Breast pain - Treatments

Painkilling gels or lotions

Doctors say that painkilling gels or lotions work well for breast pain and are safe. The one that has been studied the most is called diclofenac. It belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs for short). These drugs reduce pain and inflammation.

One small study (a randomised controlled trial) found that half the women who used diclofenac had no pain after six months.[1]

None of the women in the study had any side effects. But your skin may itch or go red and blister with these types of gels and lotions.

You can buy diclofenac gel or lotion (brand names Pennsaid, Voltarol Emulgel, Solaraze) from a pharmacy. You can also get other NSAIDs, such as ibuprofen (Fenbid, Ibugel), at a pharmacy. You shouldn't use these products if you're pregnant or breastfeeding.[2]

Danazol

Taking the drug danazol might reduce the pain in your breasts. One small study (a randomised controlled trial) found that two-thirds of women who took danazol had less pain after six months. Danazol worked as well as another drug called tamoxifen.[3]

But this treatment can have side effects that you may not be able to put up with. In the study we found, a third of the women who took danazol put on weight.[3] Other side effects in that study were a deep voice, heavy periods and muscle cramps. But you may be able to avoid these side effects if you take a smaller dose of danazol for the two weeks before your period, rather than all the time.[4]

You need a prescription for danazol. It comes as capsules and the brand name is Danol.

You must not take danazol if you are pregnant or likely to become pregnant. Danazol can harm the unborn baby. If you are taking danazol, you need to use a a non-hormonal method of contraception (for example, an IUD or condoms). The contraceptive pill doesn't work when you are taking danazol.[5]

Gestrinone

One small study (a randomised controlled trial) found that gestrinone can help to reduce breast pain.[6]

But this treatment can have side effects that you may not be able to put up with. In the study we found, 4 in 10 women who took gestrinone got at least one of these side effects: greasy skin, increased body hair, acne, bleeding between periods, voice changes, low sex drive, reduced breast size, headaches, depression and tiredness.

You need a prescription for gestrinone. It comes as capsules and the brand name is Dimetriose. It is not used much for breast pain in the UK.

Goserelin

One small study (a randomised controlled trial) found that goserelin helped reduce the number of days that women reported severe pain in their breasts during their period (menstrual cycle). On average, women had six days of pain after they had treatment instead of 17 days before they had treatment.[7]

But this treatment can have side effects that you may not be able to put up with. The main ones are hot flushes, low sex drive, vaginal dryness, irritability, oily hair or skin and reduced breast size.

Goserelin (brand name Zoladex) is a type of hormone treatment. It is given as an injection. You'll usually be offered this treatment only if you get severe breast pain and other treatments haven't helped.

Tamoxifen

Three studies (randomised controlled trials) have found that tamoxifen can help to reduce breast pain.[3] [8] [9] Tamoxifen (brand names Nolvadex, Nolvadex-D, Soltamox) is not licensed for treating breast pain in the UK. This doesn't mean it can't be used for breast pain. But only a specialist can prescribe tamoxifen, and then for no more than six months.

Tamoxifen can cause hot flushes and vaginal discharge.[3] [9] But these can be reduced with a lower dose.[10]

You must not take tamoxifen if you are pregnant or likely to become pregnant. Tamoxifen can harm the unborn baby. If you are taking tamoxifen, you need to use a non-hormonal method of contraception (for example, an IUD or condoms).[5]

Progestogens

There are many different progestogens, including progesterone, dydrogesterone and medroxyprogesterone. Two small studies found that progestogens do not help breast pain.[11] [12]

Antibiotics

There hasn't been any good-quality research on antibiotics for breast pain. So we can't say whether this treatment is helpful.

Low-fat, high-carbohydrate diet

One small study found that women who followed a low-fat, high-carbohydrate diet for six months reported less breast swelling and tenderness before their period.[13] But doctors couldn't find a difference. We need more research to say whether following this diet is helpful.

Diuretics

There hasn't been any good-quality research on diuretics for breast pain. Diuretics help to get rid of excess water from the body, so some doctors might think they could help to reduce breast pain linked with periods. But we need more research to know whether this is the case.

Vitamin B-6

Vitamin B-6 is also called pyridoxine. There hasn't been any good-quality research on whether vitamin B-6 helps breast pain. So we need more research before we can say whether vitamin B-6 can be of use in breast pain. There are concerns that taking vitamin B-6 for a long time could be harmful.[14]

Tibolone

One small study of women who had breast pain because of hormone replacement therapy (HRT) found that tibolone (brand name Livial) didn't help reduce breast pain.[15]

Vitamin E

There hasn't been any good-quality research on vitamin E for breast pain. So we can't say whether vitamin E is helpful for breast pain.

Hormone replacement therapy (oestrogen)

There hasn't been any good-quality research on whether HRT helps breast pain. But we do know that HRT can increase your chances of breast cancer, blood clots and gall bladder disease if you are past the menopause.

Bromocriptine

Bromocriptine seems to relieve breast pain.[16] [17] But it is rarely prescribed because it causes side effects that many women cannot put up with.

Evening primrose oil

One study found that evening primrose oil does not help breast pain.[18] Evening primrose oil is not available on prescription in the UK.