Cyclical breast pain, “mastalgia”, affects the majority of women over the course of her menstrual, peri-menopausal or menopausal lives (so basically, any woman at any time!)(1). It can be caused by medications and drugs such as new onset HRT use and oral contraceptives or worsened by lifestyle factors such as smoking. But the role that diet plays appears to be the best management strategy with the least side effects. (Notably, only topical pain relief from NSAIDS appears to be worth the risk-benefit ratio, but talk to us first before resorting to medication(2,3))

In our experience, the physical symptoms of PMS are under-studied. We tend to focus on mood based cyclical symptoms, and even when we ask women if they have PMS, they usually focus on how their mood responds to their cycle, not their body.

Physical symptoms can help us understand your hormone balance, and women with cyclical breast pain have been shown to have altered inflammatory hormones, lactation hormones and higher estrogen levels than women without breast pain.

When we focus on for treating breast tenderness, we look at inflammation in general (Fish oil and other healthy oils show a reduction in breast pain), hormone balance (Progesterone to Estrogen ratios in lab work), perceived stress (which has been associated with nearly a doubling risk of breast pain(4)) and dietary fat.

Determining how a woman should fuel her body is an individual prescription (say good-bye Canada’s food guide!). Some women need less carbs to improve blood sugar balance and insulin sensitivity, but interestingly, women with cyclical breast pain often do better by decreasing their dietary fat intake, and modifying their sources of fat to focus more on nuts (which also contain Vitamin E(5)), olive oil, fish oil(6) and a reduction in animal based saturated fats. Women who eat more fat have more breast pain, and low fat diets have been studied in women with mastalgia to show a reduction in pain over only a few months of treatment(7,2,3,8). Other dietary factors that are often recommended include reducing caffeine (but in our experience only some women respond(9)) and evening primrose oil (which has no evidence).

In general, this symptom goes un-discussed and unmanaged. Women with breast pain report a reduced quality of life, reduced interest in sex and avoidance of exercise – all things that can be simply supported by customizing your diet.

1. Goyal A. Breast pain. BMJ Clin Evid [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][Internet]. 2011 Jan 17 [cited 2016 Jul 15];2011. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275318/

2. Rock CL, Flatt SW, Thomson CA, Stefanick ML, Newman VA, Jones LA, et al. Effects of a high-fiber, low-fat diet intervention on serum concentrations of reproductive steroid hormones in women with a history of breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2004 Jun 15;22(12):2379–87.

3. Rose DP, Cohen LA, Berke B, Boyar AP. Effect of a low-fat diet on hormone levels in women with cystic breast disease. II. Serum radioimmunoassayable prolactin and growth hormone and bioactive lactogenic hormones. J Natl Cancer Inst. 1987 Apr;78(4):627–31.

4. Ader DN, South-Paul J, Adera T, Deuster PA. Cyclical mastalgia: prevalence and associated health and behavioral factors. J Psychosom Obstet Gynaecol. 2001 Jun;22(2):71–6.

5. Pruthi S, Wahner-Roedler DL, Torkelson CJ, Cha SS, Thicke LS, Hazelton JH, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Altern Med Rev J Clin Ther. 2010 Apr;15(1):59–67.

6. Blommers J, de Lange-De Klerk ES m, Kuik DJ, Bezemer PD, Meijer S. Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial. Am J Obstet Gynecol. 2002 Nov;187(5):1389–94.

7. Boyd NF, McGuire V, Shannon P, Cousins M, Kriukov V, Mahoney L, et al. Effect of a low-fat high-carbohydrate diet on symptoms of cyclical mastopathy. Lancet Lond Engl. 1988 Jul 16;2(8603):128–32.

8. Rose DP, Boyar AP, Cohen C, Strong LE. Effect of a low-fat diet on hormone levels in women with cystic breast disease. I. Serum steroids and gonadotropins. J Natl Cancer Inst. 1987 Apr;78(4):623–6.

9. Chase C, Wells J, Eley S. Caffeine and breast pain: revisiting the connection. Nurs Womens Health. 2011 Sep;15(4):286–94.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]