The breast pain also known as mastalgia and when related to the menstrual cycle is called, mastodinia.
It is a frequent cause of medical and gynecological consultation, since the majority of the female population of childbearing age presents some type of breast pain at some point in their life.
Sometimes, it is not usually given the importance it deserves, because it is considered something normal or temporary, often related to menstruation. In other cases, since it is mild, self-medication is usually used, so a specialized assessment is not sought.
Causes of breast pain
The breast pain can be subdivided into two subgroups according to their association with menstruation or not.
The most frequent breast pain is known as "cyclical" and is the one related to menstruation, which is why it occurs regularly with the proximity of the menstrual period.
The "non-cyclical" breast pain is the one that groups together all the other causes of breast pain that are independent of the day of menstruation, and may remain constant or alleviate over time.
Its causes vary from trauma that directly impact the breast to infectious processes.
Breast pain related to the menstrual cycle
It is necessary to clarify that a mild, diffuse, bilateral and temporary breast pain is normal, during the days before the arrival of menstruation and in some cases, it is part of the so-called premenstrual syndrome.
As the second half of the menstrual cycle progresses, the pain in the breasts can intensify and disappear once menstruation begins, due to the hormonal decline of progesterone and estradiol that is physiologically produced in those days to allow menstruation.
Another cause capable of generating breast pain associated with menstruation is fibrocystic breast pathology, since, despite being a benign pathology, patients usually present pain in a cyclical manner with hormonal changes at the localized level in the different cystic formations.
Causes of non-menstrual breast pain
· Infectious processes: such as breast abscesses or mastitis (term with which inflammation of the breast is known).
· Direct trauma: any direct trauma to the breast or nipple will generate localized pain after the event that should subside within a few days.
· Pregnancy: due to the physiological hormonal changes arising from pregnancy, the breast tissue prepares for lactation.
· Lactation: it produces especially pain in the nipples, due to the sucking of the baby, since the nipple can crack or become inflamed.
· Breast surgical interventions: any previous surgery, whether by taking a biopsy, reduction or enlargement, could leave some sequelae and present pain in the breast or nipples.
· Intercostal neuritis: due to inflammation of the intercostal nerves, which can cause pain to the touch, located in the breast.
· Breast size: a large breast volume is capable of producing pain due to the weight and pressure on the muscles at the thorax level.
· Drugs: in the case of some patients, the use of oral contraceptives, ovulation inducers such as clomiphene citrate or gonadotropins, hormone replacement therapies, among others, can cause breast hypersensitivity, causing pain to the touch or rubbing.
Treatment of breast pain
First, the characteristics of the pain must be specified and complemented with the physical evaluation and questioning of the patient to define the underlying cause.
In case the pain does not subside spontaneously, there are general measures that could help you to regulate and improve the symptoms.
1. Reducing the intake of caffeine (coffee, tea, etc.) and chocolate, can be a good first step to take to reduce or prevent breast cysts that despite being benign can cause pain.
2. A diet rich in fiber and increase the consumption of seafood. Certain vitamins and minerals can also be helpful, such as vitamin A and E, by reducing and counteracting the production of new cysts and improving breast pain.
3. The consumption of flaxseed regularly, in some studies has shown favorable results for its recommendation in the management of breast pain.
4. Reduce the consumption of sugar and fat.
5. Wear a suitable bra or bra adapted to the texture and size of the breasts to prevent the mechanical effect of a bad choice from causing pain.
6. In some cases, the use of analgesics such as NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or diclofenac, may be favorable to reduce premenstrual symptoms and secondary breast pain.
7. Recommendations on the use of oral contraceptives, progestogens, antiestrogenic drugs, or others, depend on the characteristics of each patient and cannot be recommended in a general way, requiring specialized evaluation by the doctor for greater safety and efficacy of the treatment.
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