Breast Tenderness

WHEN TO SEE YOUR DOCTOR

* The pain is severe or persists for two months or more.

* You are taking hormone replacement therapy.

What Your Symptom Is Telling You

Forget the calendar. Like many women, you chart your menstrual cycle by consulting your breasts. A week or two before your period, your breasts start to hurt. Then once your period begins, the discomfort subsides...only to start up again next month.

No one has pinned down the exact cause of monthly breast pain. Many doctors believe that it's caused by excess female hormones—too much estrogen, progesterone or prolactin. An imbalance in these hormones is another possibility. In any case, the monthly change in hormones causes fluid retention in the breasts, which makes them feel swollen and tender.

For some women, breast pain may be at its worst during the decade prior to menopause, according to Susan Lark, M.D., director of the PMS and Menopause Self-Help Center in Los Altos, California, and author of Premenstrual Syndrome Self-Help Book and Menopause Self-Help Book. "This is when female hormones are in greatest flux," says Dr. Lark.

No matter what a woman's age, the discomfort seems to escalate with emotional stress or prolonged inactivity. Excessive amounts of salt, fat and caffeine also seem to have a negative impact.

Breast tenderness that doesn't disappear in two weeks could be a sign of pregnancy. It could also be from an injury or arthritis of the neck.

Symptom Relief

If you're experiencing monthly breast pain, you don't have to wait until menopause to get relief. Here are some things you can do now.

Go for a walk. Breast pain is likely to be worse if you're a benchwarmer, according to Boston gynecologist Robert Shirley, M.D., past director of the Breast Clinic for the Boston Hospital for Women. "A half-hour to an hour daily walk or bike ride could begin to make a real difference in your monthly breast discomfort," he says.

Give your breasts full support. Wearing a good support bra while exercising and even to bed can help take strain off tender tissues, according to Kerry McGinn, R.N., nurse coordinator at the Breast Care Center of the University of California, San Francisco, and author of The Informed Woman's Guide to Breast Health.

Pad your bra. Try placing some lamb's wool inside your regular bra. The soft material sends a comfort message to your brain and crowds out the pain message, says McGinn.

Take a pain reliever. Taking two ibuprofen or other over-the-counter anti-inflammatory tablets three times daily may be all it takes to keep breast pain at bay during the week before your period, says Lois Jovanovic-Peterson, M.D., endocrinologist with the Sansum Medical Research Foundation in Santa Barbara and coauthor of Hormones: The Woman's Answer Book.

Chill your chest. Many women find that ice packs help quell the throbbing pain, says McGinn. Place a cloth-covered plastic bag filled with ice cubes against your breasts for 10 to 15 minutes and see if it brings some relief.

Imagine your breasts resting in warm sand. A simple visualization exercise can help you unwind, dissipate daily stress and program your mind to relieve pain, says McGinn. To begin, sit in a comfortable chair, close your eyes and breathe slowly and deeply. Then relax every muscle in your body, starting with your toes and working up to your forehead. Now, visualize warm sand enveloping your breasts. Hold the image for approximately ten minutes. If you find that it helps, you can practice this visualization as often as you like.

Have your hormones adjusted. If you're taking hormone replacement therapy and your breasts ache, tell your doctor. "The problem can usually be solved by prescribing progestin (synthetic progesterone) in lower doses to be taken for more days," says Dr. Jovanovic-Peterson.

Diet for Pain-Free Breasts

Here are a few dietary remedies that may help defend you against breast pain.

Forget about butter. Research shows that a low-fat diet can help relieve breast pain by reducing estrogen levels, according to David P. Rose, D.Sc., M.D., Ph.D., chief of the Division of Nutrition and Endocrinology at the American Health Foundation. "The women in our study reported that when they reduced their fat to 20 percent of their total calories, they also reduced their breast pain," says Dr. Rose. A low-fat diet bonus: It may also help you decrease your breast cancer risk. You can reduce the amount of fat in your diet by eating more fruits, vegetables and whole grains and cutting back on meat and dairy products.

Start your day with a high-fiber cereal. Dietary fiber helps keep estrogen from overstimulating breast tissue, says Dr. Shirley. Fiber may also help rid the body of excess estrogen. Bran cereals are great fiber sources. So are fruits and vegetables—especially those still wearing their skins, such as whole apples, peaches and pears.

Forgo that jolt of java. In a study done by researchers at Duke University Medical Center in Durham, North Carolina, 61 percent of women with breast pain experienced reduced tenderness when they eliminated caffeine from their diets. While the study was not conclusive, it certainly wouldn't hurt to try cutting back on caffeinated beverages like coffee, Give up chocolate. Researchers at the State University of New York at Buffalo asked 102 women to keep track of their intake of substances containing methylxanthine, which is found in such things as chocolate, coffee, Slash your salt intake. Salt promotes fluid retention and can boost pain, according to Dr. Shirley. This means stay away from processed foods. Also, read labels and avoid foods containing more than 300 milligrams per serving.

Flush out the fluid. Sarsaparilla, buchu and uva-ursi are all herbal diuretics that can help prevent fluid retention, says Dr. Lark. "I recommend that women take two dropperfuls of tincture of sarsaparilla dissolved in warm water twice daily when swelling and pain are at their worst," she says. You can purchase all these herbs as teas in most health food stores. Ditto for tincture of sarsaparilla. A number of foods also have helpful diuretic properties, she says. These include parsley, celery and cucumbers.

Take a multivitamin/mineral supplement. Your brand should include vitamin A, the B-complex vitamins, vitamin E, iodine and selenium. In research trials, all have been shown to have some beneficial effect on breast pain and lumps, even though some of the evidence is inconclusive, says Dr. Shirley. The B vitamins, for example, may function to help the liver metabolize estrogen, he says.