What is mastalgia?
Mastalgia encompasses various sensations, including:
- Heaviness
- Tightness
- Discomfort
- Burning
The pain may be felt in one or both breasts, and its intensity can range from mild to severe.
Types of Mastalgia?
- Cyclical Mastalgia: Linked to hormonal fluctuations during the menstrual cycle.
- Non-Cyclical Mastalgia: Unrelated to the menstrual cycle, with various potential causes.
Occasionally, pain may seem to originate from the breast but is coming from the chest wall – this is called extramammary mastalgia.
What causes breast pain?
Several factors can contribute to breast pain:
- Hormones: Fluctuating hormone levels, particularly in relation to the menstrual cycle. For many women, these symptoms will stop during pregnancy, breastfeeding, or at the onset of menopause.
- Trauma or Injury: Previous breast surgery or injury can lead to ongoing pain.
- Inflammation & Infection: Conditions like mastitis (inflammation of milk ducts) or breast abscess can cause acute breast pain.
- Medications: Certain medications, including hormonal contraceptives, antidepressants, and antihistamines, may list breast pain as a side effect.
Causes of Mastalgia
Cyclic Mastalgia
This type of breast pain is linked to the menstrual cycle. Symptoms usually start a couple of weeks before your period and get better once the period begins. We don’t fully understand the exact cause, but it’s thought to be related to hormonal changes that affect breast tissue. Other things like caffeine, low iodine levels, dietary fat, and smoking might play a role, but we’re not sure if they directly cause it. Sometimes it goes away on its own within 3 months or after a big hormonal change like pregnancy or menopause. Even when it resolves on its own many people report this pain often returns within 1-2 years.
Breast cyst
This is a fluid-filled lump in the breast. They’re common in women of all ages, before, during, and after menopause. Cysts do not always cause pain, but if they grow quickly, they can cause sudden, sharp pain. The size can change throughout the menstrual cycle, which can also cause pain.
Fibroadenoma
Fibroadenoma, is a benign (non-cancerous) breast lump. It is most common in women under thirty. Women of Afro-Caribbean descent are more likely to develop them.
Traumatic Fat Necrosis
Traumatic fat necrosis is a condition which occurs after a direct injury to the breast, like an accident or surgery. The injury causes fat to break down, leaving a lump or scar. It can also cause pain in some individuals.
Phyllodes Tumour
Phyllodes tumours are fast-growing breast lumps. Most are benign, but some can be cancerous. As they grow quickly and can often become very large, they can cause pain from increased pressure in the breast.
Duct Ectasia
Duct ectasia describes when milk ducts in the breast widen. This can then lead to inflammation (mastitis) and pain. It’s more common in women after menopause and in smokers, but the cause is not well-known.
Breast Cancer
Breast cancer is the most common female cancer. One in 10 new cancers diagnosed each year is breast cancer. Pain alone is not typically a symptom of breast cancer without other symptoms. However, it is important for all people experiencing breast pain to have a thorough assessment by their GP and/or a specialist at a minimum to rule out breast cancer as a cause of persistent pain.
Treatment for Mastalgia
The way we treat breast pain depends on what’s causing it. To find out the cause, you’ll need a careful check-up by a healthcare professional. They might examine your breasts and take pictures using ultrasound or a mammogram.
Important Note: Even though breast pain isn’t usually a sign of breast cancer, it’s important to rule that out before starting treatment for persistent breast pain.
Lifestyle Changes
Wearing a well-fitted bra during the day, more supportive bra during exercise, and a soft support bra at night may provide improved support and comfort. Some people find certain dietary changes, such as reducing caffeine, helps with breast pain. However, the evidence supporting this is not very strong.
Painkillers
Oral paracetamol and/or ibuprofen may be helpful. Creams and gels containing nonsteroidal anti-inflammatory medications are also recommended as first-line treatments.
Specialist Treatments
Other treatments can be considered by specialist breast clinics. These medications act upon hormones that affect cyclical breast pain and include danazol and tamoxifen.
Supplements
Whilst some people have reported potential benefits from supplements or herbal remedies, such as evening primrose oil, flaxseed, vitamin B6, or vitamin E, they are not recommended on a wider basis due to limited evidence.
How can medical cannabis help with mastalgia?
We know that breast pain can be really tough to live with and sometimes, the usual treatments don’t work well enough. Medical cannabis can be considered for people who have breast pain who have tried these typical treatments but are still left in pain.
We want you to feel in control of your health. If you’re curious about medical cannabis for long-term breast pain, please create an account for a free check to see if you might be eligible to see one of our specialists.
