Mastodynia, causes and solutions to relieve breast pain

Mastalgia, also known as breast pain or mastodynia, is frequently encountered in women. It can be mild or severe, and may occur occasionally or persistently. It is one of the most common reasons for a gynaecological consultation.

In medicine, mastalgia is described as unilateral when only one breast is affected, and bilateral when the pain affects both breasts simultaneously. The bilateral form is generally hormonal in origin, while the unilateral form warrants closer attention to rule out a local cause.

Mastalgia is not a disease in itself, but a symptom that can have many origins. In more than 90% of cases, it is benign and does not require specific medical management beyond pain relief.

Mastalgia encompasses all pain in the breast area and can be divided into two categories:

• Cyclic mastalgia (linked to the menstrual cycle): This refers to breast pain that typically occurs a few days before and during menstruation. It recurs from one cycle to the next over several months. The pain may radiate to the armpit and be accompanied by a feeling of breast swelling, as well as other symptoms associated with premenstrual syndrome.

Pain typically occurs 2 to 10 days before menstruation and disappears spontaneously when it begins.

• Non-cyclic mastalgia: This covers acute pain (linked to a breast abscess, mastitis, etc.) or chronic pain (linked to cystic conditions, for example).

It can occur at any point in the cycle and may persist after menopause. Its management requires a medical assessment to identify the exact cause.

Mastalgia manifests very differently from one woman to another. The most common signs are:

• Feeling of heaviness or swelling in the breasts
• Breast tension — the breasts feel "too full"
• Hypersensitivity to touch — even the contact of clothing or a bra becomes painful
• Shooting or stabbing pain in one or both breasts
• Burning sensation or tingling
• Pain sometimes radiating towards the armpit or arm

These symptoms are often part of a premenstrual syndrome (PMS) picture, accompanied by abdominal cramps, water retention, fatigue, or irritability.

In medicine, breast pain affecting one or both breasts is also referred to as 'mastalgia'. This pain can take different forms and have various origins. Here you will find its main causes and the steps to take in the event of breast pain.

Mastalgia refers to breast pain. Generally, this discomfort occurs as your period approaches and/or during your period. This breast pain is generally benign.

One breast may be affected (unilateral mastalgia) or both (bilateral mastalgia). It is also normal to experience breast pain during pregnancy or at the start of perimenopause or menopause.

This breast discomfort is not serious; however, do not hesitate to speak to your doctor if you have any concerns. Mastalgia can take different forms and may produce several symptoms, such as:

• Tense, swollen and congested breasts (shooting pain)
• Overly swollen breasts / warm breasts
• Hypersensitivity making the slightest contact painful
• A feeling of breast tension

In women, mastalgia mainly appears a few days before menstruation. This pain is primarily caused by the hormonal fluctuations occurring at this precise point in the menstrual cycle.

These fluctuations can indeed cause varying degrees of breast congestion. Breast pain before menstruation is fairly common, and can manifest as pulling sensations or cramps. 'Hormonal mastalgia' is the medical term used to describe a situation where the affected breast becomes tense and painful during the luteal phase, then eases when menstruation begins. This phenomenon is observed in premenopausal women, who experience significant variations in oestrogen levels. This type of presentation also occurs in women taking oral contraceptives.

In this particular case, changing contraceptive pill is generally recommended. However, this can also be a sign of oestrogen dominance, in which case it will be important to explore the underlying causes and support the elimination of circulating oestrogens with actives such as Broccoli DIM.

The main cause of mastalgia is the imbalance between oestrogens and progesterone during the menstrual cycle. After ovulation, the breasts naturally increase in size under the influence of oestrogens. If progesterone does not sufficiently counterbalance this effect, breast congestion becomes uncomfortable.

• Oestrogen: It can cause increased breast sensitivity. An excess of oestrogen can trigger an increase in breast tissue, making the breasts more sensitive and sometimes painful.
• Progesterone: If this hormone is not produced at the right time in the menstrual cycle, the balance with oestrogen is disrupted. A low level of progesterone relative to oestrogen can also contribute to mastalgia, particularly in the second half of the menstrual cycle.

Hormonal mastalgia describes a situation where the breast is tense and painful during the luteal phase and eases with the onset of menstruation. This phenomenon is observed in perimenopausal women and in those using oral contraception.

Other hormones may also play a role, such as prolactin, involved in breast milk production, which, when produced in excess (outside of pregnancy and breastfeeding), can also cause breast pain. Situations such as premenstrual syndrome (PMS) or conditions such as the hormonal imbalance associated with polycystic ovary syndrome (PCOS) can also influence the onset of breast pain through their impact on overall hormonal balance.

An excess of circulating oestrogens, known as oestrogen dominance, is a frequent cause of recurrent and intense mastalgia. This imbalance can be encouraged by chronic stress, a pro-inflammatory diet, exposure to endocrine disruptors, or insufficient liver detoxification of oestrogens.

Beyond hormonal imbalances, other factors can be at the origin of mastalgia in some women:

• Fibrocystic breast disease: This involves fibrocystic changes in the breasts. This fairly common condition is characterised by the presence of cysts (small pockets of fluid) and denser tissue in the breasts. These changes can cause pain and tenderness, particularly in relation to the menstrual cycle.
• Infections and inflammation: Breast infections, such as mastitis (often associated with breastfeeding), can cause pain. Even without infection, inflammation in the breasts can also be painful.
• Trauma and injury: A blow, an injury, or even previous breast surgery can cause persistent pain, sometimes long after apparent recovery.
• Certain medications: Some medications, particularly those influencing hormonal levels such as contraceptive pills, hormone replacement therapies, and even certain antidepressants, can have breast pain as a side effect.
• Breast conditions: Although mastalgia is rarely a symptom of breast cancer, certain benign (non-cancerous) breast conditions, such as cysts and fibroadenomas (benign solid tumours), can cause pain.

Identifying the exact cause of mastalgia may require a medical examination, as breast pain can be a symptom of various conditions. An assessment by a healthcare professional is therefore important to determine the source of the problem and recommend the most appropriate management.

• Hormonal contraception: the pill, the implant, or the hormonal coil can trigger or worsen mastalgia. A change in dosage or contraceptive method often resolves the problem.
• Pregnancy: breast tension is often one of the very first signs of pregnancy, even before a missed period.
• Menopause and perimenopause: the significant hormonal fluctuations of this period can trigger or worsen breast pain.
• Breast cyst: a benign fluid-filled pocket in the breast can cause localised pain, particularly if it grows.
• Mastitis: a breast infection, common in breastfeeding women, causes intense pain accompanied by redness and fever.
• Extra-mammary pain: some pain believed to be breast pain actually originates from the intercostal muscles, ribs, or back (intercostal neuralgia, Cyriax syndrome). It is often aggravated by movement or deep breathing.
• Large breasts: the tension exerted by the weight of the breasts on Cooper's ligaments can cause diffuse pain.

Evening primrose oil, from this beautiful yellow flower, is also known as 'evening primrose'. It is rich in gamma-linolenic acids and is particularly suited to women who are deficient and experience premenstrual syndrome. It acts effectively on breast congestion that makes the breasts hypersensitive. To be incorporated as a course of supplementation according to usage recommendations.

After your shower, massage your breasts with the plant-based oil of your choice, or with the Cycles Heureux Body Serum, developed specifically to relieve breast discomfort (suitable for pregnant women). This encourages lymphatic flow, which helps cleanse the body -- good circulation is essential for protection against infection. Self-massage also relieves tender, swollen breasts and stimulates blood circulation. In practice, gently draw small circles in a figure-of-eight motion around both breasts, then use both hands flat to soothe them.

Adjusting your diet according to your menstrual cycle is an excellent habit, particularly if you experience breast pain. The right foods help to smooth out hormonal peaks, which are responsible for the pain, and prevent water retention that causes additional swelling. To do this, replace processed meats, sweet foods (only dark chocolate is permitted, and in moderation), and other fatty or overly salty processed products with foods rich in essential fatty acids such as fish, green vegetables, and wholegrains.

Where possible, replace caffeine -- a vasoconstrictor that narrows blood vessels and increases breast pain -- with green tea, cherry stem infusions, or mate, which are better alternatives. Consumption of beer or soya may potentially intensify breast pain and oestrogen dominance.

Draining agents: Ginkgo biloba, Centella asiatica

Hormonal modulators: Yam, Evening primrose

Relaxing actives: Arnica, Magnesium

Anti-inflammatory actives: Liquorice extract, turmeric

This is the question the vast majority of concerned women ask, and the answer is reassuring: mastalgia is rarely a sign of breast cancer. Most breast cancers are painless, particularly in their early stages.

During a consultation, your doctor or gynaecologist will first carry out a clinical examination: palpation of both breasts and armpits, questions about whether the pain is cyclic or not, its location, intensity, and aggravating factors.

Based on the results of the clinical examination, they may prescribe additional tests:

• Breast ultrasound: a first-line examination, particularly suited to younger women with dense breasts. It allows visualisation of cysts and benign masses.
• Mammography: recommended for women over 40 or in cases of clinical suspicion.
• Hormone panel: measurement of oestrogens, progesterone, and sometimes prolactin, to explore an underlying hormonal imbalance.

To help relieve breast discomfort, the Cycles Heureux Body Massage Serum is specially suited to women experiencing menstrual discomfort, targeting particularly sensitive and tense areas (breasts, abdomen, and heavy legs). Thanks to its gentle formula and its richness in decongesting, draining, and soothing actives (liposomal Yam, magnesium, arnica, ginkgo biloba), it provides relief to sensitive areas when applied or used in a localised massage.

To support your comfort and feminine wellbeing, discover the Duo Feel Good Pack, made up of two natural food supplements, free from phytohormones and specifically developed to support physical and mental comfort during periods of hormonal variation (mood swings, fatigue, irritability, stress, cravings, menstrual discomfort...).