(Raynaud’s Phenomenon, vasospasm)
Definition: When blood vessels clamp up and don’t allow enough blood and oxygen to the breast tissue, nipple and/or areolae.
Symptoms and signs: Usually deep breast pain.
- May be in one or both breasts.
- May occurr before or after feedings.
- May last a few minutes to hours.
- Stabbing, aching, throbbing or shooting pain.
- Can be severe, intense pain.
- Usually feels worse in the cold.
- Patches of the nipple or areolae may appear pale or purple during the spasm.
- The areolar skin may crinkle.
- The nipple may contract.
- May feel more intense when laying in bed at night.
Causes:
Most women have vascular spasm secondary to having inflammation of the nipple/areolae or breast tissue. This inflammation could be from trauma, wounds, scabs, blisters, blebs. Infections, like mastitis may also elicit vascular spasm. The most common infection to cause vascular spasm is yeast.
Some women have primary vascular spasm. They may have a history of poor circulation, sensitivity to the cold, fingers turning white in the cold (Raynaud’s Phenomenon), an autoimmune disease or a history of autoimmune disease or Raynaud’s in the family.
Treatment
Always treat the underlying cause first and the vascular spasm should resolve.
For immediate relief, when you feel the pain starting, take the palm of your hand and press your nipple/breast against your chest wall for a few minutes.
Warmth will also ease the pain (hot water bottle, heating pad).
Occasionally taking vitamin B6, 100mg daily for two weeks only will help.
Severe vascular spasm that does not resolve after treating the underlying cause needs to be treated with medication. The medication used is nifedipine. Nifedipine is used to treat high blood pressure and also works to relieve vascular spasm. It works by opening up the blood vessels and allowing the blood to flow to the breast more easily. Because most women have normal blood pressure, you must be careful when you take this medication. It can drop your blood pressure and cause side effects of dizziness, lightheadedness or headache. Other side effects may include ankle swelling and palpitations (fast heart beat).
Precautions
If you are taking nifedipine:
- make sure to eat frequently during the day,
- drink plenty of fluids,
- get up slowly from a laying down position, so that your blood pressure does not drop too abruptly.
Most people can stop the nifedipine after two weeks and the vascular spasm will not return. If it does, speak with your doctor to make sure that the underlying cause was properly treated.