Can birth control cause breast pain?

Types of mastalgia

Mastalgia is the medical term for breast pain. Surveys amongst women have reported that breast pain affects nearly two-thirds of women and is one of the most common breast-related medical complaints amongst women ages 15-40 [1].  There are two types of mastalgia: cyclic and non-cyclic. 

Cyclic mastalgia is the most common form of breast pain [2]. Cyclic mastalgia is thought to be related to the hormonal changes during your menstrual cycle [1]. This type of pain or discomfort usually feels like soreness, heaviness, or aching and usually happens in both breasts [3]. In some cases, this pain can even extend into the armpit and down the arm. Cyclic mastalgia is usually the strongest just before and during your period, and often disappears afterwards. Cyclic mastalgia does not usually require medical attention. 

Non-cyclic mastalgia, on the other hand, is unrelated to your menstrual cycle [2]. Non-cyclic breast pain more often occurs in one breast and the pain usually feels burning or sharp. Because non-cyclic mastalgia can be caused by cysts or benign (non-cancerous) tumors, it is more common in women over the age of 30. If you are experiencing a sudden onset of pain or discomfort that persists throughout your menstrual cycle, it is recommended to contact your healthcare provider. They can help you investigate the source of the pain and rule out any more serious causes. While non-cyclic mastalgia can be alarming, it might be helpful to know that breast pain alone is not considered an indication of breast cancer [1,4].

Does birth control cause breast pain?

Sore breasts are a commonly cited symptom of frequently used birth control methods like the pill [1,2,3]. Let’s dive deeper into the different types of birth control methods, how they can affect your cycle, and unwanted side effects like breast pain.

Breast pain and the pill

Combination birth control pills that contain both estrogen and progestin (the synthetic, human-made form of progesterone) affect the levels of these hormones in the body. For some women, this can cause or worsen breast pain or tenderness [5,6]. Some studies have shown that eliminating or decreasing the dose of estrogen in oral contraception can alleviate breast pain and tenderness, minimizing the fluctuations of this hormone over the course of your cycle [1]. It is important to remember that mastaglia linked to the pill is often worse for the first couple months, after which it can decrease or even go away entirely [1,2]. Interestingly, combination birth control pills have also been used to treat breast pain for some women [1,2].

If you experience menstruation-related breast pain and it worsens after you begin taking hormonal birth control pills, talk to your healthcare provider about switching to a progestin-only or non-hormonal birth control alternative. There are lots of things to consider when changing birth control methods, so be sure to talk to your healthcare provider.

Breast pain and the birth control patch

Birth control patches are another type of hormonal birth control that releases both estrogen and progestin. Depending on the type of patch, you wear it on your stomach, back, bottom, or upper arm for about three weeks each month (changing the patch each week). Patches are then removed during the week you get your period. Because they release estrogen and progestin, birth control patches may have a similar effect on mastalgia as combination birth control [7].

Breast pain and the vaginal ring

The vaginal ring is a hormonal birth control method that releases both estrogen and progestin. To use a vaginal ring, you insert a soft, plastic ring into your vagina. You leave it in place for three weeks, after which you remove it for approximately seven days during which time you typically get your period. Like the combination pill and birth control patch, breast pain is a side effect of the vaginal ring [8].

Breast pain and the IUD 

Intrauterine devices, or IUDs, are contraceptive devices that are inserted into a woman's uterus by a healthcare professional. There are different types of IUDs that can affect mastalgia in different ways. Hormonal IUDs are progestin-only, which means they do not release estrogen into the body. Copper IUDs, on the other hand, are non-hormonal. While there is not enough evidence to link IUDs with mastalgia [9], if you begin experiencing breast pain or it worsens after getting an IUD, be sure to contact your healthcare provider.

Breast pain and the birth control implant

Birth control implants are a type of hormonal birth control that is inserted just under the skin of your inner arm. Implants are progestin-only hormonal birth control. If your breast pain worsens after getting a birth control implant, consult your healthcare provider.

Breast size changes and breast pain

Have you ever noticed that your breasts feel or appear larger or more swollen around the time of your period? Swelling and tenderness tend to occur in both breasts during the second half of your menstrual cycle. Estrogen produced during the first half of your cycle causes the milk ducts in your breasts to grow, while progesterone promotes the formation of milk glands during the second half of your cycle. Doctors believe that the changes in these hormonal levels contribute to breast swelling in the week or weeks before your period, usually lasting until the end of your period. Premenstrual breast swelling has been linked to mastalgia and investigated as a possible cause [1]. While it is possible that hormonal birth control can affect breast swelling, a link between birth control and changes in breast size has not been established. 

Other side effects of birth control

Hormonal birth control, whether it be a pill, IUD, implant, or patch, has been linked to other side effects besides mastalgia. These can include [10]:

• Nausea
• Weight gain
• Headaches
• Acne
• Mood changes
• Decreases in libido, or sex drive
• Bleeding between periods, or spotting

The side effects of birth control are highly individual. Some women experience no side effects, while others might experience all of them! In most cases, side effects tend to lessen or go away after you’ve been using the method for a few months. However, it’s important to observe any changes you notice in your own body, and to talk to your healthcare provider about what method of birth control might work best for you.

How to treat breast pain

If you are experiencing mild to moderate mastalgia, there are several ways to help alleviate your symptoms [1,2,3]:

• Hot or cold compresses on your breasts or surrounding area for a few minutes daily, or throughout the day, can help relieve pain and soreness.
• Stay hydrated and limit your salt intake. Dehydration and consuming a lot of salt can cause the body to retain water and can increase the tenderness of breast tissue.
• Check the fit of your bra to make sure you are wearing the correct size. It is estimated that up to 70% of women wear the incorrect bra size [11]! You can also experiment with wearing a bra that provides some extra support, like a sports bra.
• In some instances, an over-the-counter pain medication such as ibuprofen, acetaminophen, or an NSAID (non-steroidal anti-inflammatory) can help provide pain relief. Topical NSAIDs have also been shown to improve cyclic and noncyclic mastalgia symptoms [12].

In some cases of severe mastalgia, hormonal therapies like bromocriptine, goserelin, danazol, and tamoxifen have been prescribed [1,2]. Bromocriptine blocks prolactin, which has been linked to painful swelling in breast tissue, while tamoxifen blocks estrogen [1,2]. Danazol is the first medication approved by the Food and Drug Administration for the treatment of mastalgia and is commonly prescribed to treat the symptoms of endometriosis [1]. If you are suffering from severe breast pain, it is important to speak with your healthcare provider about possible treatments and any adverse side effects of medications.

While reducing caffeine intake and consuming a low-fat diet [1,2,3] have been recommended and can help mastalgia symptoms in specific cases, more research is required to determine the effectiveness of these treatments generally. Vitamin E has also been suggested to help alleviate both cyclic and noncyclic breast pain, but research has not yet shown whether it can lead to significant improvements [1,2,3]. 

Whether mild or severe, it is important to observe any changes to your breast pain and contact your healthcare provider if your pain changes suddenly or if you require help managing your breast pain. Keep aware of any changes in your breast appearance and texture by continuing to perform breast self exams and attend routine mammogram screenings. 

When to talk to your doctor

Be sure to contact your healthcare provider if your breast pain [3]: 

• Occurs daily and goes on for more than a couple of weeks
• Appears to be coming from a specific part of your breast
• Worsens
• Adversely affects your daily activities
• Wakes you up in the night 

Similarly, if you detect any changes to the breast tissues, including lumps or changes in texture or appearance, contact your healthcare provider. 

Know your body better with Natural Cycles

If you are experiencing adverse side effects from birth control, or if you are interested in non-hormonal and non-invasive birth control, Natural Cycles might be right for you. Natural Cycles is the first FDA Cleared birth control app. Powered by body temperature data, Natural Cycles offers a non-invasive, side-effect free alternative to hormonal methods. You can use Natural Cycles to track symptoms, and understand better when pain is occurring in your menstrual cycle.  Find out if Natural Cycles could work for you today.