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Breast Pain (Mastalgia): Causes, Diagnosis, and Treatment

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Breast pain, also known as mastalgia, often develops in women during their reproductive lives. It can have different causes.

Written byDr. Anuthanyaa. R

Medically reviewed byDr. Radha Peruvemba Hariharan

Published At April 6, 2022
Reviewed AtFebruary 17, 2026

What Is Breast Pain (Mastalgia)?

Breast pain, also known as mastalgia, is a very common condition and it affects almost every woman at some stage in life. The common symptoms of breast pain are tenderness, tightness, burning, stabbing, or sharp discomfort. It can occur in one or both breasts. The nature of the pain can be mild or severe, occasional or constant.

In most cases, it is harmless, but still, breast pain needs proper evaluation to rule out underlying causes. It occurs due to hormonal imbalance, breast tissue changes, gynecomastia in men, or hormone-related causes in transgender individuals. In many people, the pain is linked to normal hormonal fluctuations, lifestyle factors, or breast tissue sensitivity.

Diagnosis of breast pain typically involves a breast examination, ultrasound, or mammogram, depending on age and symptoms.

The treatment includes supportive bras, warm compresses, lifestyle changes, vitamin E or evening primrose oil, and management of underlying hormonal issues. If pain persists, it may require medications or further evaluation.

Types of Breast Pain (Mastalgia)

Generally speaking, breast pain is classified into two categories: cyclical and non-cyclical.

  • Cyclical Pain: This type of breast pain occurs due to the menstrual cycle and hormone fluctuation in the body. Cyclical breast pain is more common, and it typically tends to reduce after your menstrual period.

  • Non-Cyclical Pain: Non-cyclical breast pain is rare, and the cause behind it might differ. In some cases, the pain might be due to an injury, infection, or cyst, or to surrounding muscles rather than breast tissue.

What Causes Breast Pain?

The causes of breast pain include hormonal fluctuations that may occur with menstruation, pregnancy, or menopause. Other causes of mastalgia include breast injury, infections such as mastitis (breast tissue inflammation), or fibrocystic breast changes.

Rarely, mastalgia may be linked to underlying health conditions, making medical evaluation necessary for persistent or severe cases.

Some of the common causes of mastalgia (breast pain) are listed below:

1) Hormonal Fluctuation:

During the menstrual cycle, estrogen and progesterone levels fluctuate with each stage. This fluctuation in hormone levels can make a woman's breasts feel swollen, lumpy, and painful in some cases.

2) Breast Cysts:

As a woman ages, her breasts undergo a change known as involution. Involution means that breast tissue (glandular tissue) is replaced by fat tissue as we age. It is called fibrocystic breast, and there is a chance that it can cause pain. However, it does not always cause pain. Breast cysts can cause pain when their fluid-filled sacs stretch the surrounding breast tissue, creating pressure and tenderness. Hormonal changes, especially before periods, can cause swelling in the cysts, which results in discomfort. Cysts larger in size or located near sensitive nerves produce sharper pain.

3) Breastfeeding:

Though breastfeeding is the most nutritious way to feed a newborn, it also has its difficulties. Different factors are associated with breastfeeding that might lead to breast pain.

They include:

  • Mastitis - Infection of the milk duct, which causes itching, pain, or a burning sensation on the nipples.

  • Improper Latch - If your baby does not latch properly to the breast while feeding, it can lead to cracked and sore nipples.

  • Engorgement - This happens when your breasts become full of milk and enlarge, and the skin becomes tight and painful.

4) Medications

A few medications, like Digoxin (which is used to treat congestive heart failure (the heart's weak pumping) and abnormal heart rhythm), Chlorpromazine (used for mental health disorders), certain potassium-sparing diuretics, such as Spironolactone and Oxymetholone (used to treat low red blood cell count), and Methyldopa (used to treat high blood pressure), can sometimes cause breast pain. And when you take any of these medicines, you might develop medication-induced breast pain.

5) Diet Choices:

Certain diet choices may trigger or worsen breast pain. High salt or caffeine intake can result in fluid retention, making breast tissue tender and swollen. Hormonal balance is also affected by a low-nutrient diet, which can increase the chances of breast discomfort.

6) Smoking:

Smoking also worsens breast pain because it slows down the blood flow and increases the inflammation in breast tissues.

7) Costochondritis:

The costal cartilage builds a connection between the ribs and the breastbone. Inflammation in this cartilage is known as costochondritis. This inflammation creates pressure over the breast and results in breast pain.

8) Breast Surgery:

Any surgical procedure, such as augmentation, reduction, or lumpectomy, or post-surgery process, such as tissue healing, irritation of nerves, or scarring, can cause the onset of temporary or persistent breast pain. The degree of pain varies based on the type of procedure and recovery. Proper post-surgical care can help relieve discomfort as the tissue heals.

9) Ill-fitting Bras:

Poor-fitting bras cause breast pain due to excessive pressure on the breast tissues or the failure to provide support.

Symptoms of Breast Pain

Pain in the breast may be exhibited through:

  • Tenderness.

  • Aching.

  • A sharp pain inside one or both breasts.

Discomfort may become constant or sometimes occur temporarily, and discomfort may vary over time. While some of us can feel the aching in localized areas, some people experience spreading pains throughout one or both of their breasts.

These symptoms occur due to hormonal changes in the body and any injury or underlying illness. The pain may be more severe in some women, especially during a specific time in the month, for example, before menstruation or due to the physical activity of pressure.

How to Diagnose Breast Pain?

A detailed physical examination, a thorough review of the patient's medical history, and occasionally imaging tests like mammograms or ultrasounds are used to diagnose breast pain. In addition to checking for lumps, swelling, or other changes in the breasts, a doctor may examine the lymph nodes in the neck and underarms.

To identify the underlying cause, which could range from hormonal changes to cysts or infections, doctors may advise additional procedures, including blood tests, diagnostic mammography, ultrasound, or biopsy.

If the doctor suspects a tumor, the following diagnostic tests will be performed to help diagnose it.

  • Ultrasound - This will penetrate the breast tissue and help locate the tumor without radiation exposure.

  • Mammogram - This test helps identify any breast tissue abnormalities.

  • MRI (Magnetic Resonance Imaging) - If ultrasound is unclear, an MRI provides a more detailed image of breast tissue.

  • Biopsy - The doctor will remove a small portion of the breast tissue to study under a microscope to identify the presence of any cancerous cells.

What Are the Complications of Breast Pain?

The complications of breast pain, such as a pinching sensation in the breast, can vary depending on the cause. For instance, chronic pain can interfere with daily activities and quality of sleep or cause emotional distress because of fear of what might be happening in the body.

In case of infection, untreated pain can lead to complications such as abscess formation. A pinching sensation in the breast, if ignored, may delay the diagnosis of conditions like cysts, fibrocystic changes, or even rare but serious issues like breast cancer.

How Is Breast Pain Treated?

Treatment for breast pain can vary depending on the cause, but common and successful choices include:

1. Modifications to Lifestyle:

  • Wear a supportive, properly fitting bra.

  • Cutting back on caffeine (soda, tea, and coffee).

  • Reducing one's smoking.

  • Applying compresses, either warm or cold, to provide relief.

2. Drugs:

  • Acetaminophen or Ibuprofen are examples of painkillers that help ease breast pain.

  • Topical NSAIDs (Nonsteroidal Anti-Inflammatory Drugs), like Diclofenac gel, may be helpful for localized pain.

  • For breast pain caused by hormonal fluctuations, physicians occasionally use vitamin E or evening primrose oil.

3. Addressing the Root Cause:

  • After menopause or menstruation, hormonal breast pain frequently goes away.

  • Antibiotics combined with appropriate breastfeeding techniques can treat breast infections.

  • Cysts: If they are large or painful, aspiration may be necessary.

  • Costochondritis: Anti-inflammatory medicines, along with proper rest, will help.

4. Hormonal Therapies (for severe cyclic pain):

  • Low-dose oral contraceptives or progesterone therapy.

  • Rarely, medications that suppress estrogen (only for very severe, persistent cases).

5. Breastfeeding-Related Pain:

  • Adjusting the baby's latch.

  • Applying warm compresses, managing engorgement, or clearing clogged ducts.

  • Treating mastitis right away.

6. When It Is Time for Surgery:

  • Very uncommon and is only advised for cases where a painful, persistent cyst or lump is noted.

7. When to See a Physician:

  • When just one of your breasts hurts.

  • If you notice a lump, nipple discharge, or redness.

  • If you have pain for more than 2 to 3 months.

  • If your everyday living is hampered by pain.

Conclusion:

Although breast pain is a common occurrence in women, there is a need to be cautious about the different conditions that accompany it. There are several self-check techniques for breast tissue, which help ensure it is healthy and lump-free. Hormone supplements are also known to cause breast pain; always consult a doctor before using them. If the breast pain does not subside and persists for more than five days or if you begin to feel lumps in the breasts, consult a doctor immediately. With individualized guidance and care, our gynecologists at iCliniq can help you.

Key Takeaways

  • Mastalgia, or breast pain, is a common condition that is typically caused by changes in hormones, sensitivity of the breast tissue, or lifestyle choices.

  • Although the majority of cases are benign, persistent, severe, or localized pain should be assessed by a physician.

  • While non-cyclical pain can result from injuries, cysts, infections, or chest wall problems, cyclical pain is associated with the menstrual cycle.

  • Proper diagnosis and treatment will help relieve the symptoms and unnecessary anxiety associated with it.

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Frequently Asked Questions

There can be multiple reasons for breast pain which may include the following -
- Hormonal fluctuations.
- Breast injury.
- Breasts hurt due to a non-supportive bra.
- Breastfeeding causes breast tenderness.
- Breast infection.
- A side effect of some medications.
- Breast cyst.
- Complications from a breast implant.
- Breast cancer.
Breast pain that a female experience during this period is normal. This type of pain may come and go with the periods. This is caused by the fluctuations in hormone levels, causing the beast to swell and leading to tenderness. Even the pain due to an unfit bra may also be temporary and get resolved by wearing a good-fitting and supportive bra.
Breast pain that does not go away after one or two menstrual cycles or that stays long after menopause can be a sign of serious complications. Moreover, when the pain is located only at one specific region or is not associated with menstrual cycles can be a matter of concern. Most breast pain signals benign (noncancerous) conditions and rarely indicates breast cancer. 
Some of the warning signs of breast cancer include -
- A lump or hard swelling in the breast or underarm.
- Thickening of the skin of the breast.
- Swelling of a part of the breast.
- Change in breast size or shape. 
- Pain in any part of the breast.
- Irritation on the breast skin.
- Redness or flaky skin around the nipple or breast.
- Discharge from nipple such as blood.
Some of the treatment methods used to relieve breast pain, which include -
- Wear a well-fitting and supportive bra.
- Avoid smoking or other tobacco products.
- Take supplements or multivitamins such as vitamin E and magnesium.
- Take painkillers and apply heat to the tender area.
Stress can be linked to breast pain. The stress can cause fluctuation during the menstrual cycle, leading to breast pain, which may come and go. Stress can also cause breast pain affecting women before and after menopause. The pain can be experienced in both or one breast and may be resolved independently.
There are two types of breast pain which include cyclic and non-cyclic. The cyclic pain may come and go with the menstrual cycle, such as breast pain or tenderness, and can be experienced only during the menstrual cycle and will go away with the completion of the cycle. 
Non-cyclic pain is not connected to the menstrual cycle and does not come and go regularly. This type of pain is most commonly seen in post-menopausal women between 40 and 50 years old. The pain is usually described as a burning sensation or tightening of the breast area, which can be constant or intermittent.
The majority of breast cancers do not cause any pain in the breast or nipple area. Most often, women experience this pain or tenderness due to the menstrual cycle, which goes away with the end of the cycle. The signs of cancer may include a painless, hard mass with irregular borders.
There are different stages of breast cancer, ranging from stage 0 to stage 4. Stage 0 breast cancer (carcinoma in situ) is the initial stage of breast cancer. This means that cancer has not spread to other areas of the body. As the stage increases the severity of the cancer is increased and which also indicates it has metastasized to other locations also.
Pain in the left breast can occur for various reasons, including injury, hormone fluctuation, infection, or lung problems. Moreover, left breast pain can also be linked to the heart; therefore, it should not be ignored, and immediate medical assistance is needed.
The fluctuation in hormone levels is one of the reasons for breast pain. The rise in the levels of hormones such as estrogen and progesterone just before the period is one the prime reason for breast soreness. These hormones cause the breasts to swell and can cause tenderness. This gets normal as the menstrual cycle is over.
The cancerous breast has a painless hard lump in the breast. This lump may be visible to the naked eye and felt with a self-breast exam. These areas of swelling under the armpit or breast or near the collarbone are indications of cancer and must be diagnosed immediately before spreading to other locations. 
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Dr. Radha Peruvemba Hariharan

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