Chest pain

Luise Heine has been an editor at since 2012. The qualified biologist studied in Regensburg and Brisbane (Australia) and gained experience as a journalist in television, in the Ratgeber-Verlag and in a print magazine. In addition to her work at , she also writes for children, for example for the Stuttgarter Kinderzeitung, and has her own breakfast blog, “Kuchen zum Frühstück”.

More posts by Luise Heine All content is checked by medical journalists.

Chest pain can be accompanied by feelings of tension, palpable hardening and tenderness of the chest. Almost every woman is familiar with these symptoms, as they usually occur shortly before the menstrual period. Doctors call the cycle-dependent chest pain or nipple pain mastodynia. In addition, there are some, mostly benign, changes in the breast tissue that cause symptoms (med. Mastalgia) regardless of the cycle. In any case, you should have the complaints clarified by a doctor.

Chest pain: description

The breasts are a symbol of femininity. They are the erogenous zone and count among the secondary sexual characteristics. In addition, the breasts are used for breastfeeding in women. If one or both breasts are sore, every touch is uncomfortable, or the breast may feel lumpy, it is a worry for many women. The chest pain can occur in one or both breasts.

In fact, chest pain or nipple pain is very common and doesn't necessarily mean something bad. Even so, many women immediately think of breast cancer when they hear these symptoms. In most cases, the female cycle is responsible for the symptoms (mastodynia). The symptoms are part of what is known as premenstrual syndrome (PMS). It encompasses a wide variety of ailments that many women struggle with throughout their fertile period.

The chest pain can change over time. This is related to the inner workings of the female breast, which mainly consists of adipose and connective tissue. The glandular tissue, which produces milk when required, is embedded in it. In the course of life, the ratio of fat to connective and glandular tissue changes. In older women, the fat in the breast predominates. Then there are hardly any nodular changes in the breast tissue during the cycle.

Sometimes, however, there can also be growths in the breast tissue that cause pain and tightness in the breast (mastalgia) regardless of the cycle - a phenomenon that can also affect men.

Chest pain: causes and possible diseases

Mastodynia: Cycle-Dependent Causes

In most cases, chest pain occurs in connection with the female cycle. As a secondary sex organ, the breasts are under the influence of hormones, especially estrogens. These ensure that more fluid is stored in the breast tissue during the second half of the cycle. In addition, the breasts are better supplied with blood. Overall, this makes them bigger and heavier, and knotty changes may also be felt.

The increase in volume can cause some stretching pain. The chest is also more sensitive to touch. The symptoms usually go away when the estrogen level drops at the onset of menstruation and the fluid is channeled out of the tissue.

Not all women are equally affected by this phenomenon. In addition, they are also differently sensitive to stretching pain. In addition, women produce different amounts of hormones, the effects of which have different effects.

Other hormonal causes of chest pain

Premenstrual dysphoric disorder (PMDS): In around six percent of women, premenstrual symptoms (fatigue, stomach, back, headaches) are so severe that they have a significant impact on everyday life. Since 2000, this has been recognized as a disorder in its own right (depressive disorder) that must be treated.

Fibrocystic Mastopathy: The term encompasses several changes in breast tissue that usually affect both breasts. The cause is a hormonal malfunction: too large amounts of estrogen and too little progesterone occur locally - this triggers a kind of inflammatory reaction. The result is swellings the size of a cherry stone, movable nodes or cysts and slight pressure discomfort. In addition, fluid can rarely leak from the nipple. Fibrocystic mastopathy mainly affects women of childbearing age.

Fibroadenomas are benign tissue growths in the breast, especially in the connective tissue (fibroma) or glandular tissue (adenoma). These "lumps" in the breast develop and grow under the influence of estrogens. Fibroadenomas mainly occur in women between the ages of 20 and 24.

Pregnancy: A certain feeling of tightness, chest pain or sore nipples are one of the first signs of pregnancy. Because shortly after the egg cell has implanted, the breast begins to prepare for its future breastfeeding task.The change in the glandular tissue makes the breast larger and more sensitive to touch.

Jammed breast milk: If the baby is placed incorrectly for breastfeeding, or if too much time passes between the individual breastfeeding meals, the breast milk can build up in the breast. The first sign of such a blockage of the milk is when the breast or the resulting swelling hurts. Now it is time to take countermeasures, because otherwise it can lead to a breast infection!

Menopause: Naturally, women during menopause are less likely to experience cycle-dependent chest pain. Unless you are taking hormones specifically for the symptoms of menopause, then chest pain can be a possible side effect.

Mastalgia: Cycle Independent Causes

In addition to the swelling of the breasts associated with the cycle-related hormonal changes, there are other changes in the breast tissue that can cause chest pain and tension.

Cysts: A cyst is a bladder filled with fluid. In the breast tissue, such cysts can cause chest pain when they reach a certain size and push the surrounding tissue to the side. Most cysts are benign. It is not known exactly why they arise. They often occur between the ages of 30 and 50 or at the onset of menopause.

Benign soft tissue tumors: These are soft, plump, elastic lumps just under the skin. They mainly cause pain when they arise near nerves. Doctors differentiate between changes in adipose tissue (lipomas), connective tissue (fibromas) and the granules (artheromas) - this is where dead skin cells and sebum collect near a sebum gland.

Inflammation of the mammary gland in the puerperium (puerperal mastitis): If the mammary gland is inflamed, the breast is swollen and red and the nipples are painful. A purulent secretion can emerge from them. Various triggers can be considered to be the cause, for example bacteria that have entered the mammary gland via the milk ducts and have caused inflammation there. This affects up to nine percent of breastfeeding mothers in the puerperium, usually in the first and second weeks after giving birth.

Inflammation of the mammary gland outside of breastfeeding (nonpuerperal mastitis): In this form of breast inflammation, too, bacteria invade the breast tissue and cause inflammation there. Patients under the age of 30 are particularly affected.

Breast cancer: This is a malignant growth of tissue (tumor) in the breast tissue. It usually starts from the milk ducts and less often from the glandular lobules. Chest pain can also occur here, but not in the early stages. Breast cancer is the most common cancer in women.

Irritated nipples: Nipples that are particularly painful are sometimes caused by wearing the wrong clothes. Rough textiles, too tight clothing or constant friction (for example during sports) can irritate the sensitive skin there and cause chest pain.

Chest pain in the man

Men are also sometimes affected by chest pain - often in connection with a mammary gland that is enlarged on one or both sides (gynecomastia): Many sufferers also report feelings of tension and a certain sensitivity to touch of the chest. The nipples can also hurt.

Gynecomastia can occur naturally as a result of hormonal imbalances (as newborn, puberty or old age gynecomastia). However, enlarged breasts in men can also be due to illness. For example, some hereditary and chronic diseases are associated with gynecomastia. A rare cause is male breast cancer: chest pain and tumor-related gynecomastia are signs.

Chest pain: when to see a doctor?

Basically, chest pain that occurs for the first time should be clarified by a doctor. This also applies if other complaints and abnormalities occur, such as lumps that were not there before or a weeping nipple. If the symptoms are cycle-dependent, they usually go away when the menstrual period starts. If this does not happen, you should also consult a doctor.

It is helpful if women (but also men) scan their breasts regularly. In this way they get to know the tissue there better. Any changes will then be noticed more quickly. For any kind of change that seems strange to you, you should see a doctor. If in doubt, go to the doctor once too often. Breast cancer in particular is easy to treat and even curable if it is discovered at an early stage.

Chest pain: what does the doctor do?

The right contact for female chest pain is the gynecologist. He will first interview you in detail to collect your medical history (anamnesis). This is followed by a gynecological examination and a palpation examination of the chest. When palpating the chest, the doctor pays attention to any lumps or cysts.

With the help of an ultrasound examination (sonography) you can map the structure of the breast tissue and make changes in the breast tissue visible. Fluid-filled cysts, for example, appear black on the ultrasound image.

A breast x-ray (mammography) will help rule out breast cancer as a cause of breast pain. If there are suspicious tissue changes on the X-ray, the doctor can take a tissue sample (biopsy) in order to have it examined more closely in the laboratory.

The doctor will also take blood samples. As part of the blood test, the levels of the sex hormones are measured in order to possibly obtain information on a hormonal cause of the chest pain.

Note: The same examinations are carried out for clarification on men with chest pain. The right contact person here is an andrologist or a clinic that specializes in breast diseases.

Treatment of chest pain

Chest pain therapy depends on the cause. If, for example, cysts are responsible for the pain, they can be "pierced" (punctured) in order to drain the fluid they contain. This reduces the pressure on the surrounding tissue, whereupon the chest pain usually disappears. If hormonal imbalances are the cause of the pain, the doctor may prescribe hormonal drugs if necessary. If breast cancer is diagnosed, an individually adapted cancer therapy is initiated immediately (surgery, chemotherapy, radiation therapy, etc.).

Chest pain: you can do that yourself

Some women use home remedies for chest pain. Sometimes quark compresses help: Spread cool quark about half a centimeter thick on a cloth or compress. Fold the wrap so that there is a layer of fabric between the skin and the curd. Place the wrap on the sore skin area.

Herbal preparations (such as monk's pepper), meditations and relaxation exercises can be helpful for cycle-dependent chest pain in the context of PMS. Your gynecologist can advise you on this.

Tags:  symptoms sex partnership Baby Child