Photography by Natalie Rose Dodd. Art direction by Marta Pucci
Breast pain and the menstrual cycle
What it is and what to do about it
Top things to know
Breast/chest pain is a common premenstrual symptom, typically occurring in the 5–10 days before the start of your period
Cyclical breast/chest pain is a normal part of the menstrual cycle and usually not a cause for concern
For relief, try supportive bras, warm or cold compresses, massage, medications, herbs and supplements, diet changes, and/or meditation
How breast pain is related to the menstrual cycle
Cyclical breast/chest pain (also called mastalgia) is a common premenstrual symptom that occurs in a predictable pattern related to the menstrual cycle.
It usually happens during the luteal phase (after ovulation and before the period) and resolves once the period starts. People taking hormones for birth control, fertility treatments, management of abnormal bleeding, menopause or gender affirming hormone therapy may also experience breast/chest pain related to the changes in hormone levels in these treatments.
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How to know if your breast pain is cyclical
Cyclical breast/chest pain is typically experienced at particular times each menstrual cycle, and with specific symptoms:
Breast/chest pain experienced 5–10 days leading up to the start of a period, that goes away after the period starts (1)
Breasts/chest that feel aching, heavy, and tender, but the pain can also feel sharp or shooting (1)
Breasts/chest that feel swollen or lumpy in the days before your period starts (2)
Breast/chest pain can sometimes be severe enough to impact physical activity and sex (2). Some people also report breast/chest pain interfering with school, work, and sleep, though this is less common (2).
Science-backed remedies for breast pain
Even though cycle-related breast/chest pain is common and affects many people, there isn’t much research on how to relieve it. But here are some simple things you can try:
Bras. Wear a well-fitted and supportive bra (3,4). Most people are wearing the wrong bra size. If you can get properly fitted for a bra, this could help decrease pain, especially for people with larger breasts/chests. There are also online communities and retail companies that can help with bra sizing at home. Consider sleeping in a soft bra if breast/chest pain affects your sleep (3).
Well-being. Use warm compresses or ice packs (whichever feels better) and gentle massage (3).
Medications. For most people, taking over-the-counter pain medications such as ibuprofen (Motrin) or acetaminophen (Tylenol) is safe, and is a reasonable step to try to relieve breast/chest pain, but there is a lack of evidence to determine whether this would work any better than a placebo (5).
Supplements and herbs. Vitex agnus-castus (also known as chaste tree) is an herb that has been found to improve various premenstrual symptoms, including breast/chest swelling and pain (6-8). Some people may benefit from taking evening primrose oil (or its active component gamma-linolenic acid), Vitamin E, or the two together, but the research has provided inconsistent results (3,5,9). Powdered flaxseed may decrease the intensity and duration of cyclical breast/chest pain (6,10). One study showed that Matricaria chamomilla (chamomile) may help relieve premenstrual breast/chest pain, but more research is needed (11).
Dietary changes. Research suggests that diets higher in fat may play a role in cyclical breast/chest pain (12). Two studies have shown that decreasing fat intake in the diet may improve cyclical breast/chest pain (13,14).
Meditation and relaxation. People with breast/chest pain who practice progressive muscle relaxation (a process of tensing and relaxing your muscles) daily may have a decrease in pain (15). The use of mindfulness meditation can help improve premenstrual symptoms overall (16).
If these remedies don’t help
See your healthcare provider if the breast/chest pain is severe and does not improve with these steps. They will be able to discuss other options, such as starting or changing prescription medications (9,17).
Things that don’t appear to help
Some interventions have proved to be ineffective or inconclusive. Vitamins B1 and B6 have been studied, but don’t appear to be effective in reducing breast/chest pain (3). Decreasing caffeine has been studied, but the evidence is inconclusive (3). The use of diuretics (medications that reduce salt and water in your body) have also not been shown to work (3).
What’s the biological reason for cyclical breast pain?
The cause of cyclical breast/chest pain is likely hormonal due to its pattern in relation to the menstrual cycle, but the exact hormone (or hormones) involved is not known (3). Some theories include excess estrogen or prolactin, or deficient progesterone during the luteal phase, but studies have had conflicting results (3). Still, cyclical breast/chest pain is a common experience after ovulation (18).
Other theories about the cause of cyclical breast/chest pain include fluid retention and lipid (fat) metabolism (3). Swollen milk ducts have also been found in people experiencing both cyclical and non-cyclical breast/chest pain (19).
Breast/chest pain is common
While this likely won’t fix the discomfort you may be feeling, it sometimes is reassuring to know that many other people are dealing with the same thing, and that it is part of your body’s normal pattern of changes over the cycle.
Cyclical breast/chest changes that include pain, tenderness, and swelling affect about 7 out of 10 premenopausal people (2,20). Many people worry that breast/chest pain means they have breast cancer, but breast/chest pain alone—particularly when it is cyclical—is not a common symptom of cancer.
If breast/chest pain is worrying you, going to see a healthcare provider for an exam and more information may help relieve the anxiety and maybe even some of the pain (21).
What else should I know?
Pain that is not cyclical (meaning that it’s not related to the menstrual cycle or doesn’t go away) could be due to something in the breast or rib cage like inflammation, infection, or injury, or could be a sign of cancer (17). Non-cyclical breast pain that is persistently in one spot—especially if there is also a breast/chest lump—should always be evaluated by a healthcare provider (17).
Breast/chest pain can also be a sign of early pregnancy. If it’s possible that you’re pregnant, your breasts/chest may be tender and your period could be late. Taking a pregnancy test could be a good idea.
Download Clue to track breast/chest pain and your cycle so that you can better plan for and manage your symptoms.
