What causes breast tenderness?
The short answer as to what causes breast tenderness is hormone imbalance. Both the hormones estrogen and progesterone have effects on breast tissue. The relevant hormonal imbalance is often estrogen dominance, which means there is relatively higher estrogen and lower progesterone. However, higher levels of progesterone can also cause breast pain. Some women will find that their breasts hurt from ovulation onward, whereas others will find it only occurs a few days before their period starts.
Serious conditions must be ruled out by your medical doctor as a source of breast pain, particularly if there are other abnormalities, like a breast that doesn’t move normally, inversion of the nipple, or discharge from the nipple.
Breast tenderness is often worse in the week before menstruation, that is during PMS (just to add to the fun). During this week there is supposed to be a sudden drop in both estrogen and progesterone, the sudden drop of one without the other may explain why there is breast pain. How do these levels drop? Through the liver.
How is the liver involved in breast tenderness?
The liver is responsible for phase I and phase II detoxification of estrogen. Efficient liver processing of hormones requires vitamin B6, vitamin B12, 5MTHF (a special, active form of folic acid), indole-3-carbinol (a nutrient found in broccoli, cabbage, cauliflower), sulfur (found in garlic, onions, eggs), and calcium-d-glucarate (found in cruciferous vegetables, apples and onions). These substances are naturally found in cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, kale), apples, grapefruit, garlic, and onions. Dietary sources of these substances may be inadequate in women with breast tenderness, in which case I recommend supplementation.
Evening Primrose Oil has also been shown to help relieve breast tenderness.
How can a naturopath help with breast pain?
I can help with breast pain by ordering appropriate lab tests and supporting healthy liver detoxification of hormones and chemicals that may be acting like hormones. I can also help balance hormones through the use of proper herbs.
Tests That May Be Helpful for Breast Tenderness
If you’re experiencing ongoing or unexplained breast tenderness, it’s important to understand what’s causing it, especially if the discomfort interferes with daily life or changes throughout your cycle. Breast tenderness is commonly linked to hormonal imbalances, particularly fluctuations in estrogen and progesterone. Specific blood tests can be very helpful in assessing these imbalances.
Testing should include hormone levels drawn on specific days of your menstrual cycle. On cycle day 3, checking LH (luteinizing hormone), FSH (follicle-stimulating hormone), estradiol, and estrone is useful. These give insight into how your ovaries and pituitary gland function early in the cycle and whether estrogen levels are elevated. Elevated estrogen, especially in relation to progesterone, can contribute to breast tenderness by causing swelling and increased sensitivity in the breast tissue.
A progesterone test is recommended later in the cycle, on cycle day 21 (or 7 days after ovulation). Low progesterone relative to estrogen is a common cause of cyclical breast tenderness, especially in the luteal phase of the cycle. Identifying this imbalance allows us to explore safe, natural options for supporting healthy hormone levels and reducing symptoms.
In addition to hormone testing, a thorough breast exam should be performed to rule out any lumps or abnormalities. While breast tenderness is usually hormonal, it’s essential to be cautious. If there is any doubt or if the tenderness is localized to one area, breast imaging such as an ultrasound or mammogram may be necessary to rule out more serious conditions.
Addressing breast tenderness through lab testing allows for a more accurate and personalized treatment plan. Whether the cause is hormonal, structural, or related to inflammation or fluid retention, identifying the root cause is key to finding long-term relief from breast tenderness. To rule out a breast mass, and if in doubt, an ultrasound and/or a mammogram should be done.
Book an appointment here or call the office for more information at 416-481-0222.
Dr. Pamela has practiced as a naturopathic doctor in Toronto since 1999. She has received numerous “Best Naturopath in Toronto” awards. She is registered with the College of Naturopaths of Ontario.
Dr. Pamela Frank uses a natural treatment approach that may include acupuncture, herbal medicine, nutrition, diet, vitamins, supplements, and other natural remedies to restore balance and provide long-term resolution to almost any health problem.
Breast Pain Research
Based on our preliminary findings, exercise treatment is beneficial for patients with mastalgia and it can be suggested by clinicians.
Source:
Phys Sportsmed. 2017 Feb;45(1):17-21. doi: 10.1080/00913847.2017.1252702. Epub 2016 Nov 3.
The effects of exercise on mastalgia.
Genç A1, Çelebi MM2, Çelik SU3, Atman ED4, Kocaay AF3, Zergeroğlu AM2, Elhan AH5, Genç V3.
Smoking, caffeine consumption, and perceived stress were associated with mastalgia (breast pain).
Source:
J Psychosom Obstet Gynaecol. 2001 Jun;22(2):71-6.
Cyclical mastalgia: prevalence and associated health and behavioral factors.
Ader DN1, South-Paul J, Adera T, Deuster PA.