Why Are My Breasts Sore During Ovulation?

Throughout the month, female bodies go through many changes — these changes could result in glowing skin, a pimple, or breast pain, otherwise known as mastalgia. Let’s review what breast pain is, what causes it, and how best to manage it.

Types of breast pain

It’s important to note that everyone’s bodies react differently to their changing hormones throughout the month. Some women can hardly touch their breasts due to these hormonal changes around ovulation, while others may not experience mastalgia at all. We are all different, and that’s what makes us so unique.

There are two main types of breast pain:

• Cyclical breast pain
• Noncyclic breast pain

Cyclical breast pain is very common and is usually linked to menstrual periods and the rising and falling of two hormones: estrogen and progesterone. The onset of the discomfort may arise during ovulation — the most fertile window of each month — and may not end until after the period is over. The cyclical breast pain may be in one breast or both, and it can stay in one spot or radiate to different locations.

The best way to determine if your breast pain is cyclical is to track when it occurs, the duration, and the location. If there is no link to your menstrual cycle or ovulation times, and the pain is severe, a visit to your physician may be warranted for an exam.

Noncyclic breast pain occurs less often and is not related to the menstrual cycle or ovulation times. The pain can be sporadic or constant and is typically only in one location in the breast. Most commonly, the culprit for noncyclic breast pain is injury to the breast from trauma or exercise. A rare cause of noncyclic pain is from arthritis radiating down from the neck and chest toward the breast.

Reasons for breast pain during ovulation

It’s important to understand the reason breast pain can be associated with the patterns of hormone levels throughout the month. Below is a graph to visualize the changing levels of hormones during each monthly cycle.

Period. Levels of both estrogen and progesterone fall, which can reduce breast soreness.

Follicular. Progesterone remains stable, and estrogen begins to rise to prepare for ovulation.

Ovulation. Estrogen levels peak to prepare for potential fertilization, causing breast pain, soreness, or tenderness.

Luteal. Estrogen levels decrease after ovulation, and progesterone levels rise to increase the chances of an egg implanting in the uterus. The surge in hormones can also lead to breast pain just before the onset of the period.

Increased levels of prolactin — a hormone that increases breast tenderness and swelling — are a major contributor to mastalgia. During times of increased stress, the body releases inflammatory cells, including prolactin, within the body. Increased prolactin levels within the body are associated with increased breast pain, which is why it’s very important to monitor your stress levels.

Symptoms of sore breasts during ovulation

Symptoms of mastalgia during ovulation may include:

• Breast tightness
• Sensitivity to touch
• Tenderness in the upper-outer quadrant of one or both breasts
• Sore nipples
• Swelling
• Burning

Many women are unable to wear bras with underwire during ovulation and menstruation because of the increased swelling and tenderness.

Abnormal symptoms to look for

Let’s go over symptoms that are abnormal and warrant further investigation by a physician:

• New asymmetry in the breasts (one breast is a different size)
• Itching, redness, dimpling of the skin
• Nipple retraction (nipple pulling inward)
• Redness and/or flaking of the breast skin
• New lump in the breast or the underarm
• Nipple discharge (clear, white, bloody) that is not related to breastfeeding
• Severe pain or discomfort

It’s important to note that any of the symptoms above do not mean one has breast cancer; there can be many causes for these symptoms, such as fibroadenomas (benign breast mass), cysts, radial scars (tissue that looks like a scar, and may feel like a mass under the skin), and others.

How to manage your sore breasts

There are several self-care tips to help relieve breast pain at home. However, if severe discomfort persists, a visit to your primary doctor should be scheduled. Some of these at-home treatments include:

1. Fitted bra/sports bra. Some may find that symptoms can be alleviated by the reduction of breast movement during times of soreness.
2. Warm and cold compresses. Heat for comfort and cold for the reduction in swelling and inflammation. Cold compresses against the breast will result in a constriction or tightening of the blood vessels, which reduces the amount of fluid that circulates to the area. This constriction results in less swelling and inflammation. Warm compresses are especially comforting right before sleep.
3. Over-the-counter medications for pain management. Ibuprofen and acetaminophen are good pain-alleviating medications. Use caution with NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen) due to increased risks of bleeding. Always read the instructions on how to take them beforehand.
4. Reduced caffeine intake, such as coffee, tea, chocolate, and soda. There are links between caffeine and breast pain, although its mechanism of action on breasts is not yet fully understood.
5. Exercise. Physical activity during times of mastalgia increases the breakdown of estrogen and decreases its release into the body.
6. Use of flaxseed, primrose oil, and vitamin E. All three have proven antioxidant effects, aid in the reduction of inflammatory marker levels in the blood, and may reduce breast pain.
7. Breast massage. Massage to the breasts promotes blood flow to the area of inflammation — this stimulates the release of pain-relieving hormones dopamine, endorphins, and serotonin.

How long do your breasts stay sore after ovulation?

Every person is different, and how they experience breast pain also varies in duration, frequency, and severity. Ovulation and menstrual cycles typically occur each month every 28 days. If breast pain arises during ovulation, which occurs roughly 14 days before the next menstrual cycle, one can expect that pain to decrease once the menstrual cycle is over and hormone levels return to their baseline.

Some breast pain may only occur for a couple of days during ovulation or a menstrual cycle, or it can last from the beginning of ovulation until the final day of the period. Everyone is different — the most important thing is to learn your body and what is normal for you.

What your provider can do to help

If the breast pain is determined to be cyclical, your provider can recommend several treatment options to minimize discomfort, such as:

• Oral birth control
• Thyroid hormones
• Tamoxifen (estrogen blocker)
• Bromocriptine (blocks prolactin)
• Danazol (male hormone)

These medications may be prescribed in some cases but carry with them their own risks. All risks and benefits should be discussed with your healthcare provider.

Schedule an appointment with your provider if severe pain persists, if the symptoms are affecting your quality of life, and if you have any of the abnormal symptoms listed above. During your appointment with your provider, they will begin by asking you questions related to your menstrual cycle, so it’s important you know some of your recent period start dates.

The physician may perform a physical breast exam where they will have you undress from the top up. They will palpate (press) down and around both breasts with differing amounts of pressure. It’s important to communicate what you’re feeling and if there is pain. If indicated, the physician may order a biopsy to be performed, not typically on the same day as your doctor’s appointment.

Imaging may be ordered, such as an ultrasound, and, depending on your presenting symptoms, a blood draw may also be added to ensure a thorough investigation of the problem.

It’s essential to become familiar with your body and to learn what is normal and what isn’t. What works, and when do you need to seek out a second opinion from your doctor? We are the best caretakers of our bodies, and getting comfortable with examining them is the best way to prevent and treat anything that comes our way.