Officially known as ‘mastalgia’, breast pain and tenderness are common. Those of us who have boobs know the drill: a week or so before our period, our boobs seem to swell up and feel dull, heavy and achy. 

Usually, this will pass once our menstrual cycle starts over – but it’s not unusual to experience symptoms at other times of the month too.

We asked GP and lifestyle doctor Lafina Diamandis for the lowdown on what’s going on, how to cope with symptoms and when we should be getting things checked out. 

What are the main causes of sore boobs?

Mastalgia will affect most women and people with breasts at some point in their lives. It’s usually mild and short-lived, but it can occasionally be more severe and can have an impact on quality of life.

“Generally speaking, we can split breast pain into cyclical and non-cyclical causes,” explains Dr Diamandis. “Cyclical breast pain is linked to the reproductive hormones or periods and the fluctuating levels of these hormones throughout the menstrual cycle. 

“Non-cyclical breast pain is not related to your cycle and there can be many causes including cysts, pregnancy, musculoskeletal injuries and, less commonly, breast cancer.”

Cyclical breast pain

This is the one we’re pretty much all aware of. It’s one of the tell-tale signs that you’re pre-menstrual.

“Cyclical breast pain can start two weeks before a period and will resolve by the end of the period,” explains Dr Diamandis. “The pain usually affects both breasts, can feel dull or achy, can radiate to the armpits and it sometimes makes breasts feel heavy or lumpy too.”

It’s easy to get spooked by breast lumps or changes (and rightly so) – so it’s important to be aware of what’s normal for you (and what’s not). If you’re concerned about a change to your breasts, always consult your GP to rule out anything serious.

So, what’s causing our symptoms? Predictably, it’s our hormones.

“Breast tissue is really sensitive to hormonal changes,” advises Dr Diamandis. “In the two weeks before a period (known as the luteal phase), the levels of oestrogen and progesterone rise and fall – this timing will vary a little from one person to another. These hormones increase the size of breast ducts and milk glands as well as lymph nodes causing them to swell. These changes can cause swelling and tenderness just before your period.”

Birth control can exacerbate symptoms

Given that cyclical breast pain is linked to hormones, it’s no surprise that our contraceptive choices can also cause sore, tender boobs.

“Hormonal contraception, HRT, and other hormonal medications such as fertility treatments can also cause breast pain due to the changes in the levels of reproductive hormones that these cause,” says Dr Diamandis. “This of course varies from person to person and not everyone taking birth control experiences breast pain. If you experience breast pain on a hormonal medication, do bear in mind that these changes tend to settle after a few months (and after stopping the medication) but if you experience breast pain it’s always best to consult with your doctor.”

Non-cyclical breast pain

So, what about when we’re not about to get our period and our boobs feel painful out of the blue. Should we worry?

Not necessarily, says Dr Diamandis. “There are a number of reasons your breast might become painful and sore. Cysts, pregnancy, infections such as mastitis and breast abscesses, musculoskeletal injuries, medications, menopause and, less commonly, breast cancer may all cause pain or tenderness, so it’s important to be aware of any changes.”

With research showing that 80% of us are wearing the wrong bra, pain could be a simple case of lacking the correct support. If a rogue underwire is digging into breast tissue, it can cause discomfort, while anyone who has tried to run upstairs bra-less will recognise the importance of a well-fitting and supportive sports bra.

Although it’s easy to go down a dark rabbit warren of unhelpful thoughts, pain isn’t usually the first sign of breast cancer. However, if the pain is accompanied by breast changes, such as a breast lump, nipple discharge, redness, thickening or dimpling of the skin (resembling orange peel) or if you have a family history of breast cancer, always see your GP as a matter of urgency.

Additionally, if your pain is caused by a cyst, infection or mastitis, the chances are you’ll feel pretty unwell in yourself too – mastitis symptoms include redness and heat in the breast, along with flu-like symptoms, and should be checked out by a GP. 

How can we ease our symptoms?

It’s fairly straightforward to treat breast soreness, but if it’s adversely impacting your quality of life, sleep or is lasting more than a couple of weeks, you should seek medical advice.

“Treatment for breast pain really depends on the cause and I like to use a holistic approach with my patients,” says Dr Diamandis. “It’s important to take into account someone’s clinical history and examination as well lifestyle factors such as stress management, hormonal medications and diet. You should always consult your doctor if you are experiencing breast pain, specifically if your pain lasts more than one to two weeks, is worsening over time, is severe or affecting your sleep or daily life or is not relieved by painkillers.”

Simple over-the-counter medication will help in the majority of cases (paracetamol or ibuprofen), while a topical anti-inflammatory such as ibuprofen cream can help with cyclical breast pain.

Keeping boobs well-supported is also key: you may find that wearing a supportive bra day and night for the week leading up to your period can help, while some people like to sleep in a soft sleep bra too.

If you’re still not sure what’s causing your breast pain, it can be helpful to keep a diary of any symptoms for a couple of months to see if a pattern emerges. 

Images: Getty