Painful, tender or sore breasts/ nipples- causes, risk factors and solutions

sore breasts and tender painful nipplesPainful or sore breasts will occur in many women at some point in their lives – up to 70%.

Sore breasts and nipples are a common problem for many women. They can occur in women of almost any age and there are various different causes of breast pain and swollen, lumpy breasts. If you ever felt embarrassed about having severe pain in your breasts, don’t be. You’re in very good company.

Types of sore breasts

Breast pain can usually be divided into two groups:

  • Cyclical breast pain – this tends to occur every month at around the same time in your menstrual cycle
  • Non-cyclical breast pain – this type of breast pain occurs at any time and is not related to the menstrual cycle.

Causes of sore breasts and swollen nipples

Ultimately, what actually makes the breasts sore and swollen is too much water in the breast tissue. This causes the pressure and stretching of the breast tissue which causes pain. This accumulation of water, also known as water retention, also causes the bloating you may feel when you have painful swollen breasts. Any hormonal imbalance in the body will usually show itself in one way or the other. Sore breasts and nipples is one of the most common ways that the body shows that the hormones are not balanced. There a a few other reasons for tender breasts and nipples that are unrelated to hormones but these are relatively few compares to those caused by deranged hormones.

What can lead to sore breasts?

  • Pregnancy – during pregnancy you have a very high level of the hormones estrogen and progesterone. Estrogen increases the amount of breast tissue while progesterone helps to make the glands in the breast mature with some accumulation of water. This prepares the breast to manufacture food for the newborn baby. In this case, the swelling of the breasts, although it’s uncomfortable, is a good thing. Sore breasts are not cause for worry here. It’s normal for many women to have sore breasts at this stage.
  • PMS – in PMS the swelling and water retention are mostly due to hormonal imbalance – estrogen dominance. Estrogen dominance is a situation in which the levels of estrogen and progesterone are out of balance – the progesterone in your body is not enough to balance the levels of estrogen. You may have sore breasts but the discomfort will usually reduce after a few days.
  • Premenopause and menopause – before menopause, up to 15% of cycles may be anovulatory (ie no egg is released) even in women with regular cycles. As you get older, production of estrogen and progesterone in your body gradually begin to wind down and you will tend to have even more anovulatory cycles until you get to menopause. Most of the progesterone in your body is produced in the ovaries after ovulation. No ovulation means almost no progesterone. Even though you’re producing less estrogen as you go through menopause, these levels are still out of balance with the very low levels of progesterone. So you can still have estrogen dominance even if you have low estrogen levels. This leads to sore and tender breasts.
  • Imbalance in fat levels – an imbalance in the fats in your cells may make your breast tissue more sensitive to circulating hormones in the body causing breast pain.
  • Medication – drugs like oral contraceptives, drugs used for Hormone Replacement Therapy and even some antidepressants like Prozac and Zoloft.
  • Pain in the heart and chest may also be felt in the breast.
  • Very large breasts may also cause pain because of their weight. You may also feel pain in the neck and shoulders as well.
  • Breast cancer – breast pain can also be a sign of breast cancer but it is usually a late sign in advanced cases.

sore breasts, nipples, breast pain

What causes sore nipples and sore breasts?

Sore nipples and/or sore breasts are something you may experience at various times in your monthly cycle. They can mean various things depending on what’s going on in your body at that time. So let’s talk about what sore nipples and sore breasts may mean for you.

Causes before menopause

There are 2 main reasons for sore nipples/breasts before menopause:

  • Post-ovulation - During your menstrual cycle the 2 main hormones at work are:
    • estrogen before ovulation and
    • progesterone which starts to act around the time of ovulation

    Progesterone causes water to be retained in the body. The main reason for this is to prepare the uterus for a possible pregnancy by making the uterus rich in water and food for the anticipated pregnancy. Unfortunately, this same effect is felt throughout the body. Storing of water in the breast tissue causes it to become stretched leading to painful breasts and sore nipples.

    Sore breasts are much worse for some women than others. If you’ve had any trouble getting into your skinny jeans in the second half of your cycle, that’s what we’re talking about. If a pregnancy does not occur, progesterone levels start to fall about a week before your next period. Gradually, you pee out the water that your body has stored.

  • Pregnancy – If the egg that is released from the ovary during ovulation is fertilized and starts to grow in the womb, then progesterone and estrogen levels will continue to increase to sustain the pregnancy. Of course this means that the breast tenderness will get worse. I had a comment in a previous article about menopause symptoms:

    I actually have a question. I’m 44 and ttc. My nipples are sore and I ovulated 2 days ago. Is this a post-ovulation symptom? I really need to know so I don’t get my hopes up. Thank you for your reply.

    If you start having sore breasts and nipples a few days after ovulation, you can’t assume that you’re pregnant. A good sign (if you’re trying to conceive that is!) is if the breast discomfort does not subside and the breasts continue to increase in size and your period is 7-10 days late. You still need to be a bit careful because, although pregnancy is the commonest cause of a missed period, there are other causes including extreme stress and perimenopausal changes.

Causes of sore nipples and painful breasts – menopause and sore breasts

Sore breasts and nipples can occur as part of what is known as the climacteric syndrome. Symptoms of the climacteric syndrome include:

  • hot flashes,
  • sleeplessness,
  • weight gain and bloating,
  • mood changes,
  • irregular menstruation,
  • painful breasts
  • headaches

The climacteric syndrome is caused by wildly fluctuating hormone levels and irregular functioning of the ovaries.

How can you relieve breast pain

  • If you’re pregnant, wear a good bra that gives your breasts plenty of support and eat a healthy, balanced diet.
  • If you have PMS, are premenopausal or menopausal:
    • Use natural progesterone cream – natural (bioidentical) progesterone cream balances the estrogen effects in the body and so helps to reduce water retention and bloating as well as sore breasts. However, using too much can cause the very symptoms you’re trying to relieve.
    • Use evening primrose oil or borage oil – these help to normalize the fat levels in your tissues making them less sensitive to circulating hormones
    • Take a good multivitamin supplement that contains B complex vitamins, zinc, Vitamin E, magnesium and Vitamin C
    • Use a women’s herbal formula that contains some or all of the following: vitex, blue cohosh and dong quai (also known as the women’s herb)
    • Use a detoxifying formula that contains some or all of the following: milk thistle, barberry or goldenseal, burdock root, yellow dock, dandelion root
  • Practice some relaxation techniques – stress and anxiety may worsen breast pain. Try an acupressure mat which costs less than a single massage or acupressure session. It relieves tension, stress, sleeplessness, pain, and aids weight loss naturally in just 20 minutes a day. In the UK? Click here.
  • Avoid:
    • Caffeine – whether in coffee or other food and drinks
    • Using estrogen without balancing with progesterone
    • Dairy products as much as possible
    • Meat and poultry that has been exposed to drugs and hormones, try and eat free range/ organic meat and chicken

If your breast pain becomes really unbearable and none of these measures work for you, a trip to your doctor may be a good idea.