Pain in the breasts
Pulling, cocking, heaviness or pain in both breasts.Palpable indurations, especially before menstruation (pre-menstrual): Suchcomplaints cause countless women month after month – almost normal for manyyears. It is not uncommon for the symptoms to start one or two weeks beforemenstruation. From the age of 30, the bosomy often increases, but sometimes itcan also plague younger women. Only a small consolation: The prospects that theinconvenience with menopause will finally subside are good.
Doctors often talk about mastodynia in the pain of the breasts , which occurs at the rhythm of the menstrual cycle . For cycle-independent chest pain, the term mastalgia is more commonly used, as in men. Ultimately, however, the terms are interchangeable. Mastodyne is more common, at least in women who are far more likely than men to do so (more on that in the list below “The most common causes”, “… in men”).
Mammary tissue undergoes many changes in the life of the woman. The ups and downs of the hormone cycle, hormonal extremes such as puberty, pregnancy , breastfeeding and the phase of life before and during menopause (premenopause, menopause) – all this affects noticeably in the breasts and affects their structure – tension and swelling or pain remain often not out.
Painful Breasts: Most often it’s the cycle
But what exactly leads to the breast disorders programmed in women of the female cycle is still unclear. Certainly, the fluctuations of the sex hormones and related changes play a role.
While in the first half of the cycle hormonal oestrogens dominate, in the second it is the body’s progestin called progesterone , also called luteal hormone. In the changing rhythm of the hormones , there is, inter alia, increased water retention (edema) in the breasts before menstruation. Edema is one of the causes of chest problems.
Although many women actually feel an increased sense of tension, they are reasonably clear. However, some have real problems, as the breasts are extremely uncomfortable month after month. But that’s not all, the eyelids , hands , feet and legs can temporarily swell. As a result, the scale temporarily points upwards. Not only, but also because many women feel uncomfortable before menstruation.
In addition, there are other complaints, for example on the mental level. The transition to a so-called premenstrual syndrome (PMS) is often fluid. For many women, the mood swings with increased irritability, nervousness or listlessness “to the days before the days” are normal to a certain extent. In PMS, however, they can be more pronounced and experienced as particularly debilitating.
The hormone prolactin from the pituitary gland, whichincreases during the second cycle phase, also influences the breast tissue:after all, it is intended to prepare the glandular cells for milk production.Thus, the tissue is supplied with more blood, and the glandular cells begin toadjust to a possible pregnancy : they start to grow and form more secretions.
Info: The female breast (Latin “mamma”) is composed of glandular, fatty and connective tissue. The glandular tissue contains about ten to twenty glandular lobes, which consist of several branched subunits (“glandular lobules”) and a corresponding number of milk ducts (see picture). The milk ducts unite in the glandular lobes to larger ducts, and then to draw to the nipple tip. Before they form small Aussackungen, which fill themselves in the lactation with milk from the gland lobes. Themammary glands are connected to the respective supply networks of the bodyvia their lymph, blood and nerve tracts.
In males, the mammary glands are underdeveloped in comparison to those of the woman, but are the same in terms of plant. Therefore, they may become larger if, for example, they are increasingly exposed to hormones such as estrogens or estrogen-like substances.
A particular sensitivity of breast tissue to prolactin may potentiate cyclic chest pain. Incidentally, prolactin also occurs in men. Increased breast formation in them ( gynecomastia ) may also be related to prolactin.
Very often a so-called fibrocystic mastopathy develops inwomen of childbearing potential (see chapter “Painful Breasts:Cycle-Dependent Causes “). This is often accompanied by a cyclicallystressed, noticeable painfulness of the breasts. For example, the doctor caneasily identify the changes by using an imaging technique such as an ultrasoundscan of the breast (mamma ultrasound) (see also chapter “Sore breasts andgynecomastia: diagnosis ” in this article). Depending on the severity ofthe disease, physicians sometimes recommend further investigation, asindividual forms of fibrocystic mastopathy may increase the risk of breastcancer slightly.
When the breasts hurt regardless of the cycle
- Non-pregnant women, before menopause:
A common cause of breast tenderness or pain is hormonal contraception, for example with the pill . Of course, the tolerability of a method of contraception varies from woman to woman. Also, the composition and dose of the hormones contained play a role. Chest pain or pain is a known side effect of so-called estrogen-stressed pills. Breast complaints, however, can also occur, for example, after inserting the so-called contraceptive stick (hormone implant) under the skin. It contains only progestin.
Only in the Pregnancy and lactation in particular, the mammary glands mature completely. They then produce the foremilk and, after the baby’s first sucker episodes, the full-quality breastmilk. Chest pain and heaviness as well as altogether hardened, sensitive breasts are normal side effects here.
When breastfeeding , it is important to avoid a congestion with the complication of breast inflammation (so-called puerperal mastitis). Most mothers do it very well. The appropriate breastfeeding technique, careful hygiene, proper nutrition and as far as possible the avoidance of stress contribute significantly to making it work. Midwives and lactation consultants can give valuable advice and respond to individual problems. Practical tips under” Breastfeeding: the best for your baby ” (www.baby-und-familie.de).
Symptoms of congestion : First indications are local chestpain and limited hardening, a painful “bump,” usually in the firsttwo breastfeeding weeks. A breast infection (mastitis) as a bacterialcomplication indicate more significant chest pain, also in the area of thenipple. It develops a stronger redness and overheating in the inflamed chestarea, often feeling sick, sometimes muscle and limb pain and fever . This canoccur quite early. Read more in the chapter “Sore Breasts: Non-CycleCauses”.
In this period of life – the last natural hormonal incision in women – falls the body’s production of sex hormones to a low point. There are no more egg follicles. Cycle-dependent chest complaints then gradually recede and no longer appear in this form, unless a woman “substitutes” for hormones. If chest pain develops then the affected person should definitely inform the treating gynecologist. He can check if the hormone dose is too high or if there is another cause behind it. Sometimes he recommends waiting for a while to see if the symptoms subside as the therapy progresses.
Women of all ages:
A painful breast infection can also develop independently of breastfeeding (mastitis non puerperalis). However, such inflammations are rare. In some cases infections with bacteria can be considered as causes. Occasionally, other inflammatory diseases include the breasts, such as so-called sarcoidosis . Finally, the doctor will consider further breast disease; Mostly they turn out to be benign.
! Important: Chest pain is not a typical symptom of breast cancer. They occur only very rarely.
The most common causes of pain in one or both breasts in women and men
(usually both breasts are painful, possibly side difference):
- Cyclic Mastodynia – Premenstrual Syndrome (PMS) *
- Fibrocystic mastopathy *
(possibly with nodules / swelling, skin lesions or discharge from the nipple, one or both breasts affected):
- Milk extension (ectasia) *
- Treatment with sex hormones *
- Breast inflammation (mastitis) *
- Pain in the area of the nipple *
- Other benign breast diseases, such as cyst, adipose tissue necrosis (see appropriate chapter under ” Knots in the chest “)
- breast cancer
- Medications, such as spironolactone
Men , too , may experience chest pain, though lessfrequently than women, and most often associated with breast swelling(gynecomastia). Often the complaints occur on both sides. Supposedly, almosthalf of all men are affected in any way by a breast development. Among otherthings, probably the increase of overweight and obesity in the (male)population plays a role. As a natural process gynecomastia occurs duringpuberty (usually temporary) and in old age . It is morbid, for example, inhormonal disorders. More in the chapter “Sore Breasts: Causes in Men”.
- A short overview:
- Physiological Gynecomastia *
- Pseudogynecomastia in obesity(Breast formation due to increased fatty tissue) *
- gynecomastiaSex hormone deficiency or excess (either innate or acquired, treatment with sex hormones, use of anabolic steroids) *
- Breast cancer (see own article ” Breast Cancer “, chapter “Special Situations “)
- Gynecomastia under the influence of medications * , including ACE inhibitors, spironolactone, digitalis preparations, certain calcium channel blockers (for example with the drug diltiazem), stomach drugs such as cimetidine or omeprazole, drugs for prostate disease
- Alcohol; substances with hormone-like acting in personal care products with tea tree – or lavender oil with intensive application (can particularly sensitive boys before puberty * react)
Finally, pain in the chest region are felt, in both sexes also reasons that have nothing to do with the mammary glands.