Cyclical Breast Pain

Also known as: Cyclical breast pain, Cyclical mastalgia, Premenstrual breast tenderness, Mastalgia, Breast pain

Cyclical breast pain (mastalgia) is breast tenderness, heaviness or aching that follows the menstrual cycle, typically building in the week or two before a period and easing once bleeding starts. It is very common, usually bilateral, and relates to hormonal sensitivity of breast tissue rather than disease [1][2]. Non-cyclical breast pain (constant, one-sided, focal) is a different presentation and always warrants medical assessment, as does any breast lump, skin change or nipple discharge [1][2][3]. Management of cyclical pain is reassurance, a well-fitted supportive bra, simple analgesia and, where severe, medical options such as adjusting hormonal contraception or, rarely, specialist medication [1][2]. In Chinese medicine premenstrual breast distension is a classic sign of Liver Qi stagnation affecting the Liver channel, which traverses the breast; chronic cases involve Phlegm nodules or Chong and Ren vessel disharmony. Acupuncture may help cyclical pain as an adjunct, and any suspicious breast change is referred for medical assessment first [1][4].