Let’s talk about you and me. Let’s talk about all the good things and the bad things that may be. Let’s talk about… boobs, baby.
Salt-N-Pepa may have been talking about sex in their 1991 hit, but replace the three-letter word and 26 years later, the song still rings true. Which, by the way, we have some feelings about. Just like sex, having an uncensored conversation about our A team still holds a bit of shock value. Regardless, we're going to anyway. Because sometimes they’re a pain—literally.
As much as I love and appreciate my boobs, as with any great relationship, we have our issues. Especially, (but not exclusively) around that certain time of the month. As if debilitating cramps, backaches, and chocolate cravings weren’t enough, during the week prior to my period, my boobs—plain and simple—are sore. So sore that I've had to skip my favorite workouts, adjust the way I sleep, and commit to an exclusive relationship with the one and only bra that doesn’t fuel the fire.
Sore boobs are by no means earth-shattering when it comes to our beloved cycle, but sometimes the pain seems to show up for no apparent reason. Which had me worried (and wondering): What’s normal and what’s not? For some clarity, I reached out to Jaime Knopman, MD, co-founder of Truly, MD and director of fertility preservation at CCRM New York, and New York City–based plastic surgeon Dr. Adam Kolker, MD, who has been named one of New York Magazine's best doctors for five consecutive years.
Curious why your boobs feel sore? Keep reading for everything the experts want you to know.
Hormonal vs. Non-Hormonal
According to both of our doctors, there is an important (and fairly easy) first step in understanding breast pain: Distinguishing when it occus. As Kolker explains, cyclical pain is associated with hormonal changes during your menstrual cycle and is by far the most common. Noncyclical pain, on the other hand, is something we should pay attention to:
"Noncyclical breast pain can be related to a variety of causes such as breast cysts, larger/pendulous breasts, diet/lifestyle (caffeine, nicotine), hormone replacement therapy, birth control pills, duct ectasia (benign inflammation), mastitis (breast infection, most often with pregnancy), trauma, certain medications (antidepressants, antibiotics), and (most rarely) breast cancer."
Soothing our inner-hypochondriac, Knopman agrees but reiterates that for the most part, breast pain is totally normal and completely benign. (Typically, most breast cancers aren't painful.)
"The majority of breast soreness is hormonally driven, the rise in progesterone is most frequently the culprit. This is why most women experience breast soreness in the second half of their menstrual cycle (a time that is dominated by progesterone) and in pregnancy."
And since we actually have a significant amount of muscle tissue underneath our boobs, Knopman explains that soreness can even stem from a strenuous workout.
Normal vs. Abnormal
This is where the water can get murky. Because technically, both hormonal and non-hormonal breast pain can be caused by something abnormal—rare but true. To dig a little bit deeper, I asked both Knopman and Kolker what we should be looking out for and when it's time to book an appointment with a doctor.
According to Kolker, "Pain that is cyclical (hormonal) and occurs shortly before menses and resolves after the onset of menses is most often considered normal. Any unremitting pain should be evaluated, as should any new mass or lesion in the breast. In this case, a clinical examination by a physician is the first step. Then, a focused ultrasound and or mammography may be indicated thereafter."
Knopman adds that if the pain persists after your period, is constant, or is interfering with your day-to-day-activity, you should check in with your doc.
We've already mentioned that one too many push-ups at the gym can precipitate soreness, but what else? When Kolker mentioned that certain environmental factors and habits can make our boobs feel sore, we were intrigued. Remember those chocolate cravings we mentioned? According to Kolker, imbibing isn't doing us any favors; in fact, chocolate, caffeine, and even nicotine can worsen breast pain. Additionally, women with larger breasts might also notice more soreness (although Kolker acknowledges this hasn't been scientifically proven). However, you may want to invest in a really great sports bra.
Knopman also explains to us that some women are more sensitive to hormonal fluctuations and will, therefore, experience menstrual-related symptoms that are more intense. Oh, and apparently your birth control can play a part: "Furthermore, certain formulations of progesterone (different contraceptions have different progesterone preparations) can increase sensitivity."
Luckily, it's pretty easy to get a handle on pain management, and it can be as simple as taking an anti-inflammatory like Advil or Aleve, says Kolker. He recommends incorporating a vitamin E supplement with primrose, as well.
Additionally, Knopman recommends finding a supportive bra that you love, using a hot or cold compress (whichever feels better to you), and possibly switching up your birth control since certain pills can worsen or instigate soreness. For severe soreness (scientifically known as cyclical mastalgia), your doctor may prescribe a medication.