Mastodynia - Specialists and Information on Breast Pain

Do you feel a painful pulling sensation or increased sensitivity when your breast is touched? If so, you may have mastodynia. 

Sometimes these symptoms are accompanied by a burning sensation, a stinging pain, or palpable lumps. These specific symptoms are particularly common in women between the ages of 35 and 55.

Such feelings of tension in the breast area can have many causes. The pain usually occurs shortly before or during menstruation. This is because significant hormonal fluctuations are common during the final phase of a woman’s menstrual cycle. This often leads to fluid retention in the breast tissue, which usually results in the uncomfortable swelling.

Two out of three women suffer from mastodynia @ motortion /AdobeStock

Since cyclic mastodynia usually lasts several days, it often leads to physical or psychological complications.

In addition to bouts of pain and inflammation in the breasts, women experience migraines or back pain shortly before their period. These symptoms are part of typical premenstrual syndrome.

Some women experience depression or irritability. There is marked mood instability. In addition to nervousness, a loss of motivation also sets in.

Both gynecological and entirely different triggers must be considered for the symptoms of mastodynia.

A purely gynecological risk factor for breast pain is mastopathy. This affects approximately 50 percent of all girls and women.

Mastopathy refers to a change in the breast that is not due to tissue growth. It typically involves a degenerative breakdown of the cellular tissue in the mammary glands. 

The cause lies in disruptions to hormonal balance, most often an excess of estrogen. The balance between estrogen and progesterone is disrupted, with the latter being produced in the corpus luteum and the placenta.

In addition to a progesterone deficiency, the birth control pill also has a negative effect on hormonal balance. Furthermore, a deficiency in thyroid hormones is problematic.

The diagnosis begins with a medical history. During the consultation, the gynecologist first asks about the nature of the menstrual cycle and inquires about any previous pregnancies. 

The specialist then asks about any medications you are taking, particularly the birth control pill. Finally, the doctor will likely want to know about any cases of breast cancer in your family history. Lastly, the nature and location of your breast symptoms are important.

It is helpful if you keep a monthly diary of your breast pain. This allows the doctor to identify any connection to your menstrual cycle.

During a more detailed examination, your gynecologist will palpate your breasts. At the beginning of the cycle, the breasts are normally softer and less sensitive to pain. That is why this time window is ideal for diagnosis. The specialist will also examine the lymph vessels under the collarbone and in the armpits.

Using X-rays and ultrasound, the gynecologist can detect abscesses, cysts, tumors, and dilated milk ducts. This medical technology is designed to rule out more serious conditions.

Ultrasound examination for mastodynia @ Yakobchuk Olena /AdobeStock

Various treatment methods are available for cycle-related mastodynia. These vary depending on the duration and severity of the typical symptoms. Applying a gel containing the hormone progesterone to the painful breast is usually an effective treatment.

In general, the goal is to reduce the excess estrogen at the hormonal level during the second half of the menstrual cycle. The use of an ovulation inhibitor has proven effective, particularly in younger women, and alleviates the symptoms of mastodynia.

In cases of extreme cycle-related breast pain, treatment with danazol is beneficial. Danazol is a derivative of testosterone that triggers the release of the follicle-stimulating hormone (FSH). However, it also has drawbacks that lead to androgenic effects.

For milder symptoms, herbal remedies are a good option. 

These include:

• Raw flaxseed oil
• Monk’s pepper
• Evening primrose oil
• Vitamin E

The typical symptoms of mastodynia subside quickly after the onset of menstruation. However, it is advisable to consult a gynecologist if symptoms are severe. In general, treatment with a specific progesterone gel is effective.

Cycle: a woman’s approximately four-week period (development of the egg)

Menstruation: periodic bleeding from the uterus when pregnancy does not occur

Cyclic mastodynia: recurrent breast discomfort during the second half of the menstrual cycle

Premenstrual syndrome: a complex of symptoms occurring shortly before a woman’s menstruation

Mastopathy: benign changes in the breast in women of childbearing age

Estrogen: a female sex hormone

Corpus luteum: a gland that forms regularly in the ovary, producing a yellow pigment and a sex hormone

Progesterone: a hormone produced by the corpus luteum that triggers processes during pregnancy

Medical history: The course of illnesses as reported by the patient

Lymphatic vessels: channels for fluids that support the immune system

Ovulation inhibitors: methods for preventing conception (birth control pill)

Testosterone: male sex hormone

Folicle: The sac surrounding the maturing egg

Follicular hormone: see under estrogen and follicle

FSH: Abbreviation for “follicle-stimulating hormone”

Androgenic effects: promote male sexual characteristics