Sore Breasts After Ovulation

Sore breasts
after ovulation is a common problem.It is also called
perimenstrual breast pain, cyclical mastalgia.

Breast Pain

In general, breast pain(or mastalgia) can be classified into two categories, depending on its  relationship with the menstrual cycle. Pain that occurs periodically with the menstrual cycle changes is called cyclical breast pain. In contrast, pain  that does not change with the menstrual cycle is called noncyclical  breast pain(or noncyclical mastalgia). Sore breasts after ovulation is cyclical breast pain, because it is directly related to changes of the menstrual cycle.

Characteristic
Pattern

Sore breasts
that follow ovulation  has some
characteristics which distinguish it from noncyclical breast pain that is due
to a disease in the breast like a cyst.

These
characteristics are

• Cyclical: It
  occurs in cycles, in association with  the hormonal changes of the menstrual cycle.

• Timing: It
  often starts about one week before the onset of menses, is most severe during
  the late luteal phase and resolves with the onset of menstruation. Note that it
  does not start on the day of ovulation, but about one week later.

• Side and
  site:It often affects both breasts and involving almost every area of each
  breast. It does not affect a single spot only in a single breast.

How Common
Is It?

Moderate to
severe cyclical mastalgia affects about 11 to 22% of women. Minor cyclical
breast discomfort is normal and is usually does not cause any limitations in
normal daily activities of a woman.

It is also worth noting that about 77% of women
who have breast pain after ovulation did not have PMS. Therefore this  breast pain is not  of the premenstrual disorder.

Who Gets It?

There are a
few factors that have been found that increase the chances of getting cyclical
breast pain.  Those who smoke, consume
caffeine and  are in perceived stress are
at a higher risk of having this pain  than those who did not. However, women who  used 
birth control pills had a lesser chance. It was also shown that older
women who are nearing menopause were more affected than younger women.

Should I Be
Concerned?

A common
fear among women with breast  pain is
cancer. That is why women younger than 35 years  who had cyclical breast pain had  more 
mammograms done that those who did not have similar symptoms in studies.
It often have to reassure women in the clinic, that cancer does not usually
cause pain in both breasts in almost every area! You can  take this and have a cool head overnight!

The Cause  of Sore Breasts After Ovulation

The precise
cause of the breast pain that follows ovulation and before menses is not known.
It is thought to be due to the female hormonal changes that follow ovulation
causing changes in breast tissue. As noted above, this pain is not directly due
to the process of ovulation itself but as a result of the hormonal changes that  follow after.

Treatment

There is no specific treatment for
this  disorder. All that is required is
to control the pain with nonsteroidal
antiinflammatory agents which can be bought over the counter. Severe cases
require medical attention. Possible treatment options your doctor could prescribe
include   include danazole, toremifene or tamoxifen. Vitamin
E and evening primrose oil have not been shown to be effective. Bromocriptine
can be effective in women with high prolactin hormone levels.

References

Hoffman BL et al. Chapter 12. Breast Disease. In: Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw
KD, Cunningham FG, Calver LE, eds. Williams
Gynecology. 2nd ed. New York: McGraw-Hill; 2012.

Ader
DN, Browne MW. Prevalence and impact of cyclic mastalgia in a United States
clinic-based sample. Am J Obstet Gynecol 1997; 177:126.

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