Dear Alice,

I was just wondering about having a little discomfort in one of my breasts. I am on the pill and it usually occurs a week or two before my period and lasts about a week or so. My breast feels like it is bruised or something, like it is uncomfortable to lay on or even touch. Is this something to worry about or just an effect of the pill? Thanks.

Dear Reader,

Breast pain, unfortunately, isn’t uncommon among those assigned female at birth. This pain or discomfort is usually categorized as either cyclical or non-cyclical breast pain. Generally speaking, the cyclical breast pain coincides with the menstrual cycle, whereas non-cyclical pain may be the result of an injury or muscle pain, among other reasons. If you notice that the pain happens every month around the same time of your menstrual cycle, it may be hormonal. Treatment for breast pain may include lifestyle remedies or medication. It’s wise to see a health care provider if the pain continues for an extended period of time, gets worse, or impacts your ability to perform daily activities.

Some people assigned female at birth have breast discomfort or pain that’s bilateral, meaning that it affects both breasts. Others only experience pain in one breast, which may be because of differences in breast structure. Oftentimes, these symptoms are caused by fluctuations in hormone levels throughout the menstrual cycle (regardless if they’re on the pill or not). Some individuals experience pain right before their period, while for others, the pain starts during ovulation and continues until their period begins. Sometimes birth control pills are prescribed to help alleviate this achiness or tenderness, but it’s also possible that the bruised feeling can be a side effect of the pill. Other non-hormonal causes of breast pain include injury to the breast tissue, changes in the breast structure, large breasts, or scar formation following breast surgery.

While it’s possible that the bruised feeling you describe could be a result of the pill, it's recommended that you check your breasts throughout your cycle to follow any patterns in tenderness or the way the breast feels. You can do this by making notes in a calendar about any discomfort you feel throughout your cycle. It might also be helpful to do a monthly breast exam to check for any unusual lumps, increased areas of sensitivity or pain, or other changes that may be a cause of concern. Detailed instructions on how to do a breast self-exam can be found on the National Breast Cancer Foundation website. If you notice a change, a particular pattern that concerns you, or just want reassurance, you may want to make an appointment to talk with your health care provider. They may choose to do a breast exam or ultrasound to further assess your areas of pain.

Based on what your health care provider learns, they may suggest that you try some lifestyle remedies such as a hot or cold compress, wearing a supportive bra, limiting caffeine intake, or using over-the-counter pain relievers. Other treatment options could include adjusting the birth control dose or type, using nonsteroidal anti-inflammatory topical medications, or taking other hormonal or hormone blocking medications.

For more information about healthy breasts and breast issues, you could check out the Go Ask Alice! Sexual & Reproductive Health archives. 

Alice!

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