Dr Sarah Jarvis

My Weekly’s favourite GP from Tv and radio writes for you

At least two in three women get breast pain, ranging from mild discomfort on few days a month to a source of constant distress. Doing some detective work on what it’s linked to can help your GP to help you manage the misery.

The most common kind of breast pain is “cyclical” – starting in the second half of your cycle and stopping with your period. This begins most commonly in your 30s or 40s, and goes after the menopause (unless you’re taking HRT).

Cyclical breast pain is thought to happen because your breast tissue is particularly sensitive to the normal hormone changes that happen during your menstrual cycle. That’s why some women find their symptoms get worse if they get pregnant or take the oral contraceptive pill. The good news is this is one thing you won’t have to worry about after the menopause!

The other kind of breast pain is “non-cyclical” – it doesn’t come and go predictably at the same time every month. It’s more common in over 40s, and can happen after the menopause. It can affect both breasts, just one, or part of one. The key is towork out if the pain is coming from the breasts themselves or from the muscles and bones of the chest wall under the breasts. Your GP can help you work this out.

Shingles can cause pain over the skin of the breasts before a rash occurs. An infection in the breast called mastitis also causes pain, usually on one side. Pregnancy can cause swelling and pain in the breasts. Pain is rarely a sign of cancer or a non-cancerous cyst, especially

SOME WOMEN SWEAR BY EVENING PRIMROSE OIL FOR BREAST PAIN BUT THERE’S NO EVIDENCE ITWORKS, SO YOU CAN’T GET IT ON PRESCRIPTION

if there’s no lump to feel.

Whatever kind of breast pain you have, getting a properly fitted bra and buying new bras regularly (if they’ve gone grey they’ve probably also lost their support!) can make a big difference. Underwired bras can worsen pain, but a sports bra for exercise is a must.

For cyclical breast pain, changing or stopping your contraceptive pill may help – but obviously don’t do that without using another reliable form of contraception. In very severe cases, female hormone blocking medicines can be tried, but they commonly cause side effects of their own.

Most of us have learnt from experience that as you get older, everything drops a bit, Your skin is largely made up of a protein called collagen, which provides support aswell as flexibility. As you get older, all your skin gets less firm– and the skin over your breasts is no exception.

It’s hardly surprising that almost every women who asks me about breast pain is worried about cancer. Interestingly, mostwomen diagnosed with breast cancer haven’t had any pain from it. However, it’s hugely important to be breast aware so you can get changes in your breasts checked out early. Use the flat of your fingers to check for lumps or changes in breast tissue.

Get into the habit of looking and feeling your breasts when you’re in the bathroom or bedroom. Look for changes in the contours of your breasts –especially areas where the skin is puckered, as if something is tethering it from inside. Be alert for discharge (particularly if it’s bloodstained) from your nipples, or changes in their shape such as a newly turned-in nipple.

Persistent dry skin or scabbing on the nipple, aswell as a dimpled “orange peel” appearance of breast skin should also be looked at by your doctor. Next week: How do medicines work?

SLEEPING IN A BRA MAY HELP IF BREAST PAIN IS BAD AT NIGHT. GET A SOFT BRA AND DEFINITELY AVOID UNDER WIRING