Why do my breasts hurt?

Bottom lineBreast pain is usually hormonal - cyclical soreness in both breasts that builds before your period and eases when it starts - or comes from local causes like cysts, mastitis, chest wall strain, medications, or an ill-fitting bra; see a doctor for pain that stays in one spot, persists beyond two cycles, or comes with a lump, skin changes, redness, or fever.

Breast pain (the medical term is mastalgia) is very common, and most of the time it is hormonal, not dangerous. Doctors sort it into two types, and the distinction tells you a lot about the cause.

Cyclical breast pain - tied to your cycle

The most common kind. Estrogen and progesterone swings in the second half of your cycle make breast tissue swell and become tender, typically:

• In both breasts, often worst in the upper outer areas
• Starting up to two weeks before your period and easing once bleeding starts
• Feeling like heaviness, aching, or soreness rather than sharp pain

Cyclical pain is also common when hormones shift gear: starting or changing hormonal birth control, early pregnancy (often one of the first signs), perimenopause, and HRT. If you track your cycle, the pattern is easy to confirm - pain that returns at the same cycle phase each month is hormonal almost by definition.

Non-cyclical breast pain - other causes

Pain that ignores your cycle usually has a local cause:

• Breast cysts - fluid-filled sacs that can ache, especially before a period
• Mastitis - a painful, red, hot area, often with fever; common while breastfeeding but possible outside it. Needs prompt treatment.
• Chest wall pain (costochondritis, pulled muscle) - often sharp, one-sided, and worse with movement or pressing on the ribs
• A poorly fitting bra, heavy breasts, or recent intense exercise
• Medications - some antidepressants, blood pressure drugs, and hormonal treatments
• Injury or previous surgery

What helps

A well-fitted supportive bra (day and night during sore phases), regular pain relief like ibuprofen or paracetamol, warm or cold compresses, and gentle exercise. Evidence for cutting caffeine is mixed, but some women notice a difference.

When to see a doctor

See a clinician for pain that is focal (always one spot), persistent beyond a couple of cycles, severe enough to affect daily life, or paired with a new lump, skin changes, nipple discharge, redness, or fever. Breast pain alone is very rarely a sign of cancer, but new, unexplained, persistent pain deserves a check - and no amount of self-checking replaces that visit.

Related: is breast pain a sign of cancer · sore breasts: period or pregnancy? · breast self-exam guide