Ask the Doctor: I can’t stand the pain in my breasts anymore

I’m 28 years old with a two-year-old child. Every time I get my period, my breats hurt beyond comprehension. They swell and become as hard as rocks. I stopped breastfeeding when my daughter was about eight months old but this problem has been there for as long as I can remember. I once talked to a doctor friend about it and he told me that it was normal to have pain in the breasts during your period but didn’t explain it all to me very well. What causes this? Will it ever go away? I even tried some painkillers that a friend gave me but that didn’t work. How can I make it better? Tona, Kibagabaga Dear Tona, I can understand your pain and anxiety regarding the painful breasts. In most cases, painful and swollen breasts during menstruation occur due to hormonal changes. Normally the body is prepared for a potential pregnancy around ovulation. In this process, the breast tissue swells and more milk ducts are formed. As menstruation starts due to failure of getting pregnant, the estrogen level goes down and the progesterone level rises. This change in hormonal balance leads to swelling and pain over the breasts. In some women it is like your case, while in some it may be negligible. Some women suffer more from this problem as they approach menopause. Increase in weight could aggravate the pain. Apart from this, wearing very tight bras can also lead to pain and discomfort over the breasts after some time. Stress, both physical and mental, is also said to precipitate and augment the pain infection of the breast tissue and can also result in painful swelling. But in this case it will not fluctuate with the menses. There is nothing to worry about. If the pain is severe, you can take some pain killer pills like diclofenac or ibuprofen. Hot or cold compression over the affected part will also be useful. A soft and thick cotton cloth like a towel can be warmed up and put directly over the breasts for few minutes or a hot water bag can be used. Similarly, local application of analgesic ointments is also beneficial. A healthy high fibre and low fat diet is also useful to help in relieving the pain in this condition. Vitamin supplements particularly of vitamin E are very beneficial in improving this condition but the mechanism as to how they help is not clearly established. Food substances rich in vitamin E like whole grains, wheat germ oil, and germinated grains share the same benefits. Regular physical exercise to prevent obesity and being totally relaxed both physically and mentally is advised as one of the measures to get rid of painful swollen breasts during menstruation. Total relaxation can be achieved by means of meditation and yoga. At times in severe cases, hormonal therapy is given to help this problem. But apart from the benefits, it can lead to side effects like excess withdrawal bleeding, breast hyperlipidemia and heart problems, increased risk of clotting, and worse, still cancer of the breast or uterus. This pain will most likely continue till your menses stop but with different measures you can keep it minimal and get used to it. Dr. Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital.