Breast Discomfort
Breast Discomfort
16 Hints to Reduce Soreness
Maybe you're pregnant and you have trouble believing that these cartoonishly inflated and painful breasts could possibly be yours. At night, you can't find a comfortable sleeping position.
Maybe your period is around the corner and the butter-soft silk camisole you put on this morning feels like sandpaper when it shifts.
Or maybe you're still bewildered by the hard lump you found during your monthly self-exam, even though a pathologist assures you it's benign.
Welcome to the bewildering world of benign breast changes. You're not alone. An estimated 70 percent of North American women suffer from benign but discomforting breast changes during some point in their lives.
The tenderness you're apt to feel in pregnancy or just prior to your menstrual period occurs because of natural cycles of your reproductive hormones, estrogen and progesterone. These hormones signal the cells of the milk-producing glands to grow, and the areas around these glands expand with blood and other fluids to nourish the cells. These fluid-logged tissues can stretch nerve fibers, and you experience pain.
Fibrocystic changes, which include lumps and cysts, usually affect the nonworking areas: the fat cells, fibrous tissues, and other parts not involved in the making or transporting of milk.
But in either case, the same strategies can help you find relief and promote healing. Here's what our experts advise.
Switch your diet. Change to one low in fat and high in fiber—the kind of fiber in whole grains, vegetables, and beans. A study of Tufts University School of Medicine found that women who maintained this kind of diet metabolized estrogen differently. More estrogen was excreted in the stool, leaving less to circulate, says Christiane Northrup, M.D., assistant clinical professor of obstetrics/gynecology at the University of Vermont College of Medicine. And that means less hormonal stimulation of the breasts.
MEDICAL ALERT
Benign? Only Your Doctor Knows for Sure You've already had one breast lump diagnosed as benign. Your last monthly self-exam turned up yet another lump. Is it safe to assume this one's benign, too? No. Let this be your breast self-care rule: Whenever you find a new lump, consult your physician. The doctor may order a biopsy of the lump or use a needle to draw fluid out of a fluid-filled cyst. About 90 percent of breast lumps are found not by doctors or nurses or mammograms, but by women during their own breast self-exam, says Kerry McGinn, R.N. The best time to do this is one week after your menstrual period begins. That's because lumps that sometimes surface just prior to menstruation can disappear just as quickly when your period is over. |
|
Stay slim. That means you should keep your weight within the proper range for your height. For seriously overweight women, losing weight can help relieve breast pain and lumpiness, says Kerry McGinn, R.N., author of Keeping Abreast: Breast Changes That Are Not Cancer.
In women, fat acts like an extra gland, producing and storing estrogen. If you've got too much body fat, you may have more estrogen circulating in your system than is good for you. And breast tissue, says Gregory Radio, M.D., chairman of reproductive endocrinology at Allentown Hospital in Pennsylvania is "very responsive to hormones."
Get your vitamins. Be sure to get plenty of foods rich in vitamin C, calcium, magnesium, and B vitamins, says Dr. Northrup. These vitamins help regulate the production of prostaglandin E, which in turn has a prohibitory effect on prolactin, a hormone that activates breast tissue.
Pass on the margarine and other hydrogenated fats. Hydrogenated fats interfere with your body's ability to convert essential fatty acids from the diet into gamma linoleic acid (GLA), says Dr. Northrup. GLA is important because it contributes to the production of prostaglandin E. And prostaglandin E may help keep prolactin, a breast tissue activator, in line.
The Alternate Route
Comfort from Castor Oil To get relief from breast inflammation, try this castor oil compress recommended by Christiane Northrup, M.D. She says it helps heal minor breast infections, too. You'll need cold-pressed castor oil, a wool flannel cloth, a piece of plastic, and a heating pad. Fold the cloth into four layers and saturate it with the oil, but make sure it's not so wet that it will drip on the breast. Put the cloth on the breast, cover with plastic, and then apply the heating pad. Turn the setting on the pad up to moderate, and then hot, if you can stand it, says Dr. Northrup. Leave it on for an hour. Cold-pressed castor oil contains a substance that increases T11 lymphocyte function, says Dr. Northrup. This will help speed healing of any infection. You may need to use the compress for three to seven days to really see results. "This can often be extremely beneficial for taking away pain," she says. |
|
Keep calm. Epinephrine, a substance produced by the adrenal glands during stress, also interferes with GLA conversion, says Dr. Northrup.
Cut out all caffeine. Caffeine's role in contributing to breast discomfort has not been proven. Some studies say it does, other studies have been inconclusive. Still, Thomas J. Smith, director of the Breast Health Center at New England Medical Center in Boston, recommends this strongly.
"I've seen women with pain and other symptoms of benign breast changes get markedly better after abstaining. You really have to cut out all caffeine," he says. And that means forgoing soft drinks, chocolate, ice cream products, tea, and over-the-counter pain relievers that contain caffeine.
Skip the pepperoni pizza. Highly salted foods make you bloated, says Yvonne Thornton, M.D., assistant professor of obstetrics and gynecology at Cornell University Medical College. This is particularly important to do about seven to ten days before your menstrual period.
Stay away from diuretics. It's true that diuretics can help flush fluid from your system. And that can help reduce the swelling in your breasts. But the immediate relief will cost you, says Dr. Thornton. Overuse of diuretics can lead to depletion of potassium, imbalance your electrolyte system, and throw off glucose production.
Reach for an OTC. Sandra Swain, M.D., director of the Comprehensive Breast Service at the Vincent Lombardi Cancer Center at Georgetown University School of Medicine, recommends ibuprofen (Advil, Nuprin) to alleviate painful breasts. "Avoid topical, steroidal anti-inflammatories," she cautions. Pregnant women, of course, shouldn't use any drug without a doctor's okay.
Apply cold. McGinn says some women find relief by dipping their hands in cold water and cupping the breasts.
Or try heat. Other women, says McGinn, find relief after using a heating pad or hot water bottle or by taking a hot bath or shower. For others, alternating heat and cold works best.
Find a good support bra. A sturdy bra, like those made for joggers, can help prevent nerve fibers in the breast, already stretched by waterlogged tissue, from stretching farther. Some women find that wearing the bra to bed at night helps, says Dr. Radio.
Consider reconsidering the pill. The estrogen level in your oral contraceptive could help or hurt your attempt to manage benign breast changes, depending upon what your particular condition is, says Dr. Radio. In general, a low-estrogen pill may help a true fibrocystic condition but aggravate fibroadenoma, a condition in which a solid but often movable lump is present.
Try massage to ease fluid accumulation. McGinn says that some women find relief with a gentle breast self-massage that helps ease extra breast fluids back into the lymph passageways. A technique developed by masseuse Carolyn Gale Anderson involves soaping the breasts, rotating the fingers along the surface in coin-size circles, and then using your hands to press the breasts in and then up.
Discover the emotional message behind your physical symptoms. "This is absolutely the first thing I look at," says Dr. Northrup. "When I ask my patients 'what's going on in your life around the issue of nurturing or being nurtured?' I often see tears.
"Breasts as the symbol of nurturance are highly charged for women," she adds. "You know that tingling feeling that accompanies the letdown of milk? Some women who have gone through menopause still feel that when they hear a baby cry. That's how closely linked breasts are to the emotions."
PANEL OF ADVISERS
Kerry McGinn, R.N., is a staff nurse at Planetree Model Hospital Unit at Pacific Presbyterian Medical Center in San Francisco and the author of Keeping Abreast: Breast Changes That Are Not Cancer.
Christiane Northrup, M.D., is an assistant clinical professor of obstetrics/gynecology at the University of Vermont College of Medicine in Burlington, and president of the American Holistic Medical Association. She practices medicine at Women to Women in Yarmouth, Maine.
Gregory Radio, M.D., is a practicing obstetrician/gynecologist in Allentown, Pennsylvania, and chairman of reproductive endocrinology at Allentown Hospital.
Thomas J. Smith, M.D., is a chief of surgical oncology and director of the Breast Health Center at New England Medical Center in Boston, Massachusetts. He is also associate professor of surgery at Tufts University School of Medicine in Boston.
Sandra Swain, M.D., is assistant professor of medicine at Georgetown University and director of the Comprehensive Breast Service of the Vincent Lombardi Cancer Center at Georgetown University School of Medicine in Washington, D.C.
Yvonne Thornton, M.D., is a maternal fetal medicine specialist and assistant professor of obstetrics and gynecology at Cornell University Medical College in New York City. She is also director of prenatal diagnosis and an attending physician at the New York Hospital-Cornell University Medical Center.
