Non-cyclic breast pain
Non-cyclic breast pain is pain in the breast and/or nipple that is not related to your period and that doesn’t have any particular pattern. About a third of women who have breast pain have the non-cyclic kind.
How will you feel if you have non-cyclic sore breasts?
- The pain may be continuous or may come and go.
- The pain may be felt in both breasts, one breast or even a specific part of one breast.
- Pain may extend into the armpit and down the arm.
- The pain may be described as burning, aching, drawing or pulling, or as heaviness in the breast.
Causes of non-cyclic breast pain
The source of the pain may be from within the breast itself or from structures close to the breast.
Pain from the breast
- Puberty: During puberty, breast pain may occur in both boys and girls, due to hormonal changes.
- Breast feeding,
- Breast cysts: A cyst is a localized collection of fluid. Pressure from the cyst pressing on surrounding tissues and nerves may lead to pain.
- Infections of the breast (mastitis): Mastitis may occur during breast-feeding (breast-feeding mastitis), or at other times. If you have mastitis, you may experience the following symptoms:
- Pain in the breast,
- Redness of the skin,
- Warmth in the breast,
- Breast swelling,
- Body aches,
- Extreme tiredness, or
- Fever and chills.
- Breast abscess: This is a collection of pus in the breast and is usually a result of infection. You may experience the following:
- A painful, mobile lump in the breast (if the abscess is very deep within the breast, you may not be able to feel it),
- Pus draining from the nipple, or
- Fever and other symptoms that have not improved 72 hours after starting treatment for mastitis.
- Tumors of the breast: Non-cancerous growths in the breast may cause pain due to compression. The most common non-cancerous growth is fibroadenoma.
- Shingles may cause breast pain before the rash appears.
- Previous breast surgery: This may leave scar tissue that causes persistent pain.
Pain from outside the breast
- Tietz’s syndrome: This causes inflammation of the joints where the ribs meet the breastbone (costochondral junction). Pain is felt deep within the breast.
- Gastro-esophageal reflux disease (GERD): Acid that is regurgitated back into the lower esophagus (food tube) from the stomach can cause pain that may be felt in the breast.
- Arthritis of the spine
- Hiatus hernia
- Nerve entrapment syndromes, such as carpal tunnel or cervical rib, where the nerve is compressed against bone leading to persistent pain.
- Chest infection
Sore breasts in pregnancy
Many women will complain of discomfort in the breasts when they are pregnant. It is possible to start feeling pain, tingling or swelling in the breasts even before you confirm that you are pregnant.
I’m pregnant. Why are my breasts sore?
When you are pregnant, a lot of hormonal changes take place in your body. You produce large amounts of estrogen and progesterone. This is similar to what happens between ovulation and your period. The difference is that in pregnancy the hormone levels are much, much higher. This helps to prepare the body for pregnancy and nursing.
Changes in the breasts during pregnancy
The breasts usually get bigger, increasing by several cup sizes for some women.
The increase in size is due to:
- fat being stored in the breast,
- milk glands becoming larger and more developed, and
- blood vessels increasing in number and becoming larger. This accounts for the blue or green lines (which are actually veins) that you may see just under the skin on your breasts.
Your nipples become larger and darker, and you may also notice small bumps on the areola or flat part of the nipple; these are called Montgomery’s tubercles. You may also notice a yellowish fluid leaking from your nipples towards the end of your pregnancy; this is called colostrum or the first milk.
On the other hand, you may find that your breasts change very little during pregnancy. This does not mean that you are abnormal or that you won’t be able to breastfeed your baby. Every woman’s body is unique and different.
Breast and nipple soreness tends to be worse in the first three months (first trimester) of pregnancy, causing some women to avoid lovemaking at this time. For some women, the discomfort may appear on and off at the beginning of pregnancy, whereas for others, sore breasts may persist throughout pregnancy.
Sore breasts during breast-feeding
Sore breasts and nipples can be very alarming and may give rise to a lot of anxiety, even if you have nursed before.
The commonest causes of sore breasts
- Milk let-down reflex: In the first few days of breast feeding a new baby, you may feel pain deep inside the breast when your baby is feeding. This may be felt as a tingling, or a feeling of heaviness or pain. This is a result of the milk let-down reflex or milk ejaculation reflex. When your baby suckles, the hormone oxytocin is released. This makes the muscles lining the ducts of your breast squeeze out milk.
- Breast engorgement: In the first few days after your baby is born, your breasts may feel swollen, hot and painful. Large amounts of milk are produced to make sure the baby is well fed. Large amounts of blood flow to the breast, and the milk producing cells become enlarged. All this makes it difficult for the milk to leave the breasts. As the baby starts to nurse and the breast empties, milk production stabilizes and the engorgement subsides.
- Plugged milk ducts: Milk flows through passages in the breasts called ducts. Sometimes a duct becomes blocked and milk cannot flow freely. The skin over the affected area may or may not be red, and you may feel a lump where the milk has accumulated.
- Infection of the breast, or mastitis: This usually arises from a blocked milk duct that has not been treated. Symptoms include:
- generally feeling unwell or feeling run down,
- redness of the skin, or
- severe pain.
- You should see your healthcare provider if pain and fever lasts for more than 24 hours.
Sore Breasts and Nipples after Menopause
Sore breasts and nipples are a very common complaint in women who have gone through menopause. With the prominence given to hot flushes and night sweats in particular, sore breasts don’t get much attention. To make things worse, you may not find much information on breast and nipple soreness after menopause.
What causes sore breasts after menopause?
The exact cause is unknown, but it is most likely linked to hormonal imbalance. A large part of the progesterone in your body is produced by the corpus luteum after ovulation. When there is no ovulation and you are no longer menstruating after menopause, your body no longer gets progesterone from that particular source; in fact, your progesterone levels may be as low as 1 percent of the pre-menopausal level. In contrast, estrogen is produced in the ovaries, adrenal glands and fat cells. This means that even when you go through menopause, your estrogen levels may be as high as 50 percent of the levels before menopause.
Even though both progesterone and estrogen are reduced after menopause, there is an imbalance because progesterone levels are so low. Without a corresponding level of progesterone to oppose its action, the body is set to be in a state of estrogen dominance.