Breast Pain And Menstrual Periods

1
Breast Pain And Menstrual Periods

Cyclical Breast Pain and Menstrual Cycle
Cyclical Breast Pain and Menstrual Cycle. Art © Pam Stephan

Breast pain or breast tenderness can be related to your menstrual periods. This type of breast pain comes and goes with your cycle, and is called cyclical breast pain. Your menstrual periods can vary in response to natural hormones and to birth control pills.

Noncyclical breast pain is not related to your menses, and is rarely a symptom of breast cancer. Breast pain may also be referred to as mastodynia, mastalgia, mammalgia, or mastitis.

Cyclical Breast Pain And Menstrual Periods

Cyclical breast pain happens in response to the hormonal ebb and flow of your menstrual cycle. Every month during your fertile years, your reproductive system gears up for a potential pregnancy. Estrogen levels rise to a specific point, then your pituitary gland signals the production of luteinizing hormone, and ovulation occurs. If your egg is not fertilized, then the lining of your uterus will be shed during your menses. As progesterone levels drop, breast pain or tenderness may increase until your period starts. As your menstrual period tapers off, so does your cyclical breast pain.

Your breasts are intended to make milk to nourish a baby at the end of a full-term pregnancy. Lobes and ducts respond to the monthly hormonal swings by swelling, which may partly explain cyclical breast pain. The enlargement of your milk-producing system may press against other features within your breast: cysts, fibroadenomas, nerves, ligaments and muscles. Breast skin may become more sensitive than average and your nipples may feel sore and irritated. If pregnancy interrupts your monthly cycle, your breasts will respond to a sustained progesterone level by fully maturing over the next nine months.

Birth Control Pills And Breast Pain

Birth control pills are sometimes prescribed to relieve breast pain in premenopausal women. Because we all process the hormones in these pills differently, the pill helps some women, while others feel more breast pain. The synthetic hormones in birth control pills affect your menstrual cycle as well as your breast health. Let's look at how hormone and breast pain levels are affected by the pill, by comparing the combination pill and the minipill.

How Birth Control Pills Affect Breast Pain

2
Breast Pain And Combination Birth Control Pills

Breast Pain and Combination Birth Control Pill
Breast Pain and Combination Birth Control Pill. Art © Pam Stephan

Cyclical breast pain can occur even while you're taking birth control pills. In fact, birth control pills are sometimes prescribed to help relieve breast pain, since they change the hormonal cycle. Some types of birth control pills help relieve breast pain for some women, while other women have more breast pain while on the pill. Each woman processes hormones differently, so taking a birth control pill is actually no guarantee for breast pain relief. You have to try the pill in order to find out whether or not it works for your breast pain.

Two Types of Birth Control Pills

Birth control pills use synthetic hormones to stop ovulation and change your cervical mucus, reducing the chance of a pregnancy. There are two types of birth control pills available in the United States: the combination pill and the minipill (progestin). Your risk of endometrial and ovarian cancer is lower when taking a birth control pill, but your risk of estrogen-positive breast cancer is slightly higher.

The Combination Oral Contraceptive Pill (COCP) And Breast Pain

The combination birth control pill contains two synthetic hormones: progestin and estrogen. It works by preventing ovulation. In the graph, you can see that the combination pill boosts hormone levels and maintains those levels before, during, and after the time that ovulation would normally occur. When used as prescribed, an egg is not released to your uterus, preventing the chance of conception. In this hormonal climate, breast pain can take on a couple of different patterns. Depending on how much estrogen and progesterone you normally have, your breast pain may be less than normal overall, or it may be worse than normal during menses and less than normal for the balance of your cycle.

If you are taking the minipill, also called the POP, Progestin Only Pill, your menstrual and breast pain cycles will be different from those on the combination oral contraceptive pill (COCP). Now let's look at how the minipill affects your breast pain levels.

How Minipills (Progestin Only Pills) Affect Breast Pain

3
Minipills (Progestin Only Pills) And Breast Pain

Minipills - Progestin Only Pills - Breast Pain
Minipills - Progestin Only Pills - Affect Menstrual Cycle and Breast Pain Cycle. Art © Pam Stephan

Minipills, also called POP, Progestin Only Pills, are another type of birth control pill. Unlike the combination oral contraceptive pill, which uses synthetic estrogen and progestin, minipills contain progestin only. Your natural estrogen levels may remain in their normal monthly cycle on minipills, which is why breastfeeding women may take these contraceptive pills. Estrogen signals the release of breast milk, which must be unaffected if a woman plans on breastfeeding her newborn baby. Minipills work by creating a more challenging environment for sperm -- your cervical mucus will thicken and your endometrium (the lining of your uterus) will thin out. Most sperm can't make it past these unfriendly conditions to reach the egg, if it is present. Some women don't ovulate on the minipill, and some don't even have periods -- not everybody has the same experience with this contraceptive pill. Your symptoms may smooth out after a couple of months.

The dose of progestin that the minipill contains is lower than you'll find in the combination pill. In order to work effectively, it must be taken as prescribed to maintain an even level of progesterone every day. You can see in the graph how the estrogen levels rise and fall in a normal pattern, while the progesterone levels remain constant -- induced by the minipill. Since we all react to progesterone in different ways, your levels of breast pain may be less, get worse, or remain unchanged while on the minipill.

Breastfeeding itself may cause many sensations in the breast and nipple, so if you're taking minipills while nursing a baby, it may be hard to sort out what is causing any breast pain. Consult your obstetrician if you're concerned about breast and nipple pain during breastfeeding.

Changing Your Hormone Levels Changes Your Breast Pain

Hormones that influence the menstrual cycle also affect breast pain or breast tenderness in premenopausal women. When you take synthetic hormones in birth control pills or hormone replacement therapy (HRT) your cyclical rhythms will change. Sometimes taking a contraceptive pill will help relieve breast pain and sometimes it may make the pain worse. Give yourself time to let the new cycle establish itself with the pill and keep your doctor informed of your menstrual and breast pain symptoms. Get professional help if your symptoms don't improve, or if you run into problems.

Sources:

Breast Pain; Pp. 77-85. Dr. Susan Love's Breast Book. Susan M. Love, M.D. Fifth Edition, 2010.

Breast Pain. MedlinePlus Medical Encyclopedia. National Institutes of Health. Last Updated: 12/31/2008.

Oral Contraceptives and Cancer Risk: Questions and Answers. National Cancer Institute. Reviewed: 05/04/2006.

The Menstruating Years. Pp. 17-18. Dr. Susan Love's Breast Book. Susan M. Love, M.D. Fifth Edition, 2010.

Continue Reading