Care Advice
Breast Pain or Tenderness Before Menstrual Periods
What You Should Know:
- Some teens (10%) have breast pain and fullness on a monthly basis. This occurs just before their menstrual period.
- The discomfort can range from mild to moderate.
- Pain and swelling goes away between menstrual periods.
- Cause: normal changes caused by hormone cycles.
- Medical name: cyclic mastalgia.
Pain Medicine:
- Ibuprofen is best for this type of pain. Give ibuprofen every 6 hours, as needed.
- If you don't have ibuprofen, give acetaminophen every 4 hours. Do this until you can get ibuprofen.
Wear a Support Bra:
- Wear a well-fitted support bra or sports bra when breast pain occurs.
- This is especially important when you exercise.
- Some women with large breasts are more comfortable wearing a bra even when sleeping.
Reduce Caffeine:
- Some women report increased breast pain after drinking coffee or colas.
- If that applies to you, avoid caffeine or reduce your intake.
Expected Course:
- Should go away between menstrual periods.
- If symptoms are not better between periods, make an appointment to see your doctor.
Breast Self-Examination (BSE):
- The American College of Obstetricians and Gynecologists (ACOG) does not recommend teaching teens BSE until age 18 years.
- Reason: incidence of breast cancer between age 15 and 19 years is low (2 cases per million girls).
- BSE is best learned in person from a health care provider. If you are over 18, make an appointment to discuss this with your provider.
- Best time for BSE is at the end of each menstrual cycle. Lumps are easiest to feel at that time.
Call Your Doctor If:
- Breast pain doesn't go away between periods
- You miss a period or pregnancy test is positive
- You feel a lump
- You think your teen needs to be seen
- Your teen becomes worse
Breast Pain During or After Exercise
What You Should Know:
- Breast pain during or following hard exercise is common.
- Cause: stretching of ligaments inside the breast.
- Most common in girls with large breasts.
- Large breasts may also cause back pain.
- The pain most often lasts 1 or 2 days.
Wear a Sports Bra:
- Wear a good quality sports bra when you exercise.
Pain Medicine:
- Ibuprofen is best for this type of pain. Give ibuprofen every 6 hours, as needed.
- If you don't have ibuprofen, give acetaminophen every 4 hours. Do this until you can get ibuprofen.
Call Your Doctor If:
- You feel a lump
- Breast pain lasts more than 2 days
- You think your teen needs to be seen
- Breast pain becomes worse
Breast Size Unequal
What You Should Know:
- A difference in breast size is common and normal.
- At puberty, breast development most often starts on one side before the other.
- While breasts are growing, 50% of girls have breasts that are different sizes.
- After the breasts are mature, 25% of women still have unequal breasts. Usually the left is larger.
- The difference is most often minor.
- Medical name: normal breast asymmetry.
Treatment for Breast Asymmetry:
- Wearing a bra pad on the smaller side is an option.
- After age 18, if the difference is major, referral to a plastic surgeon can be considered.
Call Your Doctor If:
- You think your teen needs to be seen
- You have other questions or concerns
Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.