Tender Breasts? What Does That Mean?

Did you know that for many of us, breast tenderness is due to hormonal imbalances – specifically, oestrogen dominance? Do your breasts get lumpy and achy before your period, or anytime of the month for that matter? Oestrogen causes breast tissue to grow. It is also inflammatory. Getting to the root cause of oestrogen dominance can help you say goodbye to breast tenderness forever! Let’s look at this further and I’ll also provide you with some advice to help alleviate unnecessary breast tenderness. I’ll also cover when breast tenderness is something you need to worry about so that you can act on that if necessary or put that concern to bed.

Is it Cancer?

First things first let’s discuss the risk of cancer because a lot of women become plagued with worry when their breasts become tender. Here’s two things to remember – cyclic, generalized breast pain is basically never due to breast cancer and this is the type that most of us get. Additionally, localized, non-cyclic breast pain is also rarely due to cancer. However, as we know some breast pain can be due to cancer. Though this is rare, especially when not associated with an abnormal breast exam, it can happen. Scary breast pain symptoms that could mean breast cancer include breast pain associated with a rapidly progressing tender, firm, enlarged breast. The skin over the breast may also feel warm and thick, with an orange peel appearance. Or if you have any sudden and new breast symptoms or pain in one local area. Unless of course you are breastfeeding, and you know it’s mastitis and you feel flu-y and may have a fever. Have a read of our blog on Mastitis as home treatments, tend to do the trick to resolve the issue. If you do go to your doctor with your concerns, make sure an actual physical exam is done. It’s not enough for a doctor to say, “Oh, you’re young and low risk so don’t worry about it.” Make sure you get a thorough, proper inspection and proper testing and referrals are done. An ultrasound should be done if there is localized breast pain, and if there were a lump plus pain, a mammogram would be appropriate for many women over 35.

Cyclic and Non-Cyclic Breast Tenderness

Let’s Get Clear on Definitions. Most of us experience cyclical breast tenderness at one time or another. It is typically generalized throughout both breasts, associated with your period, and may start somewhere after mid-cycle or the week before your period, and usually goes away when your period starts. Gynaecologists consider a minor amount of cyclic breast tenderness normal and just related to cyclic hormonal changes. A third of women experience non-cyclical breast tenderness – it may be persistent throughout the month and is usually localized to one area of the breast. This can be caused by hormonal imbalances, pregnancy, large breasts, hormone replacement therapy, other medications including antidepressants, mastitis or local infection, cysts, and is very rarely caused by breast cancer. Women with fibrocystic breasts (breasts that are naturally lumpier and bumpier due to more fibrous tissue) may experience more breast tenderness.

What Can Cause Breast Tenderness?

Here’s some general points to consider. What feels like breast pain might be coming from your chest wall. This is the area of muscle, tissue and bone that surrounds and protects your heart and lungs. Common causes of chest wall pain include:

• A pulled muscle. Have you injured yourself at the gym during a workout?
• Inflammation around the ribs. Are you coughing a lot and immune compromised? Are your lymph glands up?
• Trauma to the chest wall (getting hit in the chest)

Most women wear poorly fitting bras. If you have large breasts, make sure your bra fits properly and gives you the excellent support you deserve. Yes, good bras are expensive, but can save yourself years of breast, back, and neck pain – even headaches! And those have a cost, too. Take stock of any medications that might be causing your breast pain and switch to natural alternatives if possible. Some drugs with this known side effect include:

• Oxymetholone, used to treat some forms of anaemia
• Chlorpromazine, used to treat various mental health conditions
• Water pills (diuretics), drugs that increase urination and are used to treat kidney and heart disease and high blood pressure
• Hormone therapies (birth control pills, hormone replacement or infertility treatments)
• Digitalis, prescribed for heart failure
• Methyldopa, used to treat high blood pressure

An ultrasound can tell you if you have a cyst. The treatments below can also help clear up breast cysts. Sometimes additional hot compresses are needed over the cyst. Compresses (warm or cool) can be helpful for breast pain in general, but like pain relieving drugs they provide only symptomatic relief. Some women have complications with breast implants, whether made of silicone or saline. One of the most common causes of pain after breast augmentation surgery is capsular contracture, when scar tissue forms too tightly around implants. Breast pain can also be an indication that one of your implants has ruptured. Talk to your doctor about any pain you’re having to determine if it could be related to the breast implants. For most of us, breast tenderness is due to hormonal imbalances – specifically, oestrogen dominance.

Oestrogen Dominance: A Major Root Cause

Here’s a brief outline of how oestrogen levels can become high:

• With excess body fat (> 28%) because body fat produces more oestrogen
• With stress because the adrenal system also controls our women’s hormones
• Due to poor elimination with constipation and inadequate dietary fibre because you don’t get rid of oestrogen
• With decreased liver detoxification of hormones because you don’t detoxify oestrogen
• Environmental exposures leading you to absorb too much
• Nutrient insufficiencies which can impair detox and elimination
• Additionally, many of us, due to environmental toxins, insulin resistance, and stress, have a higher rate of chemicals called inflammatory cytokines circulating in our bodies. These can increase breast tenderness cyclically and non-cyclically.

Tips for Happier Breasts

If you follow them closely, you can generally expect to see improvements in 2-3 months. While the role of diet and lifestyle changes in treating breast discomfort remain medically “unproven,” numerous women report relief using some or all the suggestions below – and most integrative doctors recommend these based on seeing reliable results. We know that great digestion and elimination are key factors in getting your hormones in balance. Quit the Smokes I know this may be obvious, but if you’re a smoker, it’s important to quit. I also know this is easier said than done, but nicotine use is associated with increased breast pain through its effects on a chemical in your body called epinephrine. Cigarette smoking also increases your risk of cervical cancer. Listen to Your Body Our bodies can provide an amazing amount of mirroring for what is going on in our emotional lives. What’s your body telling you? Are you more stressed or tired than usual? Are you struggling with a relationship? With issues at work? Are you taking care of yourself? Exercising? Eating well? Reduce Oestrogen Exposure Our environment is so filled with oestrogen’s that entire populations of male fish have become female just from pharmaceutical run-off into major water systems! The list of possible oestrogen sources is long. Here are simple things you can do to reduce your environmental oestrogen exposure:

• Avoid oestrogen-based birth control when possible.
• Eat organic, especially your meats, dairy, and the “dirty dozen“.
• Avoid pesticide and herbicide exposures, for example when gardening.
• Drink and eat out of glass and other non-plastic packaging only; particularly avoid soft plastics such as plastic wrapped foods and never microwave food in plastic containers.
• Preferably, eliminate dairy for 3 months and see if this helps. If it does, keep it pretty much out of your diet. Many of my patients have told me it really helps.
• Flax seeds are an excellent source of phytoestrogens – remember, they replace strong oestrogens with weaker ones that don’t stimulate your breasts as much and help with constipation. If you have tenderness include 2 TBS of freshly ground flax seeds in your diet every day. Flax seeds can be ground in your blender, a week’s worth at a time, and stored in the fridge in an airtight container. They must be fresh, don’t use old flaxseeds. Add them to smoothies, vegetable or fruit salads, or even over whole grains, they taste nutty and delicious. Don’t cook them though.
• Take Vitex (chasteberry, Vitex agnus castus): While vitex does not actually play a role in oestrogen metabolism, several studies have shown that this herb does reduce PMS symptoms, including breast tenderness. Most herbal products that contains vitex and other homeopathic ingredients tend to contain around 32.4 mg of vitex/day. Most Chinese herb practitioners recommend 5 mL of the liquid extract daily. Interestingly, there are anecdotal reports on the internet of women reporting increased breast tenderness on vitex, this is not my clinical experience but try it for 1 month and if your symptoms worsen at all, discontinue use.

Hydrate – With Water!  Drink water with lemon. It’s delicious and taken first thing in the morning, may help your body eliminate excess hormones! Avoid Alcohol Alcohol increases oestrogen and is one of the few dietary factors directly associated with breast cancer. Reduction in alcohol can reduce oestrogen-related breast pain and your breast cancer risk at the same time! Avoid Coffee! Many women are super-sensitive to its hormone disrupting and stress increasing effects. Even a couple of cups of coffee a week are enough to knock some women off kilter. Try green tea instead; it seems to interfere less with hormone balance and is a healthy choice. Or you may need to eliminate caffeine altogether. Try for 2-3 months and see if you notice a difference. Love Your Liver The liver is your body’s main site for detoxifying oestrogen and getting the excess or used up forms ready for elimination. A lot of us have sluggish liver detox systems make sure you have a read of our liver blogs but here are a few suggestions on  how to make your liver work better for you:

• Eat your greens – kale, collards, broccoli, Brussels sprouts, broccoli sprouts. These contain chemical compounds that help to detoxify oestrogen, and the fibre helps you to clear it out of your body before it can be reabsorbed (yup, this can happen).
• Take bitter herbs that support the liver’s ability to detoxify. My top choices are extracts of Artichoke (Cynara scolymus), Dandelion root (Taraxacum officinalis), Turmeric (Curcuma longa), Milk thistle (Silybum marianum), and Greater Celandine (Chelidonium majus). Liver Health by Herb Pharm and Liver Cleanse by Gaia Herbs are specific compounds that include some of these herbs, and others than can be helpful. I usually recommend using 1-2 times daily for up to three months. Talk with your doctor before using if you have liver disease.

Support Gut Health We have several blogs on gut health that can help you work out what’s healthy and what’s not when it comes to your poo and bowel habits. Good digestive strength means having 1-2 healthy bowel movements daily – not too hard, not too soft. Excess oestrogen is eliminated through your digestive system – that is, you poop out the extra. And it is special bacteria and enzymes in your gut that help this to happen. Probiotics can help provide these. Women who eliminate daily have much less breast tenderness than those who only go a few times or less per week.

• Take a daily dose of freshly ground flaxseed as described above – flax contains lignans that help with hormone elimination.
• Eat plenty of fibre. This not only keeps your bowels moving, but also helps eliminate excess hormones. And check this out: Flax and leafy greens are high in fibre!
• Magnesium citrate: Take from 120-1200 mg daily to achieve a soft but firm bowel movement daily.
• Take a probiotic daily ( we love this one) and eat fermented foods such as sauerkraut and miso to keep gut flora healthy.

Eat Iodine Rich Foods Iodine deficiency is on the rise and may contribute to fibrocystic breasts. If your breasts are generally lumpy and tender, make sure to include seaweeds, and check to make sure that your multivitamin supplement contains iodine. We have some blogs on Iodine that you’ll find fascinating! Cool Inflammation Inflammation causes pain and swelling. Reducing the number of inflammatory hormones, you have hanging out in your system can help to reduce breast tenderness for many women. Here’s how to do it:

• Eat less sugar: Sugar creates inflammation and inflammation wreaks all kinds of havoc in your system. I know it’s tough, but you can do it – and you’ll feel so much better!
• Eat good quality fats: Poor quality oils, and oils that are rancid, increase your inflammation. Stick to olive oil, walnut oil, and coconut oil for cooking, and use these and flaxseed oil raw for dressing salads, grains, and vegetables.
• Evening primrose oil: While the data on evening primrose oil and breast tenderness has yielded mixed results, many practitioners find it helps a great deal.
• Vitamin E in the form of d-alpha tocopherol: 600 units daily helps many women with cyclic breast pain. I generally recommend trying this dose for 3 months

Massage Your Breasts Take some time to nourish your breasts directly – really. Rub them firmly with a pleasantly scented massage oil or with soapy hands while taking a bath or shower several times each week. Massaging your breasts can facilitate drainage of the lymph glands, can reduce pain and engorgement, and is an important part of nurturing your body. All in all, there are lots of suggestions here in this blog for you giving you the opportunity to get back in tune with your body and take charge of your health outcomes. Once you appreciate what may be triggering your breast tenderness – it’s easy to wrangle the driving forces. You’ve got this!!