What Is Mastalgia?
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Mastalgia - Causes and Types

Published on Mar 08, 2023   -  5 min read


Mastalgia refers to commonly occurring breast pain. Read this article to know the types, causes, symptoms, diagnosis, and treatment of mastalgia.


Mastalgia is a condition characterized by pain and tenderness in the breasts. It can be caused by breast cancer, benign breast disease, or fibrocystic breast disease. Mastalgia is a term used to describe the pain most women experience in their breasts which can occur during pregnancy, after giving birth, during the menstruation period, or even during menopause. The most common cause of mastalgia is fibrocystic breast disease (FBD). This condition causes small lumps on the surface of the breast tissue. Mastalgia may also be related to other health problems, such as low estrogen levels or thyroid problems.

What Is Mastalgia?

Almost all women experience breast pain at least once in their lives. It is a prevalent condition and can be present as tenderness, stabbing, burning, sharp pain, or tightness in the breast tissue. Breast pain can range from mild to severe, or it can be continuous or intermittent. Mastalgia requires adequate evaluation and proper treatment.

Mastalgia is common in women but can also occur in men and transgender people.

  • It occurs in one or both breasts in men due to gynecomastia (increased breast gland tissues due to hormonal imbalance).

  • In transgender women, breast pain can be due to hormone therapy.

  • In transgender men, it can occur due to excess breast tissues after mastectomy (surgery performed to remove breast tissues from the breasts).

What Are the Different Types And Symptoms of Mastalgia?

Mastalgia can be-

Cyclic Mastalgia - Breast pain is related to the menstrual cycle and hormonal changes. Pain occurs in a regular pattern. Most commonly present in pre-menopausal women.


Non-cyclic Mastalgia - The pain can be in the breasts or surrounding muscles. Pain is constant, but no regular pattern can be identified. Pain that is not related to the menstrual cycle or hormonal imbalance; instead, it can be due to injuries, surgeries, infections, or some breast pathology. They are primarily seen in women between thirty to fifty years of age.


  • Localized sharp, stabbing, tightening, or burning breast pain.

  • It is usually unilateral (on one side), intermittent, or constant.

Extramammary Mastalgia - The breast pain that occurs due to some reason outside the breasts, like the heart, chest wall, lungs, or the esophagus.


  • The pain originates from breast tissues, but it is mostly a referred pain.

  • Pain originating from the chest wall, gallbladder, epigastric pain, and stomach diseases give a false impression of breast pain.

What Are the Causes of Mastalgia?

Mastalgia can occur due to the following reasons-

  • Cyclic mastalgia is triggered mainly due to hormonal changes during the menstrual cycle.

  • Pregnancy.

  • Infections and inflammations.

  • Birth control pills.

  • Hormone therapy.

  • Medication for infertility.

  • Antidepressants.

  • Radiation therapy.

  • Conditions affecting breasts like- cysts, fibroadenomas, or costochondritis (rib cage inflammation).

  • Large-sized breasts.

  • Surgical scars.

  • Fatty acid imbalance.

  • Breast pain without any apparent cause.

  • Some activities can cause breast pain- smoking, breastfeeding, stress, or caffeine consumption.

How Is Mastalgia Diagnosed?

During investigations, the primary aim is to rule out severe pathologies like breast cancer. Young females with cyclic mastalgia related to the menstrual cycle and no family history do not need further investigation. However, a female with focal non-cyclic mastalgia needs further investigation to determine the cause.

Following investigations can be done to diagnose mastalgia-

  • Breast Ultrasound - This is used in younger females (less than 35 years) with dense breast tissue. If any suspicious finding is observed, then a mammogram is advised.

  • Mammogram - This is done in females older than 35 years of age. A mammogram investigation is recommended if the physical examination findings are a focal area of pain, unusual thickening, or a breast lump.

  • Breast Biopsy - If any abnormal lumps are detected in ultrasound or mammogram, a biopsy of the breast tissues can be done for further histopathologic evaluation.

How to Prevent Mastalgia?

  • Cyclic pain is a regular part of the menstrual cycle, so it can not be prevented.

  • Reduce caffeine intake.

  • Include a low-fat diet.

  • Avoid hormone therapy.

  • Avoid medications that alleviate breast pain.

  • Wear a properly supportive and fitted bra.

  • Relaxation therapy to control anxiety.

  • Over-the-counter painkillers.

  • Avoid prolonged lifting activities.

What Is the Treatment of Mastalgia?

The initial step is to determine the cause of mastalgia and treat the condition accordingly.

The following measures can be taken to treat or manage mastalgia-

Conservative Management -

  • Using a well-fitted sports bra.

  • Using a hot and cold compress to relieve mastalgia-associated anxiety and depression.

  • Dietary modifications - Avoid tea, coffee, chocolate, and carbonated drinks. Consume a low-fat diet.

  • Do exercise daily.

  • Using over-the-counter painkillers- Oral or topical painkillers like Acetaminophen, Ibuprofen, Diclofenac, Aspirin, or Naproxen sodium can be used.

Medication - Generally, the pain resolves independently in three to six months. Still, if the pain is severe and conservative management is not much help, a doctor must be consulted for medication. Following medications can be used to manage mastalgia-

  • Topical and Oral NSAIDs (Non-steroidal Anti-inflammatory Drugs) - Oral NSAIDs like Acetaminophen or Ibuprofen and topical NSAIDs like Diclofenac (as a patch or in gel form) can be used.

  • Evening Primrose Oil and Vitamin E - Primrose oil is believed to maintain a favorable balance of acid in cells and vitamin E as an antioxidant. Both these elements play an essential role in decreasing breast pain.

  • Prescription Medicines -

    • Tamoxifen - This is the first line of treatment in severe refractory breast pain cases. However, this drug is also used to treat breast cancer, and it has many side effects, like nausea, headache, hot flashes, vaginal dryness, and joint pain. Thus, close monitoring of the patient is recommended.

    • Danazol - It is most commonly used for the treatment of mastalgia. Its side effects include acne, weight gain, hot flashes, voice changes, and menstrual irregularities.

Can Mastalgia Be a Reason for Breast Cancer?

Breast cancer is often the primary concern for females presenting with mastalgia, but breast pain is the least associated symptom of breast cancer. Breast pain does not mean it is breast cancer in most cases.


Breast pain can cause significant discomfort to women, but it is not a very severe condition. The symptoms can be managed with simple self-care practices and over-the-counter medications. However, a woman must seek help from healthcare providers if there is the development of any other symptoms like lumps, change in the texture of breasts, or discharge from the nipples along with breast pain.

Last reviewed at:
08 Mar 2023  -  5 min read




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