Premenstrual Breast Swelling and Tenderness
Premenstrual breast swelling and tenderness
is a common concern among women. The symptom is part of a group of symptoms
called premenstrual syndrome, or PMS. Premenstrual breast swelling and
tenderness can also be a sign of fibrocystic breast disease. Fibrocystic breast
disease is a term used to describe painful, lumpy breasts prior to the
Women with this condition often notice large,
benign (noncancerous) lumps in their breasts prior to their monthly periods.
These lumps may move when pushed on, and typically shrink once your period has
PMS-related breast soreness can range in
severity. Symptoms often peak just before menstruation begins, then fade during
or immediately following a menstrual period. Most of the time, the symptoms are
more of an annoyance than a serious medical concern. Nonetheless, whenever you
are worried about changes in your breasts, consult your doctor.
Causes of Premenstrual Breast Swelling and Tenderness
Fluctuating hormone levels account for most episodes
of premenstrual breast swelling and tenderness. Your hormones rise and fall
during a normal menstrual cycle. The exact timing of the hormonal changes
varies for each woman. Estrogen causes the breast ducts to enlarge.
Progesterone production causes the milk glands to swell. Both of these events
can cause your breasts to feel sore.
Estrogen and progesterone both increase
during the second half of the cycle — days 14 to 28 in a “typical” 28-day cycle. Estrogen peaks in the middle of the
cycle, while progesterone levels rise during the week before menstruation.
Medications that contain estrogen can also
cause breast changes such as tenderness and swelling.
Symptoms of Premenstrual Breast Swelling and
Tenderness and heaviness in both breasts are
the main symptoms of premenstrual pain and swelling. A dull aching in the
breasts can also be a problem for some women. Your breast tissue could feel
dense or coarse to the touch. Symptoms tend to appear the week before your
period, and disappear almost immediately when menstrual bleeding begins. Most
women do not experience severe pain.
In some cases, breast tenderness affects the
everyday routines of some women of childbearing age, and is not necessarily
connected to the menstrual cycle.
Due to the natural change in hormone levels
that occur as a woman ages, premenstrual breast swelling and tenderness usually
improves as menopause approaches.
When to Call a Doctor
Sudden or worrisome breast changes should be
discussed with your doctor. While most premenstrual breast pain and swelling is
harmless, these symptoms could be warning signs of infection or other medical
conditions. Contact your health provider if you notice:
- new or changing breast lumps
- discharge from the nipple, especially if discharge is brown
- breast pain that interferes with your ability to sleep or perform
- unilateral lumps, or lumps that occur only in one breast
Your doctor will perform a physical examination,
including a breast exam, and will ask for more information about your symptoms.
Your doctor may ask the following questions:
- Have you noticed any discharge from the nipple?
- What other symptoms (if any) are you experiencing?
- Does breast pain and tenderness occur with each menstrual
During a breast exam, your doctor will feel
for any lumps, and will take notes about the physical qualities of the lumps. If
asked, your doctor can also show you how to properly perform a self breast exam.
If your doctor detects any abnormal changes,
they may perform a mammogram (or an ultrasound if you are under age 35). A mammogram
uses X-ray imaging to view the inside of the breast. During this test, the
breast is placed between an X-ray plate and a plastic plate and compressed, or
flattened, to create a clear image. This test may cause temporary discomfort or
a pinching sensation. In some cases, a biopsy (tissue sample from the breast
lump) may be necessary if lumps appear to be malignant (cancerous).
Treatment for Breast Swelling
Premenstrual breast pain can be treated
effectively with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs),
- naproxen sodium
These medications can also relieve cramping
associated with PMS.
Women with moderate to severe breast swelling
and discomfort should consult their doctor about the best course of treatment.
Diuretics can reduce swelling, tenderness, and water retention. However,
diuretic medications increase your urine output and can also increase your risk
of dehydration. Use such prescriptions carefully under your doctor’s direction.
Hormonal birth control, including oral
contraceptive pills, could also calm your premenstrual breast symptoms. Ask
your healthcare provider about these options if you suffer from severe breast
pain and are not interested in becoming pregnant in the near future.
Lifestyle changes can also help manage
premenstrual breast swelling and tenderness. Wear a supportive sports bra when
symptoms are at their worst. You may choose to wear the bra at night as well,
to provide extra support while you sleep.
Diet can play a role in breast pain.
Caffeine, alcohol, and foods that are high in fat and salt can increase
discomfort. Reducing or eliminating these substances from your diet in the week
or two before your period may help manage or prevent symptoms.
Certain vitamins and minerals may also help
relieve breast pain and related PMS symptoms. The U.S. Department of Health and
Human Services Office on Women’s Health recommends consuming 400
international units (IU) of vitamin E and 400 mg of
magnesium daily to help ease PMS symptoms.
Choose a variety of foods rich in these
nutrients, such as:
- corn, olive, safflower, and canola oils
- oat bran
- brown rice
Your doctor may also recommend vitamin
Self-examinations can also help monitor any
changes in breast tissue. According to the American
Cancer Society (ACS), women in their 20s and 30s
should perform breast self-exams once per month, typically after their monthly
period, when swelling and tenderness are minimal.
Exercise can also improve breast soreness,
cramps, and fatigue associated with PMS.
Premenstrual breast tenderness and swelling
is often effectively managed with home care and sometimes, medication. Discuss
your condition with your healthcare provider if lifestyle changes and
medications do not help you feel better.