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What is mastalgia?

Mastalgia is a name your provider may use for breast pain. It includes a wide range of pain in the breasts—from mild discomfort to more intense pain. The most common cause of breast pain in those who have a menstrual cycle is normal changes in hormone levels.

In men, gynecomastia is the most common cause of pain and enlargement in the breast tissue. However many conditions cause pain in one or both breasts.

Occasional or monthly breast pain is very common; it usually doesn’t indicate a serious condition. If you’re experiencing breast pain, our team is here to get to the source of your symptoms and help you take steps to care for your breast health.

  • Cyclical breast pain

    Cyclical breast pain is a common symptom of regular hormone changes during your monthly cycle. You’ll most often notice increased breast pain or tenderness in both breasts a few days to a few weeks before your period. This pain ranges from mild to severe. Most of the time, cyclical breast pain goes away after you reach menopause and no longer have a monthly period.

  • Extramammary breast pain

    Extramammary breast pain is felt in the breast area, but it’s actually caused by a condition outside the breast tissue. For example, inflammation in the rib cage, a pulled muscle in the chest or pain caused by arthritis may radiate into the breasts.

  • Non-cyclical breast pain

    Non-cyclical breast pain is pain that isn’t related to monthly changes in your hormones. This type of pain is more likely to occur after menopause. Causes of non-cyclical breast pain could include breast cysts, injuries to the breast, inflammation or conditions near the breast. Talk to your doctor if this pain is ongoing or in a specific breast area.

    Focal, persistent pain that doesn’t come and go and that keeps increasing should be evaluated by your doctor.

Breast pain symptoms

How you experience breast pain symptoms will differ depending on whether you have cyclical or non-cyclical pain. Paying attention to the timing of your pain, what it feels like and other symptoms will help your doctor determine your breast pain cause. Knowing the source of your breast pain is an important step in figuring out which treatment options may be right for you. Below is a breakdown of the differences between non-cyclical and cyclical breast pain. Your doctor can also help determine whether your pain is cyclical or not.

Non-cyclical pain often:

  • Causes ongoing discomfort or pain that comes and goes but doesn’t follow your menstrual cycle
  • May feel like stabbing, burning or tightness in the breast
  • Only affects one breast or a specific area of the breast
  • Happens after menopause

Cyclical pain often:

  • Gets worse during the week or two before your period and follows your menstrual cycle
  • May feel achy and heavy and include other symptoms like lumpy breasts or swelling
  • Affects both breasts, including areas under the arms
  • Happens in those who have a menstrual cycle

When to see a doctor for a breast pain

While mastalgia or breast pain isn’t usually a cause for concern, it’s important to be familiar with your breasts’ normal feeling, texture and appearance and contact your doctor if you notice changes.

Schedule a visit with your doctor if you have:

  • Ongoing breast pain that doesn’t get better or gets worse
  • Breast pain that’s affecting your daily life
  • A new, persistent breast lump
  • Changes to the skin on your breast, such as redness or a rash
  • Other signs of an infection in the breast, like fever, pus or redness
  • Changes in nipple appearance or discharge from your nipples

Breast pain causes

Many things can lead to breast pain—from natural changes in your hormones to medications to medical conditions. Usually, the cause of your breast pain isn’t serious and can be easily managed at home. But sometimes, breast pain can be caused by a condition that requires medical care, like an infection or injury. Your doctor can help pinpoint the cause of your breast pain, but below is a breakdown of the most common reasons why people experience breast pain, including hormonal changes, breast injuries, breastfeeding, infections, medications and fibrocystic breast changes.

Hormonal changes

Natural hormone changes throughout the menstrual cycle are among the most common causes of mastalgia. You may experience similar breast pain symptoms during pregnancy due to hormone fluctuations.


Breast injuries

An injury or trauma to the breast, for example, a hit while you’re playing sports, can also cause breast pain. Most minor injuries can be treated at home, but your doctor should check breast pain that persists after an injury.

Breastfeeding

Pain caused by breastfeeding is a common concern for nursing moms. You may feel a normal tingling when your milk lets down, or breast engorgement can lead to tender, swollen breasts. Nipple pain often occurs due to cracked skin or problems with a proper latch. Talk to your OBGYN or a lactation consultant if you're having pain with breastfeeding.

Infections

A breast infection causes a painful, inflamed area in the breast called mastitis. Infections happen when bacteria from the skin get into the breast. Mastitis is most likely to happen in those who are breastfeeding, but an infection can happen when you’re not breastfeeding, too.


Medications

Like your natural hormones, hormonal medications may cause breast pain as well. These include birth control pills, infertility treatments, hormone replacement therapy in menopause, or hormone therapy in transgender women. Other medications that can cause breast pain as a side effect include treatments for high blood pressure or heart disease, antibiotics, and some medicines for mental health conditions.

Fibrocystic breast changes

Fibrocystic breast changes, or lumpy breasts, can also cause breast pain. These normal changes in the breasts include fibrous tissue and fluid-filled cysts. Because fibrocystic breasts are often related to hormone changes, this type of breast pain tends to be cyclical.



Mastalgia and breast pain risk factors

While there are many causes of breast pain, some people have factors that put them more at risk for mastalgia. Understanding your risk factors can help you take steps to manage breast pain better and care for your breast health. The most important risk factors to be aware of are age, menstrual cycle status, breast size, lifestyle stress level and diet.

Some risk factors include:

  • Age – Most people with breast pain are in their 20s, 30s or 40s. Breast pain increases during the perimenopausal timeframe and is less common after menopause.
  • Menstrual cycle – Those who have a period and haven’t reached menopause are most at risk, but it can also affect men or transgender people undergoing hormone therapies.
  • Breast density – Dense breasts put you at risk for non-cyclical breast pain.
  • Stress – Stress or anxiety, especially around your period, may affect hormone levels, leading to increased breast pain.

Diagnosing breast pain

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If you’re having breast pain, your primary care provider or gynecologist (OBGYN) can help diagnose the cause and work with you to develop a care plan for your breast health. Most people only need a clinical breast exam to diagnose the source of their breast pain. However, if there’s an area of concern during the breast exam or based on your symptoms, your doctor may recommend additional tests to check your health. These include imaging tests, like mammograms or ultrasounds.

  • Breast exam

    Breast exam

    During a clinical breast exam, your doctor will examine the breasts, the area under your arms and the lymph nodes in your neck. If your healthcare provider doesn’t find any areas of concern, this may be the only exam you need for breast pain.

    Learn more about self breast exam

  • Imaging tests

    Imaging tests

    Your doctor might order imaging tests to get a better look at an area of your breast that feels or looks abnormal. The most common imaging tests for breast pain are a mammogram or a breast ultrasound. Mammograms use X-rays to create an image of your breasts, while ultrasounds use sound waves.

  • Biopsy

    Biopsy

    A breast biopsy lets your healthcare team take a tissue sample from the breast. This sample is then sent to a lab to help diagnose breast conditions. Usually, you’ll only have a biopsy as a follow-up to imaging tests, and up to 80% of breast biopsies come back as benign—or not cancerous.

Breast exam

During a clinical breast exam, your doctor will examine the breasts, the area under your arms and the lymph nodes in your neck. If your healthcare provider doesn’t find any areas of concern, this may be the only exam you need for breast pain.

Learn more about self breast exam

Imaging tests

Your doctor might order imaging tests to get a better look at an area of your breast that feels or looks abnormal. The most common imaging tests for breast pain are a mammogram or a breast ultrasound. Mammograms use X-rays to create an image of your breasts, while ultrasounds use sound waves.

Biopsy

A breast biopsy lets your healthcare team take a tissue sample from the breast. This sample is then sent to a lab to help diagnose breast conditions. Usually, you’ll only have a biopsy as a follow-up to imaging tests, and up to 80% of breast biopsies come back as benign—or not cancerous.

Treatment of breast pain

The right treatment for your breast pain depends on the cause of your pain, so figuring out the cause is a critical first step to helping you feel better. If your breast pain is caused by injury, infection or medications, treatment will address that underlying cause to relieve the pain. If you’re diagnosed with cyclical breast pain related to hormone changes, there are steps you can take to reduce pain, such as lifestyle changes or over-the-counter medications. If breast pain doesn’t improve with care at home, talk with your health provider about other treatment options, like prescription medications. 

Treatment options include:

  • Diet and lifestyle changes

    Your doctor may recommend starting with simple diet or lifestyle changes to see if they help manage your pain. Changes may include:

    • Wearing a well-fitting bra to provide more support, especially during times when your breasts are most sensitive
    • Using ice packs, a heating pad or a warm compress
    • Choosing a low-sodium diet to reduce fluid retention
    • Reducing the amount of alcohol you drink
    • Using relaxation techniques or complementary therapies
    • Using Vitamin E or primrose oil
  • Pain relief medications

    Over-the-counter pain medications help treat breast pain. Try acetaminophen, ibuprofen or other non-steroidal anti-inflammatory drugs to help manage your pain as needed. Medications are also available in a cream or gel form that can be applied directly to the area of pain. Talk to your doctor to help determine the appropriate medications to manage your pain.

  • Hormone drugs

    Hormone-containing medications, like birth control pills, reduce breast pain in some people. When your mastalgia is related to monthly hormone changes, these prescription medications may help. Always talk with your doctor about the risks and benefits so you can choose the right treatment for you.

Our breast imaging centers near you

If you have breast pain, start with a visit to your primary care provider or OBGYN. We offer several locations for your care, including clinics throughout North and Central Texas.

Frequently asked questions

  • Is breast pain cancer?

    Not usually. It's rare to have breast pain as a symptom of breast cancer. While some types of breast cancer—specifically inflammatory breast cancer—can cause breast pain, it isn't a common sign. If you're concerned about cancer, having routine screening mammograms can give you peace of mind about your breast health.

  • Is breast pain normal?

    Having mild breast pain related to hormone changes or your period is expected. But ongoing pain, severe pain or pain along with other symptoms can also be signs of a medical condition. Make an appointment with your doctor if something feels off.

  • Can stress cause breast pain?

    Yes. There’s evidence that stress and anxiety increase breast pain. This may be because of the effect of stress on hormones, which leads to worsening breast pain symptoms.

  • Does ovulation cause breast pain?

    Yes, some people start having breast pain around ovulation, which continues for a couple of weeks until their period begins. However, cyclical breast pain is most common in the days before the start of your period.

  • Is breast pain a sign of pregnancy?

    Yes, breast pain may be an early sign of pregnancy—before you miss your period. Hormonal changes in early pregnancy often cause breast pain. However, since breast pain is also very common leading up to your period, it could be caused by normal cyclical changes, not pregnancy.