12 Reasons Your Boobs Hurt
What causes breast pain?
If your boobs hurt, your mind may jump right away to the “C” word. But chances are slim that breast pain is breast cancer.
“Breast pain alone is rarely, rarely associated with cancer,” says Monique Swain, MD, an obstetrician and gynecologist in the breast division at Henry Ford Health System in Detroit.
There are two types of breast pain: Cyclical pain is associated with your period and most often affects both breasts. Noncyclical pain is due to any other reason and doesn’t follow a monthly pattern. It can affect one or both breasts, all of the breast, or just part of it.
Most breast pain goes away on its own or can be easily treated. Talk to a doctor if the pain doesn’t go away in a week or two or if it gets in the way of normal activities. You should also contact a doctor if you have other symptoms, including a lump that’s not related to your period, discharge from your nipple, or signs of infection like redness, swelling, and warmth.
Here are some possible reasons why you have breast pain.
You're getting your period
Two-thirds of breast pain is caused by the predictable surges of estrogen and progesterone around your monthly period.
“Hormonal breast pain can happen to any woman that is menstruating,” Dr. Swain says. “It doesn’t matter if they’re 14 or 44, as long as they’re still menstruating they have the risk of having cyclic breast pain.”
You’ll usually feel period-related boob pain in both breasts at once and all over your breasts. Most people describe the pain as achy rather than sharp.
For some women, it’s enough just to know that the pain will go away, usually in a week to 10 days. Other women seek relief from over-the-counter pain medications. There is one FDA-approved prescription drug for breast pain, called danazol, but it (as well as other prescription painkillers) can have serious side effects.
Tweaking your diet may limit menstrual breast pain as well: Eating more flaxseed might help, as can sticking to a low-fat diet that’s rich in complex carbs, says Dr. Swain.
Breast tissue grows, milk ducts fill, and nipples become sensitive, says Jennifer Wu, MD, an obstetrician and gynecologist at Lenox Hill Hospital in New York City. The pain is due to “acute hormonal changes,” she says, including in human chorionic gonadotropin. “You’re going from zero HCG hormone all the way up.”
The pain is usually temporary. Take comfort knowing that the second and third trimesters will bring many more changes–and that one of them will be less or no breast pain.
Your baby’s mouth at your breast is perfectly natural, but it can also cause discomfort and pain. You may feel pain when the baby first latches onto your nipple or if his or her mouth isn’t positioned correctly. The first goes away, and the second can be fixed by repositioning the baby.
The wetness of your baby’s mouth may also cause painful chapped and cracked nipples. Talk to a doctor or lactation counselor about how to handle these symptoms, as they can lead to infections, including yeast infections.
Your boobs might also hurt when you’re breastfeeding if you have an infection in the milk ducts. If you do, “the milk ducts are very swollen,” says Dr. Wu. “They may get clogged and backed up.” Contact your doctor if pain in your breast while you’re nursing lasts more than a couple of days.
You take certain meds
Any type of medication that contains hormones–birth control, hormone therapy, some infertility treatments–can also cause breast pain just like surges of naturally occurring hormones do before your period.
But so can other types of medications. For instance, the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may cause breast pain, and chlorpromazine, an antipsychotic, can make your boobs hurt too. The reasons why aren’t entirely clear. Certain heart medications may also cause breast pain.
Talk to your doctor if a medication might be causing the problem; there could be a substitute treatment for you to try instead.
You have a cyst
Cysts are common in women 35 and over. “A cyst is a plugged or obstructed breast gland with fluid accumulation behind the obstruction,” says Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center in Houston.
Cysts are generally harmless, but they can be painful. “If [the fluid] is distending the walls of that duct, stretching tissue, it can become sensitive and very painful,” says Dr. Bevers.
Treatment depends on your age, how big the cysts are, and if they hurt or not. You may decide to do nothing or your doctor may drain the fluid to ease the pain.
You had surgery
Any kind of trauma to the breast can cause pain, including from surgery, a biopsy, an elbow to the chest, a seatbelt injury, or even rough sex.
If you sustained an injury, you’ll probably know right away why you hurt. Hopefully it’s not so serious that the pain sticks around.
After the fact, sometimes as long as two years later, an injury can cause fat necrosis, which appears as a thickening or lumpiness in the breast. By this time, you may not remember the original injury, but luckily this isn’t dangerous and doesn’t need to be treated.
You have shingles
Shingles is a later-in-life manifestation of the chickenpox virus. Anyone who had chickenpox when they were younger can develop shingles, but your boobs will only hurt with the infection if the trademark shingles rash turns up on your breasts.
“I’ll find a rash on the side of the breast and sometimes the patient didn’t even know it was there,” says Dr. Swain.
That rash can be extremely painful, with itchy blisters that burst. You might also have a fever, headaches, and sensitivity to light.
Shingles usually lasts from two to six weeks and there’s no cure (there is a shingles vaccine). Antiviral medications can help you get better faster. Your doctor might also prescribe painkillers, antidepressants, and anti-seizure drugs that can help ease nerve pain.
You strained a muscle
A strain to your pec muscle after a tough workout might feel like breast pain even though the injury is actually elsewhere. Heat and OTC pain relievers are usually enough to ease muscular pain; your doctor may recommend something stronger if the pain is more severe.
Problems with muscles are just one type of so-called “extramammary” pain, or pain that originates outside of but is felt in the breast. Other causes include pneumonia, heartburn, spinal problems, gallbladder disease, heart disease, and neck arthritis.
Of course, don’t overlook any kind of chest pain (including in your boobs) that could be a sign of a heart attack. Other symptoms of a heart attack in women can include pressure, squeezing, or tightness in the middle of your chest; shortness of breath; and pain in your arms, back, neck, jaw, or stomach. Call 911 right away if you think you’re having a heart attack.
You have big boobs
Voluptuous, pendulous boobs can cause enough of a strain that they stretch breast ligaments and tissues. This can cause pain not only in your breasts, but also possibly in your back, neck, and shoulders.
Finding the right, supportive bra can go a long way towards alleviating this type of pain. You can also try over-the-counter painkillers. For intense pain, you might consider prescription treatments like tamoxifen or danazol, but side effects can be severe.
In extreme cases, some women opt for breast reduction surgery.
You're wearing the wrong bra
An ill-fitting bra can cause pain even if you don’t have big boobs. “The majority of the time women are wearing bras that are too big,” says Dr. Swain, and a too-big bra isn’t going to support you very well.
A too-small bra isn’t much better, since it might feel restrictive and uncomfortable. If underwire makes your breast pain worse, pick one with more cushioning at the base of the breast, Dr. Swain says.
She also recommends getting fitted at a department or specialty store where you can buy a well-made bra. “Specific brands are more supportive than others,” she says.
You're nearing menopause
Women approaching the Big Change might experience a painful widening and thickening of the milk duct called duct ectasia. This causes a buildup of fluid and debris. “It can cause pain in the nipple and areola,” Dr. Swain says.
Other symptoms can include a cottage cheese-like discharge from the nipple, a nipple that is turned inward, or a lump, but some women have no symptoms of duct ectasia at all.
The condition usually takes care of itself over time (warm compresses can help in the meantime) and doesn’t change your risk of breast cancer. However, if the pain doesn’t go away, your doctor may recommend removing the duct with surgery.
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You could have inflammatory breast cancer
This is one of the few times breast cancer may actually involve pain. Inflammatory breast cancer is a rare and aggressive form of the disease that accounts for about 1% to 5% of all breast cancers.
In people with inflammatory breast cancer, the cancer cells obstruct the lymph vessels in the skin of the breast, causing redness, swelling, and inflammation over about a third of the breast. The skin may also look pitted due to the buildup of lymph fluid. Sometimes you might feel a lump, but usually not.
Inflammatory breast cancer is more common in younger women, African-American women, and obese women–and it’s usually treated with surgery, chemo, and/or radiation. Targeted therapies are also sometimes used.
Many of these symptoms could also be from an infection or injury. Don’t panic, but do get checked out.