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The menstrual cycle can cause many symptoms, including sore breasts. Hormone fluctuations before a period can lead to breast tenderness or pain. Doctors do not fully understand what causes these breast symptoms, but they know that specific hormones are involved.

• People can take some measures to reduce breast discomfort.
• However, if their breast pain becomes severe or they have signs of a breast infection, they should seek medical attention.
• According to the American Academy of Family Physicians (AAFP), hormone changes due to menstruation are the most common cause of breast pain.

A reduction in the levels of the hormones estrogen and progesterone before a period can cause sore breasts. These changes can also cause lymph node swelling, which may contribute to breast pain too. There may also be an association between breast pain and a hormone called prolactin.

This hormone stimulates breast milk production in women following childbirth. It is present in the body of females, and it can affect the breasts even if a woman has not recently given birth. Breast pain may also occur around the time of ovulation, which is when an ovary releases an egg for potential fertilization.

It usually takes place 12 to 14 days before a person has their period. However, hormones may not be the only cause of sore breasts before a period. Some women report pain in only one breast. If hormones were the only underlying cause, some doctors believe that both breasts would respond the same way.

Therefore, it is possible that other changes in the body can cause breast pain around the time of menstruation. Another explanation is that the cells in each breast respond differently to fluctuating hormone levels. The feeling of breast pain may differ from person to person. Some people describe the pain as soreness, while others are more likely to define it as achiness or tenderness.

Breast pain may:

be dulloccur in one or both breastsradiate to the underarmsfeel sharp at timesoccur alongside swellingfeel more intense in the nipple area

Some people experience constant pain over several days, while others find that it comes and goes. Breast soreness may also make it uncomfortable to wear regular bras or tight clothing. Breast pain may also occur as a result of other factors, including:

a clogged or plugged milk ductmastitis, a breast infection that can develop while breastfeedingfibrocystic breast tissue, which makes the breasts dense and lumpy and may be more painful around menstruationlarge, heavy breastsa history of breast surgeryusing hormone therapy medicationstaking certain medications, such as digitalis, methyldopa, spironolactone, diuretics, chlorpromazine, or oxymetholonea breast injury water retention

Breast cancer can sometimes cause breast pain, but this is rare as the disease tends to be slow-growing and to produce other symptoms before pain occurs. However, a rare form of breast cancer called inflammatory breast cancer can cause redness, pain, or swelling in the breasts.

over-the-counter pain relievers, such as ibuprofen or acetaminophen birth control pills to control hormone fluctuations

Alternatively, if an infection is responsible for the pain, a doctor may prescribe antibiotics, In rare instances, a doctor may prescribe other medications, such as danazol, which is a male hormone that research has shown to reduce breast pain. However, this medication has significant side effects, so doctors do not usually recommend it.

wearing a larger or more supportive bra or trying a different cup sizewearing a supportive bra at nightreducing the amount of caffeine in the diet by limiting coffee, soda, energy drinks, and teaeating less salt to reduce water retentionusing hot and cold therapy, such as ice packs or heating pads

According to the AAFP, taking supplements, such as vitamin E or vitamin B-6, may help reduce breast pain. Low-impact exercise may also be beneficial, but high-impact activities, such as running or jumping, might cause additional breast pain. Share on Pinterest A person should discuss changes in the breasts or ongoing pain with a doctor.

a painful breast lump or lumpsbloody or foul-smelling nipple dischargebreast pain that lasts for more than several weeksbreast pain that makes it hard to do regular activities, even if the pain ties in with the menstrual cyclesigns of infection, such as warmth or redness of the breast or fever

A doctor will typically ask questions about a person’s symptoms to determine what makes the pain worse or better and how long it lasts. It can be helpful to let the doctor know if the pain consistently happens at certain points during the menstrual cycle.

• The doctor may also examine the breast for signs of injury or infection.
• Sometimes, they may recommend an imaging test, such as an ultrasound or mammogram.
• Sore breasts before a period are normal but can be bothersome.
• The soreness is usually due to hormone fluctuations.
• Home remedies and medical treatments are available to lessen menstruation-related breast pain.

If these do not reduce discomfort, it may help to speak to a doctor.

How do you get rid of period breast pain?

My Breasts Ache During My Period. What Can I Do? Before I start my period, I get aches in my breasts. This happens every time. Will it go away when my breasts finish developing? And will wearing a more supportive bra help? – Simone* Lots of girls get aching in their breasts before their periods start.

The aches are caused by a decrease in the hormones estrogen and progesterone, which are responsible for a girl’s menstrual cycle. For some girls, these aches happen less often as they grow older. But that’s not the case for everyone. Some women continue to get aches in their breasts for as long as they have their periods, which is completely normal.

So what can you do? Cutting back on salt, sugar, caffeine, and dairy may help. You might feel more comfortable if you wear a supportive bra during this time. Taking an over-the-counter pain reliever like ibuprofen or naproxen can help reduce pain. Regular exercise also may help lessen menstrual breast pain.

How long should menstrual breast pain last?

How to know if your breast pain is cyclical – Cyclical breast/chest pain is typically experienced at particular times each menstrual cycle, and with specific symptoms:

• Breast/chest pain experienced 5–10 days leading up to the start of a period, that goes away after the period starts (1)
• Breasts/chest that feel aching, heavy, and tender, but the pain can also feel sharp or shooting (1)
• Breasts/chest that feel swollen or lumpy in the days before your period starts (2)

Breast/chest pain can sometimes be severe enough to impact physical activity and sex (2). Some people also report breast/chest pain interfering with school, work, and sleep, though this is less common (2).

Why is my period very painful breast?

Most women experience some form of breast pain at one time or another. Breast pain is typically easy to treat, but on rarer occasions it can be a sign of something more serious. Medical director of the Suburban Hospital Breast Center Pamela Wright, M.D,, discusses the most common causes of breast pain (mastalgia), their treatments and when to see a doctor:

1. Hormones are making your breasts sore. Hormonal fluctuations are the number one reason women have breast pain. Breasts become sore three to five days prior to the beginning of a menstrual period and stop hurting after it starts. This is due to a rise in estrogen and progesterone right before your period. These hormones cause your breasts to swell and can lead to tenderness. “It’s normal to have breast tenderness that comes and goes around the time of your period,” says Wright. “It’s nothing to worry about.” If you become pregnant, your breasts may remain sore during the first trimester as hormone production ramps up. Breast tenderness is one of the earliest signs of pregnancy for many women. Steps you can take to minimize sore breasts include:
   • Eliminate caffeine
   • Eat a low-fat diet
   • Reduce salt intake
   • Avoid smoking
   • Take an over-the-counter pain reliever
   • Ask your doctor if switching birth control pills or hormone replacement therapy medications may help
2. You have a breast injury. Like any part of your body, breasts can be injured. This can happen because of an accident, while playing sports or from breast surgery. You may feel a sharp, shooting pain at the time of injury. Tenderness can linger for a few days up to several weeks after trauma to the breast. See your doctor if the pain doesn’t improve or you notice any of these signs:
   • Severe swelling
   • A lump in the breast
   • Redness and warmth, which could indicate an infection
   • A bruise on your breast that doesn’t go away
3. Your breasts hurt due to an unsupportive bra. Without proper support, the ligaments that connect breasts to the chest wall can become overstretched and painful by the end of the day. The result is achy, sore breasts. This may be especially noticeable during exercise. Make sure your bra is the correct size and provides good support.
4. Breast pain is really coming from your chest wall. What feels like breast pain may actually be coming from your chest wall. This is the area of muscle, tissue and bone that surrounds and protects your heart and lungs. Common causes of chest wall pain include:
   • A pulled muscle
   • Inflammation around the ribs
   • Trauma to the chest wall (getting hit in the chest)
   • Bone fracture
5. Breastfeeding is causing breast tenderness. Breastfeeding can sometimes be the source of breast pain. Some of the things you can experience while nursing include:
   • Painful nipples from an improper latch (the way a baby latches on to suck)
   • Tingling sensation during letdown (when the milk starts to flow to the baby)
   • Nipple soreness due to being bitten or having dry, cracked skin or an infection

   If you have pain while breastfeeding, it’s best to talk to your doctor or a lactation consultant. They can help you troubleshoot the problem while maintaining your milk supply.

6. You have a breast infection. Breastfeeding women are most likely to get breast infections (mastitis), but they occasionally occur in other women, too. If you have a breast infection, you may have a fever and symptoms in one breast, including:
   • Pain
   • Redness
   • Swelling

   If you think you may have a breast infection, it’s important to see a doctor. Treatment typically includes antibiotics and pain relievers.

7. Breast pain could be a medication side effect. Some medications may cause breast pain as a side effect. Talk to your doctor about the medications you’re on and if this could be the case for you. Some drugs with this known side effect include:
   • Oxymethone, used to treat some forms of anemia
   • Chlorpromazine, used to treat various mental health conditions
   • Water pills (diuretics), drugs that increase urination and are used to treat kidney and heart disease and high blood pressure
   • Hormone therapies (birth control pills, hormone replacement or infertility treatments)
   • Digitalis, prescribed for heart failure
   • Methyldopa, used to treat high blood pressure
8. You have a painful breast cyst. If a tender lump suddenly appears in your breast, you may have a cyst, says Wright. “These fluid-filled lumps aren’t dangerous and often don’t need to be treated as they may resolve on their own. But it’s important to get any lump in your breast evaluated by a doctor.” To diagnose a cyst, your doctor may recommend a mammogram, ultrasound or aspiration (drawing fluid from the lump). Draining fluid from the cyst is also a form of treatment. If the cyst isn’t bothersome, you may not need any treatment at all. Learn more about breast cysts and other noncancerous breast lumps,
9. You’re experiencing painful complications from breast implants. Some women have complications with breast implants, whether made of silicone or saline. One of the most common causes of pain after breast augmentation surgery is capsular contracture, when scar tissue forms too tightly around implants. Breast pain can also be an indication that one of your implants has ruptured. Talk to your doctor about any pain you’re having to determine if it could be related to the breast implants.
10. Breast pain can sometimes be a sign of breast cancer. It’s unusual for breast cancer to cause pain, says Wright, but not impossible. Inflammatory breast cancer often causes pain but it’s rare, accounting for 1% to 5% of breast cancer cases in the United States. Symptoms of this aggressive disease often come on suddenly and progress rapidly. Inflammatory breast cancer may cause the breast to become:
    • Red or discolored
    • Swollen or heavy
    • Painful

    Skin on the breast may also thicken or dimple. If you’re concerned about inflammatory breast cancer, see your doctor immediately.

What vitamins help with breast pain?

Sore breasts can signal the onset of PMS – that ‘ouch’ feeling tells some women they’re premenstrual more reliably than a calendar. Cyclical breast soreness shouldn’t cause concern, according to Women’s Health America. However, breast pain doesn’t have to be tolerated.

Here’s how to minimize discomfort, and how to recognize cautionary signs that should send you to your doctor. Sore breasts can signal the onset of PMS – that ‘ouch’ feeling tells some women they’re premenstrual more reliably than a calendar. Cyclical breast soreness shouldn’t cause concern, according to Women’s Health America.

However, breast pain doesn’t have to be tolerated. Here’s how to minimize discomfort, and how to recognize cautionary signs that should send you to your doctor. Watch what you eat and drink. Caffeine and sugar can cause premenstrual breast tenderness. If you can’t give up coffee, cut down all month, not just premenstrually.

1. Salt is often mistaken as the culprit in bloating and breast tenderness, but sugar is actually implicated in puffy, sore breasts.
2. Minimizing sweets helps manage breast soreness, and may improve other PMS symptoms.
3. Eep moving.
4. Breast pain can make exercising uncomfortable.
5. But regular exercise actually helps reduce premenstrual breast soreness, according to a Canadian study.

Supplement. The supplement Vitamin B6, taken as part of a B-complex vitamin that contains magnesium, can reduce premenstrual breast soreness. Evening primrose oil may also help premenstrual breast tenderness. Review your medication. During perimenopause, PMS-like symptoms such as breast tenderness often worsen.

1. A woman taking hormones who continues to experience breast soreness should evaluate her regimen.
2. Breast tenderness often results when HRT dosages are too high,” says Gloria Bachmann, M.D., professor of ob/gyn at the University of Medicine and Dentistry of New Jersey.
3. You don’t have to stop taking HRT or oral contraceptives if you have breast soreness, Dr.

Bachmann notes. “Dosages can be adjusted or the delivery system changed.” Natural progesterone can also help alleviate breast soreness. Synthetic progestins in birth control pills or in HRT may cause breast pain. Natural progesterone, identical to the hormone the body produces, is often easier to tolerate.

• Cause for Concern Intense or prolonged breast soreness, or pain occurring at unexpected times of the month should be evaluated, says Dr. Bachmann.
• Irregular menstruation during perimenopause can make it difficult to tell if breast pain is cyclical or something out of the ordinary.
• Any nipple discharge that accompanies the pain is a red flag,” says Dr.

Bachmann. She also advises examining your breasts carefully. “Any discoloration or dimpling needs to be checked out,” she says.

What triggers breast pain?

Pain – breast; Mastalgia; Mastodynia; Breast tenderness Breast pain is any discomfort or pain in the breast. The female breast is either of two mammary glands (organs of milk secretion) on the chest. Breast pain can be due to many possible causes. Most likely breast pain is from hormonal fluctuations from menstruation, pregnancy, puberty, menopause, and breastfeeding. Breast pain can also be associated with fibrocystic breast disease, but it is a very unusual symptom of breast cancer.

What does period breast pain feel like?

Period breast pain vs. pregnancy breast pain: what’s the difference? – For many people, breast changes are among the earliest signs of pregnancy. Pregnancy influences the levels of estrogen and progesterone in your body. Estrogen enhances the growth of breast ducts, and progesterone supports the growth and formation of milk-producing tissue.

Your breasts may feel swollen, sensitive, tender, or sore during early pregnancy because of these hormonal changes. Your breasts may also feel heavier and fuller. These changes usually occur one to two weeks after conception and may last until your progesterone levels settle. Symptoms of PMS, such as breast pain, tenderness, and swelling, can happen during the second half of the menstrual cycle.

The symptoms tend to be most severe just before your period starts. Your breasts may feel dense and bumpy, particularly in the outer region. Breast pain caused by your period may feel like a dull pain with a sense of heaviness and fullness. The pain usually gradually improves after your period.

Breast pain can appear a week before your period starts and gradually taper off afterwards. You can take over-the-counter nonsteroidal anti-inflammatory drugs to relieve the breast pain. You can also make certain lifestyle changes to improve the pain. Breast pain after your period that doesn’t get better may have no relation to your menstrual cycle.

If you have breast pain unrelated to your menstrual cycle that doesn’t get better and there is an accompanying lump, nipple discharge, or signs of a breast infection, then immediately consult your health care provider. Mayo Clinic Staff. “Breast Pain.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 31 Jan.2019, www.mayoclinic.org/diseases-conditions/breast-pain/symptoms-causes/syc-20350423,

Breast Pain.” NHS Choices, NHS, 28 June 2017, www.nhs.uk/conditions/breast-pain/, Editorial staff. “Breast Pain in Women – Breast Pain Causes.” Familydoctor.org, 18 Dec.2019, familydoctor.org/condition/breast-pain-in-women/?adfree=true, Mancini, Mary. “Breast Pain: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S.

National Library of Medicine, 30 Oct.2018, medlineplus.gov/ency/article/003152.htm, “Mastalgia Fact Sheet: Westmead BCI.” Westmead Breast Cancer Institute, Apr.2018, www.bci.org.au/breast-cancer-information/fact-sheets/mastalgia/, Cleveland Clinic medical professional.

Breast Pain (Mastalgia) Management and Treatment.” Cleveland Clinic, 29 May 2014, my.clevelandclinic.org/health/diseases/15469-breast-pain-mastalgia/management-and-treatment, Kataria, Kamal, et al. “A Systematic Review of Current Understanding and Management of Mastalgia.” The Indian Journal of Surgery, Springer India, June 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4141056/,

Current version (23 November 2022) Reviewed by Dr. Anna Klepchukova, Intensive care medicine specialist, chief medical officer, Flo Health Inc., UK Published (20 December 2018)

Can lack of vitamin D cause breast pain?

* Corresponding Author: Elizabeth Li, Department of General Surgery, Sandwell And West Birmingham Hospitals NHS Trust, UK, Tel: 0121 371 7889, Email: [email protected] Received: 11-Sep-2018 / Accepted Date: 05-Oct-2018 / Published Date: 12-Oct-2018 DOI: 10.4172/2167-0846.1000330 Non-cyclical breast pain is a common, potentially debilitating condition affecting 70% of women at some point during their lives and represents a third of all breast pain complaints. It is often difficult to treat, can last for several months, relapses in up to 60% of cases (1) and can represent a significant work load for breast care services. Several treatment modalities have been trialled such as NSAIDs, steroids, antibiotics, hormone modulators, vitamin E and topical treatment, which have had with mixed outcomes and none have been definitively recommended, Another group of patients well known to breast care services are cancer patients, and there is a growing body of evidence that vitamin D deficiency is a major contributing factor in the well-recognised side effect of chest and musculoskeletal pain in patients receiving aromatase inhibitors (AI). Vitamin D deficiency has been found to be significantly lower in patients undergoing AI treatment experiencing musculoskeletal pain, as well as increased intensity of observed pain, Regimented supplementation has been demonstrated to raise serum vitamin D levels and significantly improve symptoms from Musculoskeletal disability, Furthermore, pre-treatment with vitamin D has also been shown to reduce musculoskeletal side effects after starting AI therapy with prolonged improvement in symptoms during and after treatment. Vitamin D deficiency has also been strongly associated with arthritic pain, fibromyalgia, chronic non-specific pain and other musculoskeletal pain, Moreover, severe hypovitaminosis D has been linked with persistent non-specific pain, in patients from ethnic minorities such as Afro-Caribbean, Hispanic, American-Indian, aboriginal, non-western immigrants and Arab and Indian- Pakistani patients when compared to Caucasian patients, It also been linked to fatigue, secondary hypoparathyroidism, headaches low mood and depression, However, little is known about the effects of vitamin D deficiency on non-cyclical breast pain and how supplementation could potentially improve symptoms. Our local population exhibits a high ethnic diversity with a larger than average percentage of patients from south Asia, Africa and the Middle East. We have observed a similar trend of increased musculoskeletal pain in patients undergoing AI treatment. However, we have also noted a high number of non-Caucasian patients presenting with non-cyclical breast pain. These patients are also those who are at higher risk of vitamin D deficiency due to their ethnic background and prolonged stay in temperate climate of the UK. The aim of this exploratory study was to investigate if vitamin D deficiency has any link to non-cyclical breast pain and whether supplementation can deliver symptomatic improvement in a cohort of patients from a range of ethnic backgrounds. This is a prospective observational study conducted in City Hospital, Birmingham, over a two-year period. All participants were recruited from the out patients department. Patients who had presented with breast pain had a full history, drug history and clinical examination. Imaging and other clinical investigations were performed to exclude other potential causes of breast pain. Patients who presented with chest wall pain, referred shoulder pain or dermatological conditions were excluded. Patients over 18 years old, with an established diagnosis of non-cyclical breast pain were approached, provided information and consented in clinic and a blood test to investigate vitamin D levels was performed. The cut off selected for defining deficiency was a serum level of vitamin D 25(OH) biochemical assay. All patients with low vitamin D were sent an information sheet detailing our findings and recommendations for vitamin D supplementation. The blood sample findings were also relayed in a letter to the patient’s respective general practitioner doctors, explaining our study and a recommendation to commence supplementation in accordance to their normal practice and national guidelines. A follow up questionnaire was then sent to those who had low vitamin D blood levels 12 months following the initial appointment in order to follow uptake of recommended treatment and clinical response. The questionnaire asked the patient to rate the improvement, if any, in pain (Pain Score 1-10) and also, treatment they had received from their general practitioners (GPs), their ethnic origin and also the dose, duration and specific preparation of vitamin D supplementation they were prescribed. The responses were categorised as Poor (pain score >5), Average (pain score 4-5), Good (pain score 2– 3) and Excellent (pain score =1). We classified the groups into those who experienced symptomatic improvement (pain score ≤ 5), and those who did not have symptomatic improvement (pain score >5). This study was registered with the trust Research and Development and audit department. A specific regimented treatment or dosage was not mandated at any point during this study. As this follows national guidelines in diagnosis and treatment of low vitamin D and treatment overseen by GPs, ethical approval was not required. All analysis was performed using SPSS version 16.0. A total of 110 surveys were sent out, and 68 patients returned completed questionnaires (62% response rate). All participants were female, mean age at recruitment was 48.2 years (±13.7) and baseline serum vitamin D level at recruitment was 24.1 nmol/L (±10.9) ( Table 1 ).

Total (n=68), 4 patients excluded*
Age (years)	48.2 (± 13.7)
Gender	Female	64
	Male
Race	Caucasian	16
	Asian	39
	Afro-Caribbean	9
Menstruation	Pre-menopausal	48
	Peri-menopausal	2*
	Post-menopausal	18
Serum vitamin D (nmol/L)	24.1 (± 10.9)
Laterality of pain	Bilateral	14
	Unilateral	52

Patients excluded due to confounding factors: Peri-menopausal, pregnancy, change of oral contraceptive pill Table 1 : Baseline patient demographics. There was no statistical significant difference in the age of the women who in each pain score subcategory ( Table 2 ).

Total (n=64)	Vitamin D supplementation (n=46)	No vitamin D supplementation (n=18)	p (Vit D supplmentation
	improvement	no improvement	improvement	no improvement	versus no supplmentation)
Overall (n)	35	11	3	15	<0.001
Age (years)	48.1 (27-84)	47 (26-71)	51 (41-63)	44.2 (29-61)	0.505
Race
Caucasian	5	3	2	6	0.314
Asian	26	6	1	6	0.002
Afro-Caribbean	4	2		3	0.167
Serum Vitamin D 25(OH)
mean	24.71	17.45	23.90	30.39	0.038
<20 nmol/L	17	8	1	4	0.128
<35 nmol/L	10	3	1	5	0.041
<50 nmol/L	8		1	6	0.001

Table 2 : Results summary of vitamin D supplementation and improvements in pain alongside ethnic background and baseline serum vitamin D levels. Of the 68 patients who responded to the questionnaire, 46 patients were prescribed vitamin D supplementation by their GP and 18 patients either had not been prescribed or had chosen not to take vitamin D supplementation. Four patients were excluded from analysis as they had also reported other potential confounding factors: pregnancy (n=1), peri-menopause (n=2), and change in oral contraceptive use (n=1). From the 46 patients who received vitamin D, 23 patients (51%) experienced complete or near complete remission of all symptoms following therapy, 12 patients (26%) noted a pain score of 5 despite therapy. Of the 18 patients who had not received vitamin D supplementation, 3 patients experienced spontaneous resolution or improvement of symptoms and 15 reported no change in symptomatic relief, Overall, 77% of patients experienced symptomatic improvement of their noncyclical breast pain after treatment with vitamin D when compared to 17% of those who had not (p=0.0001) ( Table 2 ). Patients of an Asian ethnic origin demonstrated the most significant improvement of symptoms with vitamin D supplementation (p=0.002). Afro-Caribbean patients also tended to experience symptomatic improvement, though the observed improvement was not significant. Perhaps this is due to the small number in this cohort (n=9, p=0.167), whereas within the Caucasian patients there was no significant improvement above background spontaneous recovery (n=16, p=0.314). The overall average baseline serum vitamin D level was 25.2 nmol/L (± 11.2 SD). The patients who had baseline serum vitamin D levels between 35-50 nmol/L demonstrated the most improvement of symptoms with treatment (p=0.0001) and those with baseline levels between 20 to <35 nmol/L also had a significant improvement in symptoms (p=0.041). Whereas in patients with a baseline serum vitamin D of <20 nmol/L, a weak trend towards association of supplementation and pain relief was observed, however this was not significant (p=0.128). This suggests that perhaps those patients who are mild to moderately deficient have a shorter gap to close to achieve therapeutic benefit, whereas those with severe deficiency reap some benefit but still experience persistent pain. Patients who had been treated with vitamin D had a significantly lower baseline serum level compared to those who were not treated (p=0.038). This may be a reflection of the normal practice for GPs managing those who are only mildly vitamin D deficient versus those who are profoundly deficient. NICE guidelines recommends treating all patients with a serum level <30 nmol/L, but only recommends treatment for those with a serum level 30-50 nmol/L if the patient has other risk factors such as concurrent metabolic or malabsorption disorders, or are at risk of fractures or display symptoms suggestive of vitamin D deficiency. The final decision to offer treatment was left to the discretion of the GP. Furthermore, the patients with poor response tended to have received a shorter treatment course 1 month (median, IQR range 0.6-5.25 months), compared with patients with symptomatic response 2.5 months (median, IQR range 0.8-8.5 months), p=0.267. The exact type and strength of vitamin D supplementation was managed by the GP in line with their normal practice, which varied between differing preparations and strengths from 400 iu to 10,000 iu per day ( Table 3 ), a relatively low treatment dose compared to other studies (5,7,8). There was no difference in the dosages of vitamin D supplementation between those who did and did not experience symptomatic improvement (p=0.957) ( Table 3 ).

	Vitamin D supplementation (n=46)	p
improvement	no improvement
Vitamin D dose (per day)	n=35	n=11
400 iu	11	6
800 iu	14	2
>800 iu	6	2
Unknown	4	1
mean (iu / day)	2438	2400	p=0.957
Cummulative dose (iu)	11361	6480
Duration of treatment (months)	4.66 (0.1-12)	2.70 (0.1-9)	p=0.267

Table 3 : Summary of daily and cumulative dosages of vitamin D taken and duration of treatment. However, if the cumulative dose of vitamin D is calculated, the patients who had symptomatic improvement received almost twice as much (11361 iu) vitamin D supplementation as the patients had no improvement (6480 iu), which suggests that beneficial effects are not only dependent on the daily regimented dose, but the duration of treatment and aggregate of total supplemented vitamin D that has been delivered. Vitamin D has a significant role in bone, joint and muscle metabolism, is critical to calcium and phosphorus homeostasis and has been implicated in cancer, metabolic syndromes, heart failure, infection and immune disorders, There are two main sources of non-prescriptive vitamin D: Diet and sun exposure. For dermal synthesis of vitamin D to occur exposure to ultraviolet B radiation is necessary. Due our northern location, 90% UK and other countries lying on or situated further north of these latitudes experience ultraviolet B radiation for only 6 months of the year, Though Caucasian patients can achieve adequate vitamin D synthesis from 10 minutes of sun exposure three times a week during the summer, this is wholly insufficient for an individual with darker skin who requires 2-10 times more sun exposure, Other factors such as diet, occlusive clothing, age and pregnancy can also compound this risk. In the current climate of ethnic fluidity and migration, many communities living in the UK’s temperate climate are risk of vitamin D deficiency. In our study, we have shown that not only a large majority of patients presenting with non-cyclical breast pain are of a non- Caucasian ethnic origin, but also that they experience symptomatic improvement with low dose vitamin D supplementation. There is a substantial body of research linking vitamin D deficiency and nonspecific chronic pain, however there are no studies specifically investigating the link between breast pain and vitamin D deficiency outside the realm of aromatase inhibitor treatment in breast cancer. Several mechanisms have been proposed for developing musculoskeletal pain in vitamin D deficient states. One proposed explanation is an interruption of calcium deposition in collagen matrices of bone, which results in malformation of pathologically soft bone that continues to expand and exerts pressure on periosteal surfaces and subsequently on sensory pain receptors, Other mechanisms that have been suggested include a reduction in nerve conduction velocity resulting in muscular atrophy and myopathy and hyperparathyroidism by way of proteolysis of muscle leading to fatigue and muscle, bony and joint pain, however the mechanism for vitamin D deficiency in non-cyclical breast pain is unclear. Recent studies have shown that vitamin D receptors are available in almost all cells and current theories around the pathogenesis of this heightened pain response implicates an exaggerated immune possibly as a reaction to infection and sensitisation of pain signalling pathways, This would reflect how vitamin D deficiency is linked to a number of multi-organ disease states and could be the underlying mechanism by which vitamin D deficiency results in breast tissue tenderness. We attempted to exclude patients who were experiencing chest wall pain or costochondritis to isolate a cohort with breast tissue tenderness, though it is possible some of these patients were suffering from referred pain and that the perceived breast tenderness have a musculoskeletal origin. Nevertheless, this highlights a group of patients whose vitamin D deficiency may have been overlooked when the focus is on investigating the breast. The lowest serum level of vitamin D 25(OH) necessary for promotion of optimal bone health is considered to be approximately 12-30 nmol/L, as this is the level required to prevent increases in parathyroid hormone (4). However, this standard may be insufficient to achieve improvement in pain and may not represent the therapeutic threshold we should be targeting treatment. Our results show that that those with a mild vitamin D deficiency (35-50 nmol/L) have the most demonstrable improvement in pain from low dose supplementation when compared with those with severe deficiency (<20 nmol/L), suggesting that low dose supplementation is not enough to elevate vitamin D levels sufficiently to yield therapeutic results in those with severe deficiency. This reflects the findings of a systematic review study looking into the optimum target vitamin D levels for multiple end points, including reduced myopathy. Bischoff found that a posttreatment serum level of at least 30 nmol/L produces the most detectable adventitious outcomes and demonstrates continuing improvement with higher concentrations, though not as pronounced, This is also in line with several other studies that have noted a threshold of demarcation whereby improvement in musculoskeletal pain was achieved with serum vitamin D level of 30-66 ng/ml (75-165 nmol/L), and conversely, post-treatment serum vitamin D levels of <30 ng/ml (75 nmol/L) did not achieve a significant improvement in musculoskeletal pain. However the serum vitamin D targets suggested by these studies are considerably higher than what was found in our study. One possible explanation is that all of these studies were conducted on patients undergoing AI treatment for breast cancer. These patients are at higher risk of vitamin D deficiency due to reduced oestrogen levels and subsequent diminished joint vitamin D receptors, which leads to development of myopathy and joint pain, and increased metabolic requirements as vitamin D plays a crucial role in the detoxification of aromatase inhibitors by the liver, Therefore, a therapeutic threshold can still be observed, but is likely to be observed at much higher level. In light of this, perhaps we should not only be supplementing simply to improve serum vitamin D, but calibrating our treatment towards achieving a therapeutic threshold and clinical reduction in pain. The aim of this exploratory study was to probe the link between vitamin D deficiency and non-cyclical breast pain and establish a connection in view of opening up further inquiry. The limitations of this study include the lack of a blinding between the treatment and control group, and no follow up vitamin D 25-OH blood test to investigate post treatment serum vitamin D levels. Indeed a larger scale blinded investigation with greater power to detect smaller variations between the subgroups is warranted. Consideration must be given to dosing, and cumulative vitamin D that is given, as previous studies have regimented supplementation 400 iu daily to 150,000 iu single dose in previous studies and cumulatively up to 800,000 has been given before. The method for delivery and duration of treatment requires thought: Daily oral supplementation is less invasive and more acceptable for patients, however regular injectable high dose supplementation can have a greater impact and ensure compliance. Information on biochemical serum concentrations of vitamin D, pre, during and post treatment as well as calcium, phosphate, parathyroid hormone would also be informative. Clinical symptoms should be collated alongside menstrual status and hormonal contraceptive use as oestrogen levels has linked to musculoskeletal pain, and smoking and BMI as these have been found to be independent factors affecting breast pain. In conclusion, in patients experiencing non-cyclical breast pain who have vitamin D deficiency, low dose supplementation reduces breast pain, in particular in patients of a non-Caucasian ethnic origin. Further work is required, but this could establish a treatment option for those patients who present with non-cyclical breast pain that is unresponsive to conventional treatment.

Is ice or heat better for breast pain?

Gel Hot & Cold Pack for Mastitis Mastitis is a breast tissue infection that can result from breast-feeding. If you have mastitis, your breasts may become sore, swollen, red, and warm. You might also experience flu-like symptoms, such as chills, fatigue, and a fever.

You can continue breast-feeding your bundle of joy if you have mastitis; however, it may be more difficult due to the symptoms you are experiencing. An antibiotic will most likely be needed to cure mastitis since it is a bacterial infection. At the same time, a reusable hot/cold pack can help you take charge of your symptoms.

A warm pack is a wonderful way to soothe sore breasts while they are healing. You should aim to apply a warm pack to the affected areas four times a day for the doctor-recommended time of 20 minutes. An ice pack can reduce the swelling and pain in your breasts.

If you notice swelling, you should apply an ice pack within 24 hours, and leave it on for 20 minutes at a time. If your breasts are tender, a gel hot and cold pack at the perfect temperature can help you relax and recover. The THERA°PEARL Breast Therapy pack is made to conform to your body for maximum comfort and relief.

: Gel Hot & Cold Pack for Mastitis

Is it good to massage your breast while on your period?

Lymphatic flush – There are hundreds of lymph nodes located all over our bodies. These nodes are small, bean-shaped structures that are part of the body’s immune system. These little beans filter substances that are located in lymphatic fluid. Movement or activity is necessary for the lymph system to flow properly.

Stretches, light activity, and breast massage therapy are all great ways to help flush your lymph system. The lymph system in our bodies is not connected to the heart — or any pumping organ for that matter — so the fluid does not move throughout the body on its own. It’s propelled by muscle motion only.

Movement or activity is necessary for the lymph system to flow properly. Stretches, light activity, and breast massage therapy are all great ways to help flush your lymph system. The area between your lower breast and your armpit can get quite sore when there’s stagnant lymph fluid.

Does massaging sore breasts during period help?

Why do you need that? – Women who are pregnant can benefit from breast massage to help with rapid growth that may cause breast pain or tenderness. Postpartum mom’s may experience issues with milk flow, blocked ducts, recurring breast infections, and may find breast massage increases flow and can reduce postpartum issues.

Women who experience breast pain and tenderness due to menstruation, peri-menopause or menopause can find that breast massage helps with these symptoms. Women who are about to experience breast surgery can find breast massage helps them prepare emotionally for surgery as well as soften the tissues to potentially make surgery and recovery easier.

Women who have already experienced breast surgery, when safe to receive massage, will find relief from post-surgery pain, and aid in the reduction of scar tissue development.

Does massaging sore breasts help?

Lymph node drainage –

Place one hand on top of the breast on the opposite side of the body, so that the fingertips go into the armpit and the palm rests on the chest.Squeeze the hand over the breast in a pumping motion.Using the same pumping motion, slowly move the hand down toward the nipple.Massage around the outside, bottom, and inner areas of the breast.Repeat on the other breast.

Breast massages are generally safe, However, anyone who has breast cancer or who has had recent surgery should take care when massaging near a lump or scar. A doctor can provide guidance, which may be especially helpful for people undergoing treatment for a breast-related health condition.

The doctor may recommend working with a licensed massage therapist to reduce the risk of harm. Some people believe that breast massage increases breast size, firmness, or skin elasticity. But there is a lack of scientific evidence behind these claims. One study did find that a 15-minute breast massage with bitter almond oil may reduce stretch marks during pregnancy.

Breast massage may help detect breast cancer, support lymphatic drainage, and relieve pain from breastfeeding. Various massage techniques can have different effects. Some people should be cautious about trying breast massage, such as people undergoing cancer treatment.