
• Postmenopausal hormone therapy;
• Antidepressants, especially selective serotonin reuptake inhibitors;
• Fertility treatments;
• Blood pressure medications;
• Some antibiotics.

Management

Discuss with your doctor whether your medications might cause mastalgia and explore alternatives if necessary.

8. Breast Injuries

Trauma from impact or compression can cause breast pain lasting several days.

Management

For minor injuries without visible bruising or swelling, allow time to heal and use over-the-counter pain relief. Protect your breasts from future trauma to prevent tissue changes.

If injury causes noticeable symptoms, consult a healthcare professional.

9. Ill-Fitting Bras

Bras that are too tight can compress breast tissue, leading to pain and impaired circulation. Conversely, bras that are too loose may cause tissue stretching and discomfort, especially in larger breasts.

Management

Choose properly fitting bras to avoid pain. Detailed fitting guides are available from trusted sources.

10. Referred Pain

Sometimes breast pain originates from other structures, such as strained chest muscles after intense exercise or conditions like angina, gallstones, or costochondritis (inflammation of rib cartilage).

Management

If muscle strain is suspected, rest and allow time for recovery. Persistent pain or unclear causes should prompt consultation with a gynecologist to rule out other issues.

11. Fibroadenoma or Breast Cancer

Both involve breast lumps; fibroadenoma is benign, whereas breast cancer is malignant and life-threatening. Early detection is challenging but crucial. Signs include a persistent lump in one breast, unexplained pain lasting over two weeks, nipple discharge (clear, bloody, or pus-like), nipple shape or color changes, and skin texture resembling an orange peel.

Management

Do not delay medical evaluation if you notice these symptoms. Early diagnosis and treatment improve outcomes. Regular screenings with a breast specialist at least once or twice a year are recommended to reduce cancer risk.

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