In some cases, cyclical breast pain improves without treatment. Many women find comfort in the reassurance that their breast pain is not due to a more serious condition.
Self-help
If your breast pain requires treatment, there are several self-help measures that you can try. These include:
- wearing a better-fitting bra during the day
- wearing a soft support bra while you are sleeping
- taking over-the-counter painkillers, such as paracetamol or ibuprofen, when you experience breast pain
If you are taking over-the-counter painkillers, make sure that you are taking the correct dose and that the medicine is suitable for you. For example, ibuprofen should be used with caution in people with:
- asthma – when the airways of the lungs become inflamed (swollen)
- kidney problems
- liver problems
Your GP may also recommend a topical non-steroidal anti-inflammatory drug (NSAID) such as a cream or gel that can be rubbed directly on to the painful areas. Possible topical NSAIDs that may be prescribed include:
- a gel containing diclofenac, such as Voltarol Emulgel
- a gel containing ibuprofen, such as Ibugel Forte
Again, follow the manufacturer’s instructions and make sure that the medicine is suitable for you. For example, topical NSAIDs should not be used where the skin is broken, such as on a scratch on your breast.
Other options
Some experts have also suggested that breast pain may be improved by:
- reducing your intake of caffeine, which is found in tea, coffee and cola
- reducing your intake of saturated fat, which is found in butter, crisps and fried food
- not smoking (if you smoke)
However, the benefits of making these changes have not been scientifically proven.
Alternative therapies
Some women may use alternative therapies, such as acupuncture or reflexology, to relieve the symptoms of cyclical breast pain. However, the lack of evidence supporting their effectiveness means that more research is needed before they can be recommended by the NHS.
Acupuncture is a form of ancient Chinese medicine in which fine needles are inserted into the skin at certain points on the body. See the Health A-Z topic about Acupuncture for more information on this alternative therapy.
Reflexology is a type of a therapy where certain areas of the body, such as the soles of the feet, are massaged to help improve general health.
Evening primrose oil
Some GPs may recommend taking evening primrose oil. This is made from the seeds of the evening primrose flower and usually comes as a capsule. These are not available with a prescription but can be bought from some pharmacies and health food shops. Your GP will be able to recommend a suitable product and tell you how much you should take.
There is no evidence that evening primrose oil is any better for cyclical breast pain than a placebo (sham treatment), but the placebo effect of evening primrose oil is significant. The placebo effect is when people get better even though they have only taken a fake treatment. As evening primrose oil is unlikely to cause any side effects, your GP may suggest it as a treatment.
In some cases, evening primrose oil may not be advised – for example, if you are trying to get pregnant or if you have epilepsy (a condition that causes seizures). For this reason, always speak to your GP before trying a new treatment such as evening primrose oil.
Further treatment
If you have cyclical breast pain that is severe enough to affect your quality of life and the treatments above do not help, or if the above treatments have not worked after six months, your GP may suggest other treatment options.
Pain chart
If you have not already used a breast pain chart to record your breast pain, your GP may ask you to complete one. You will usually be asked to make a daily record of your pain for at least two months so that your GP can analyse whether there is a pattern to your pain.
After you have recorded your breast pain over a two-month period, your GP will be able to determine:
- the severity of your breast pain
- when your breast pain is most severe
- how well you have responded to treatment
Referral
If your GP is unable to treat your breast pain, they may refer you to a breast specialist for further treatment, either at a hospital or a specialist breast clinic.
Medication
If you need further specialist treatment, you may be prescribed one of the following medications:
- danazol
- bromocriptine
- tamoxifen
- goserelin
- toremifene
Some of these medications are unlicensed for the treatment of breast pain (see below). This means that the medication’s manufacturers have not applied for a licence for it to be used in treating breast pain. In other words, the medication has not undergone clinical trials (a type of research that tests one treatment against another) to determine whether it is an effective and safe treatment.
Sometimes, doctors will use an unlicensed medication if they think that it is likely to be effective and that the benefits of treatment outweigh any associated risk.
If your specialist is considering prescribing an unlicensed medication, they should inform you that it is unlicensed and discuss the possible risks and benefits with you.
The medicines mentioned above all affect the levels of hormones (powerful chemicals) in your body, and some evidence suggests that they may help to reduce cyclical breast pain. However, they can also all cause some unpleasant side effects, such as excessive hair growth and a permanently deep voice. Most women will not need to take these medicines and the side effects that are associated with them often put women off.
Danazol
Danazol is licensed to treat severe pain that is caused by fibrocystic breast disease (fibroadenosis). This is a condition that causes benign (non-cancerous) growths to develop in the breast. Side effects include:
- nausea (feeling sick)
- dizziness
- a rash
- weight gain
- heavy periods (menorrhagia)
- a deepening voice – this may be permanent
- spots (acne)
- hirsutism – excessive hair growth, for example on the face
Bromocriptine
Bromocriptine is licensed to treat some conditions that affect the breasts, such as galactorrhoea (the over-production of breast milk). Side effects include:
- nausea (feeling sick)
- low blood pressure (hypotension), which can cause dizziness
- headaches
- constipation (an inability to empty your bowels)
Tamoxifen
Tamoxifen is a medicine that is used to treat breast cancer. It is also used as an unlicensed medicine to treat breast pain. Side effects include:
- vaginal bleeding or discharge
- hot flushes
- an increased risk of womb cancer (endometrial cancer)
- an increased risk of thromboembolism – when a blood clot forms in your veins (thrombosis) which may cause a blockage
Goserelin
Goserelin is a medicine that is used to treat breast cancer. It may also be used as an unlicensed medicine to treat breast pain. Side effects include:
- vaginal dryness
- hot flushes
- decreased libido (less interest in sex)
- depression
Toremifene
Toremifene is a medicine that is used to treat breast cancer. It may also be used as an unlicensed medicine to treat breast pain. Side effects include:
- nausea (feeling sick)
- depression
- hot flushes
- vaginal bleeding or discharge
- deep vein thrombosis (DVT) – a blood clot in one of the deep veins in the body
