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Why Does Endometriosis Contribute To Breast Pain?

Posted on April 25, 2022
Medically reviewed by
Dan Martin, M.D.
Article written by
Alicia Adams

Breast pain or breast tenderness (also called mastalgia or mastodynia) is a common complaint among many MyEndometriosisTeam members. “My boobs hurt so much!” wrote one member. “Does anyone else suffer breast pain?” Another member said, “I am suffering from really painful and sore breasts — it makes wearing a bra difficult.” A third member stated that their breast pain was interfering with their sleep: “My breasts hurt often during ovulation and my period. I can’t even sleep properly sometimes.”

The causes of breast pain generally fall under three categories: changes in hormonal balance, menstruation, and medication.

Changes in Hormone Balance

Two hormones produced by the ovaries, estrogen and progesterone, help direct changes in the endometrium (lining of the uterus) and play a role in breast cell development. Estrogen tells the endometrial tissue to thicken to prepare for possible pregnancy, while progesterone maintains the endometrium and balances out estrogen’s effect.

When endometriosis occurs inside the ovaries, it forms fluid-filled cysts called endometriomas. These cysts can impact the production of hormones from the ovaries, which can indirectly cause breast tenderness and pain.

Menstruation

Breast pain that occurs before your menstrual period is called cyclical breast pain. Both breasts may feel heavy or achy. Swelling, lumpiness, or tightness can also occur. This pain is connected to hormonal changes that occur with the monthly menstrual cycle. Therefore, the pain and discomfort can start anywhere from just a few days to two weeks before menstruation. It can recede once your period starts.

Medication

Certain medications used to treat endometriosis can cause tenderness and pain in the breasts. For instance, progesterone (sold as Prometrium) lists breast pain as one of the side effects. Oral contraceptives such as birth control pills and other types of hormonal medication can also cause breast discomfort and pain. Medications used to suppress ovulation, like danazol (sold as Danocrine), can cause breast pain and tenderness as well.

Are There Other Causes of Breast Pain?

Breast pain associated with endometriosis can be influenced by a variety of other factors.

Fibrocystic Breasts

Fibrocystic breasts are often associated with endometriosis and can cause sore, painful, and tender breasts. The underlying breast tissue can change texture in response to hormone fluctuation and can have a bumpy or ropey feel to it.

Stress

Research has shown that stress exacerbates the symptoms of endometriosis. Breast pain that is hormone-related can increase or intensify during times of stress due to cortisol, the stress hormone. Pain itself can also be a source of stress, contributing to the cycle.

Caffeine

Caffeine has been shown to influence the hormones estrogen and cortisol, both of which are associated with breast pain. A small Duke University study found that 61 percent of people with breast pain from fibrocystic disease experienced a reduction in breast pain after dropping their caffeine intake significantly.

Tips for Managing Breast Pain

Breast pain can be managed in several ways.

Lifestyle Changes

Dietary and lifestyle changes can include:

  • Reducing or eliminating caffeine
  • Quitting smoking and other tobacco products
  • Reducing salt intake
  • Switching to a low-fat diet

Pain Medication

Over-the-counter pain medication can often help with the pain and soreness. These medications can include:

Doctor-prescribed medication, such as diclofenac sodium gel, may also help with breast discomfort. Your doctor or health care provider may prescribe other medications if the pain is severe. They may also consider adjusting hormonal therapy or birth control medication, if applicable.

Hot or Cold Therapy

Applying heat or cold with heating pads, ice packs, and moist warm or cold compresses may help relieve breast pain.

Heat application is a popular way to manage pain, according to MyEndometrosisTeam members. One member said, “A heating pad is the only thing that works for me.” Another member wrote that instead of a heating pad, they have “a hot water bottle with a fluffy cover.”

Other members shared that they have several heating pads at home and at work since they are effective at controlling the pain. As one member said, “I have two heating pads that are electric and several microwavable ones.”

A Properly Fitted Bra

Wearing a supportive bra can also help in managing breast pain. Because your breasts may change size and shape over the course of your lifetime, it is important to get fitted for a bra regularly to ensure the proper size and support.

When To Call Your Doctor

If you notice any of the following changes in your breasts, it might be a good idea to make an appointment with your doctor or health care provider:

  • Persistent, specific areas of continuing or worsening breast pain
  • Thickening or firmness of breast tissue in a new area of the breast
  • An area or lump that has been examined before showing signs of change
  • Redness, swelling, or discharge from nipples

Talk With Others Who Understand

MyEndometriosisTeam is the social network for people with endometriosis and their loved ones. On MyEndometriosisTeam, more than 125,000 members come together to ask questions, give advice, and share their stories with others who understand life with endometriosis.

Are you living with endometriosis and breast pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Pain in Endometriosis — Frontiers in Cellular Neuroscience
  2. Mammary Gland Development — Wiley Interdisciplinary Reviews. Developmental Biology.
  3. Mastodynia — StatPearls
  4. Progesterone and Estrogen Signaling In the Endometrium: What Goes Wrong in Endometriosis? — International Journal of Molecular Sciences
  5. Hormone Therapy for Menopause Symptoms — Cleveland Clinic
  6. Deep Ovarian Endometriosis (Endometriomas) — Brigham and Women’s Hospital
  7. Ovarian Cyst — Cedars-Sinai
  8. Breast Pain — BMJ Clinical Evidence
  9. Breast Pain — Mayo Clinic
  10. Treating Endometriosis — The Women’s
  11. Trolamine Salicylate — RxList
  12. Contraception and Endometriosis: Challenges, Efficacy, and Therapeutic Importance — Open Access Journal of Contraception
  13. Fibrocystic Breasts — Mayo Clinic
  14. Prevalence Of Fibrocystic Disease of Breast in Patients With Endometriosis — Ginecología y Obstetricia de México
  15. What Is Cyclical Breast Pain? — Johns Hopkins Medicine
  16. NIH Study Shows Caffeine Consumption Linked to Estrogen Changes — National Institutes of Health
  17. Cortisol Responses to Mental Stress, Exercise, and Meals Following Caffeine Intake in Men and Women — Pharmacology, Biochemistry, and Behavior
  18. Caffeine Restriction as Initial Treatment for Breast Pain — The Nurse Practitioner
  19. Trolamine Salicylate Skin Cream — Cleveland Clinic
  20. Highlights of Prescribing Information: Voltaren Gel — U.S. Food and Drug Administration
  21. Breast Pain: Fitting Your Bra — MyHealth.Alberta.Ca
  22. Optimising Breast Support in Female Patients Through Correct Bra Fit. A Cross-Sectional Study — Journal of Science and Medicine in Sport
  23. Breast Pain (Mastalgia) — Cleveland Clinic

All updates must be accompanied by text or a picture.
Dan Martin, M.D. is the scientific and medical director of the Endometriosis Foundation of America. Learn more about him here.
Alicia Adams is a graduate of Ohio State University and worked at their medical research facilities supporting oncology physicians and investigators. Learn more about her here.

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