Updated February 3, 2016
Breast tenderness. Ouch. You may experience it just occasionally, be bothered for a few days each month before your period, or you may feel tortured by aching breasts for weeks at a time. Many women tell me their breasts are so achy and swollen that sometimes they are too painful to fit them into their bra. For some, breast pain interferes with sex, work, or school.
While painful breasts are super common – almost half of all women experience them, with over 20% describing severe symptoms – breast tenderness is not just a normal part of being a girl. Your breasts are telling you it’s time to do some health fine-tuning. And that’s what we’re going to do together through this article!
But First Some Definitions: Types of Breast Tenderness: Cyclic and Non-Cyclic
Most of us experience cyclical breast tenderness at one time or another. It is typically generalized throughout both breasts, associated with your period, and may start somewhere after mid-cycle or the week before your period, and usually goes away when your period starts. Gynecologists consider a minor amount of cyclic breast tenderness normal and just related to cyclic hormonal changes.
A third of women experience non-cyclical breast pain – it may be persistent throughout the month and is usually localized to one area of the breast. This can be caused by hormonal imbalances, pregnancy, large breasts, hormone replacement therapy, other medications including antidepressants, mastitis or local infection, cysts, and is very rarely caused by breast cancer.
Women with fibrocystic breasts (breasts that are naturally more lumpy and bumpy due to more fibrous tissue) may experience more breast tenderness.
The Scary Stuff: Is it Cancer?
Ok, let’s get the scary stuff outta’ the way right up front so you can pay attention to the rest of this article without worry. Or you can take action if needed.
I’m a girl, too. We worry that any breast lump or pain is breast cancer until proven otherwise. Rest easy, ladies: Good news first: Cyclic, generalized breast pain is basically never due to breast cancer. And that’s the type that most of us get. Localized, non-cyclic breast pain is also rarely due to cancer.
Inhale. Now sigh of relief.
Not so good news: Some breast pain can be due to cancer. Though this is rare, especially when not associated with an abnormal breast exam, it can happen, so don’t skip this section. Scary breast pain symptoms that could mean breast cancer include breast pain associated with a rapidly progressing tender, firm, enlarged breast. The skin over the breast may be warm and feel thick, with an orange peel appearance. If you have any sudden and new breast symptoms or pain in one local area, go ahead and see your doctor – unless you are breastfeeding and you know it’s mastitis. With mastitis, you usually feel flu-y and may have a fever – sometimes a doctor is needed, but most often, home treatments do the trick (see my books The Natural Pregnancy Book and Natural Health After Birth).
If you do go to your doctor, make sure an actual physical exam is done. It’s not enough for a doctor to say, “Oh, you’re young and low risk so don’t worry about it.” No ma’am. Make sure you ladies get a thorough, proper inspection and proper testing and referrals are done. An ultrasound should be done if there is localized breast pain, and if there were a lump plus pain, a mammogram would be appropriate for many women over 35.
What’s a Girl to Do About Breast Tenderness?
Whether you have cyclic or persistent breast discomfort, take care of the common things first. If you have large, pendulous breasts make sure your bra fits properly and gives you the excellent support you deserve. Most women wear poorly fitting bras. Yes, good bras are expensive, but can save yourself years of breast, back, and neck pain – even headaches! And those have a cost, too.
Take stock of any medications that might be causing your breast pain and switch to natural alternatives if possible. An ultrasound can tell you if you have a cyst. The treatments below can also help clear up breast cysts. Sometimes additional hot compresses are needed over the cyst. Compresses (warm or cool) can be helpful for breast pain in general, but like Tylenol and ibuprofen (i.e., Motrin), provide only symptomatic relief.
For most of us, breast tenderness is due to hormonal imbalances – specifically, estrogen dominance. Estrogen causes breast tissue to grow. It is also inflammatory. Getting to the root cause of estrogen dominance can help you say goodbye to breast tenderness forever!
Common causes of estrogen dominance include:
- Excess body fat (> 28%) because body fat produces more estrogen
- Stress, because the adrenal system also controls our women’s hormones
- Poor elimination with constipation and inadequate dietary fiber because you don’t get rid of estrogen
- Decreased liver detoxification of hormones because you don’t detoxify estrogen
- Environmental exposures leading you to absorb too much
- Nutrient insufficiencies which can impair detox and elimination
Additionally, many of us, due to environmental toxins, insulin resistance, and stress, have a higher rate of chemicals called inflammatory cytokines circulating in our bodies. These can increase breast tenderness cyclically and non-cyclically.
While the role of diet and lifestyle changes in treating breast discomfort remain medically “unproven,” numerous women report relief using some or all of the suggestions below – and most integrative doctors recommend these based on seeing reliable results. We know that great digestion and elimination are key factors in getting your hormones in balance. I know this may be obvious, but if you’re a smoker, it’s important to quit. I also know this is easier said than done, but nicotine use is associated with increased breast pain through its effects on a chemical in your body called epinephrine. Cigarette smoking also increases your risk of cervical cancer.
Here are the top 7 strategies that I use in my practice and trust enough to share with my own daughters!
If you follow them closely, you can generally expect to see improvements in 2-3 months.
1. Reduce excess estrogen exposure: Our environment is so filled with estrogens that entire populations of male fish have become female just from pharmaceutical run-off into major water systems! The list of possible estrogen sources is long. Here are simple things you can do to reduce your environmental estrogen exposure:
- Drink and eat out of glass and other non-plastic packaging only; particularly avoid soft plastics such as plastic wrapped foods and never microwave food in plastic containers. Life Factory makes excellent, affordable, and durable water bottles that are easy to carry around and hold hot beverages, too.
- Eat organic, especially your meats, dairy, and the “dirty dozen“.
- Preferably, eliminate dairy for 3 months and see if this helps. If it does, keep it pretty much out of your diet. Many of my patients have told me it really helps.
- Avoid pesticide and herbicide exposures, for example when gardening.
- Replace strong estrogens with weaker ones by eating phytoestrogen-rich plants including traditional soy foods (see my soy blog) and other legumes daily.
- Avoid estrogen-based birth control when possible.
- Flax seeds are an excellent source of phytoestrogens – remember, they replace strong estrogens with weaker ones that don’t stimulate your breasts as much and also help with constipation so I ask all of my patients with breast tenderness to include 2 TBS of freshly ground flax seeds in their diets every day. Flax seeds can be ground in your blender, a week’s worth at a time, and stored in the fridge in an airtight container. Added to smoothies, vegetable or fruit salads, or even over whole grains, they taste nutty and delicious. Don’t cook your flax seeds.
- Take Vitex (chasteberry, Vitex agnus castus): While vitex does not actually play a role in estrogen metabolism, several studies have shown that this herb does reduce PMS symptoms, including breast tenderness. The dose in Mastodynon, a popular European product that contains vitex and some homeopathic ingredients as well, is 32.4 mg of vitex/day. Most herbal practitioners recommend 5 mL of the liquid extract daily. Interestingly, there are anecdotal reports on the Internet of women reporting increased breast tenderness on vitex – so try it for 1 month and if your symptoms worsen at all, discontinue use.
2. Get your liver detox system revved up: The liver is your body’s main site for detoxifying estrogen and getting the excess or used up forms ready for elimination. A lot of us have sluggish liver detox systems – but we can get ours revved up with diet and a few herbs and supplements. Here’s how to make your liver work better for you:
- Eat your greens – kale, collards, broccoli, Brussels sprouts, broccoli sprouts. These contain chemical compounds that help to detoxify estrogen, and the fiber helps you to clear it out of your body before it can be reabsorbed (yup, this can happen).
- Take bitter herbs that support the liver’s ability to detoxify. My top choices are extracts of Artichoke (Cynara scolymus),Dandelion root (Taraxacum officinalis), Turmeric (Curcuma longa), Milk thistle (Silybum marianum), and Greater celandine
(Chelidonium majus). Liver Health by Herb Pharm and Liver Cleanse by Gaia Herbs are specific compounds that include some of these herbs, and others than can be helpful. I usually recommend using 1-2 times daily for up to three months. Talk with your doctor before using if you have liver disease.
3. Keep your digestive system in top functioning: This means having 1-2 healthy BMs daily – not too hard, not too soft, and keeping your gut flora healthy with probiotics. Excess estrogen is eliminated through your digestive system – that is, you poop out the extra. And it is special bacteria and enzymes in your gut that help this to happen. Probiotics can help provide these. Women who eliminate daily have much less breast tenderness than those who only go a few times or less per week.
- Take a daily dose of freshly ground flaxseed as described above – flax contains lignans that help with hormone elimination.
- Eat plenty of fiber. This not only keeps your bowels moving, but also helps eliminate excess hormones. And check this out: Flax and leafy greens are high in fiber!
- Magnesium citrate: Take from 120-1200 mg daily to achieve a soft but firm bowel movement daily.
- Take a probiotic daily and eat fermented foods such as sauerkraut and miso to keep gut flora healthy.
4. Reduce inflammation: Inflammation causes pain and swelling. Reducing the amount of inflammatory hormones you have hanging out in your system can help to reduce breast tenderness for many women. Here’s how to do it:
- Eat less animal protein – Vegetarian sources of protein are less pro-inflammatory than most meat. Fish is also low inflammatory – just make sure to eat varieties that are low in mercury.
- Eat good quality fats: Poor quality oils, and oils that are rancid, increase your inflammation. Stick to olive oil, walnut oil, and coconut oil for cooking, and use these and flaxseed oil raw for dressing salads, grains, and vegetables.
- Eat less sugar: Sugar creates inflammation and inflammation wreaks all kinds of havoc in your system. I know it’s tough, but you can do it – and you’ll feel so much better!
- Evening primrose oil: While the data on evening primrose oil and breast tenderness has yielded mixed results, many practitioners find it helps a great deal. Consider Omega Woman by Nordic Naturals.
- Vitamin E in the form of d-alpha tocopherol: 600 units daily helps many women with cyclic breast pain. I generally recommend trying this dose for 3 months
5. Drink water (That is ditch the coffee and 86 the Alcohol): I’m not saying all caffeine is bad for you, but many women are super-sensitive to its hormone disrupting and stress increasing effects. Even a couple of cups of coffee a week are enough to knock some women off kilter. Try green tea instead; it seems to interfere less with hormone balance and is a healthy choice. Or you may need to eliminate caffeine altogether. Try for 2-3 months and see if you notice a difference. Or drink water with lemon. It’s delicious and taken first thing in the morning, may actually help your body eliminate excess hormones! Alcohol increases estrogen and is one of the few dietary factors directly associated with breast cancer. Reduction in alcohol can reduce estrogen-related breast pain and your breast cancer risk at the same time!
6. Increase dietary iodine: Iodine deficiency is on the rise and may contribute to fibrocystic breasts. If your breasts are generally lumpy and tender, make sure to include seaweeds, and check to make sure that your multivitamin supplement contains iodine.
7. Take stock spiritually/Pay attention to “Body Speak”: Our bodies provide an amazing amount of mirroring for what is going on in our emotional lives. What’s your body telling you? Are you struggling with a relationship? With issues at work? Are you more stressed or tired than usual? Are you taking care of yourself? Exercising? Eating well? See if a little bit of introspection gives you any insights into whether and what your body is telling you – and what you need to change. And find ways to reduce stress. Take some time to nourish your breasts directly – really. Rub them firmly with a pleasantly scented massage oil or with soapy hands while taking a bath or shower several times each week. Massaging your breasts can facilitate drainage of the lymph glands, can reduce pain and engorgement, and is an important part of nurturing your body.
I hope these suggestions lead you to experience relief from breast pain – as it has others who have followed them.
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