Premenstrual breast tenderness

Premenstrual breast tension is breast pain or discomfort that recurs cyclically every month; it usually starts during the previous two weeks, increases progressively until the start of menstruation and improves when it ends.

It is related to the hormonal fluctuations of the menstrual cycle.

It manifests with pain in both breasts and can occur as a single symptom or associated with other symptoms in Premenstrual Syndrome, such as abdominal distension, irritability, mastalgia, arthralgia, low back pain and cramps.

The diagnosis is clinical and is based on the clinical history and physical examination. The breast exam will focus on ruling out physical abnormalities, since typically there should be no physical abnormality.

In the majority of women with premenstrual mastalgia without suspicious findings, imaging tests are not recommended. In case of diagnostic doubt, it may be necessary to perform a breast ultrasound to rule out other pathologies.

Treatments for premenstrual mastalgia include lifestyle changes (balanced, varied diet, rich in vegetables and low in saturated fat, reducing tobacco, alcohol and caffeine consumption) or the use of food supplements with evening primrose or vitex agnus castus. The use of non-steroidal anti-inflammatory drugs (NSAIDs) and certain diuretics may be effective. In the event that the cyclical discomfort is very intense, oral contraceptives can be used to regulate the cyclical hormonal changes. Using topical progesterone creams may also reduce discomfort.