Breast pain, cyclical - Treating breast pain

You can improve your symptoms of cyclical breast pain by wearing well-fitting bras and taking painkillers. Some cases don't need any treatment.

Some women find that cyclical breast pain improves on its own. In other cases, it may disappear and return periodically over a number of years.

Many women also feel reassured to know that their breast pain is not due to a more serious condition, and therefore find it easier to live with.

Self-help

If your breast pain requires treatment, there are several self-help measures you can try. These include:

• wearing a better-fitting bra during the day
• wearing a soft support bra while you are sleeping
• wearing a sports bra while exercising
• taking over-the-counter painkillers, such as paracetamol or ibuprofen, when you experience breast pain

Your GP may also recommend a topical non-steroidal anti-inflammatory drug (NSAID) that can be rubbed directly on to the painful areas, such as:

• a gel containing diclofenac
• a gel containing ibuprofen

Follow the manufacturer’s instructions and make sure the medicine is suitable for you. For example, topical NSAIDs should not be used where the skin is broken.

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, and they are not usually recommended by doctors.

Alternative therapies

Some women 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.

Evening primrose oil

Although there is no scientific evidence to suggest that capsules of evening primrose oil can treat cyclical breast pain, many women find it beneficial.

Evening primrose oil can be bought from some pharmacies and health food shops.

As evening primrose oil may not always be suitable – for example, if you are trying to get pregnant or if you have epilepsy – you should speak to a GP before using it. Your GP may also be able to recommend a suitable product and tell you how much you should take.

Further treatment 

If you have cyclical breast pain that is severe enough to affect your quality of life and the above-mentioned treatments do not help, your GP may suggest other treatment options. 

You may also be referred to a breast specialist, either at a hospital or a specialist breast clinic.

Medication

In rare cases, you may be prescribed one of the following medications if you need further specialist treatment:

• danazol
• tamoxifen
• goserelin

These medicines affect the hormone levels in your body, and evidence suggests that they may help to reduce cyclical breast pain. However, they can also cause some unpleasant side effects, such as excessive hair growth and a permanently deep voice.

Some of these medications are unlicensed for the treatment of breast pain. This means the medication’s manufacturers have not applied for a licence for the drug 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 for breast pain.

Doctors will sometimes use an unlicensed medication if they think 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 let you know it is unlicensed and discuss the possible risks and benefits with you.

Danazol

Danazol is licensed to treat severe pain 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
• a deepening voice – this may be permanent
• spots (acne)
• hirsutism (excessive hair growth) – for example, on the face

Tamoxifen

Tamoxifen is a medicine 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 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
• less interest in sex
• depression