Cyclical breast tenderness is so common that a lot of us think that it is a normal part of our cycle experience, but the truth is that it typically indicates a hormonal imbalance. It may affect as many as 70 percent of women at some point in their lives, so know that you are not alone! You can also take comfort in the fact that cyclical breast pain can be addressed through completely holistic means.
(Note: Non-cyclical breast tenderness does exist, but for the purposes of this post, I’ll be focusing on cyclical breast tenderness.)
What is cyclical breast tenderness?
Cyclical breast tenderness, known in the medical community as “cyclical mastalgia,” is described as “discomfort, tension or pain in one or both breasts” (1). It typically occurs during the second half of the cycle (known as the luteal phase), following ovulation. Personally, I used to experience it as swelling and increased tenderness towards the end of my cycle. The experience of mastalgia can be milder, as in my case, or can be severe enough to disrupt sleep, interfere with sexual activity and make wearing a bra painful.
What causes breast tenderness?
Cyclical breast tenderness in the second half of the cycle is the result of hormonal activity that leads to water retention in the breast tissue, known as stroma.
Hormone imbalances are the primary cause of breast tenderness. Too much estrogen or too little progesterone are the most common imbalances (and can occur together). Increased prolactin levels may also play a role in some cases.
There are numerous lifestyle factors associated with mastalgia: smoking and caffeine consumption are both highly correlated with breast pain. Oral contraceptives, other forms of hormonal birth control, and hormone replacement therapy may also contribute to cyclical breast pain.
How can you treat it holistically?
The good news is hormone imbalances are completely treatable and cyclical breast pain does not have to be a part of your monthly cycle!
1. Reducing estrogen and boosting progesterone
Estrogen and progesterone are the two dominant hormones in the reproductive cycle and need to be in the correct balance in order to have a symptom-free cycle.
Unfortunately, our modern diets and lifestyles often increase estrogen levels while reducing progesterone levels, creating an imbalance that leads to symptoms like cyclical breast tenderness.
The best way to reduce estrogen exposure is to avoid BPA and other environmental estrogens, eliminate conventional dairy and meat (opt for grass-fed, organic instead), and limit phytoestrogens like soy. Your liver has to process and eliminate estrogen from your body, so consuming liver-boosting foods like cruciferous veggies (kale, Brussels sprouts, etc.) can also help!
To increase progesterone levels, focus on stress management and eat plenty of green leafy vegetables. Leafy greens are packed with B vitamins that help support your body’s stress response.
2. Seed cycling
Seed cycling is a nutritional protocol that incorporates flax and pumpkin seeds into the diet daily during the first half of the cycle, and sunflower seeds and sesame seeds during the second half. Seeds contain compounds called lignans, fiber, essential fatty acids and nutrients that help to detox hormones (especially estrogen) and build both of the hormones that we need.
While I am not aware of any studies on the effectiveness of seed cycling itself, there is plenty of evidence for the impact of seeds on hormonal activity. Flax seeds can be effective at reducing cyclical breast pain.
(You can download my free seed cycling guide here.)
3. Evening primrose oil
Evening primrose oil (EPO) is my go-to for cyclical breast tenderness and other nuisance symptoms during the premenstrual phase. In one study, it was demonstrated to be just as effective as prescription drugs danazol and bromocriptine, but with significantly fewer complaints of “adverse events.”
EPO is rich in gamma linoleic acid (GLA), which helps to balance estrogen and progesterone levels.
Vitamin E may also improve outcome rates of treatment with EPO when the two are taken together. It also supports detoxification of estrogen.
Cyclical breast tenderness is a common occurrence, but it does not have to be a regular part of your monthly cycle! Be mindful of diet and lifestyle changes that support a healthy ratio of estrogen to progesterone, and employ the help of seed cycling and supplements as needed, and you will be able to banish that breast pain for good!
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Kara DeDonato is a fertility health expert who works with women to troubleshoot their cycles and digestion so that they can feel their best. She is a certified women’s health coach and works with women at Quit The Pill to transition off of hormonal birth control as seamlessly as possible, and repair health post-HBC. Read her full bio here.