Hormonal contraception and breast tenderness: A Danish cross-sectional study

Breast tenderness is an acknowledged side effect of hormonal contraception, reflecting hormonal effects on breast tissue, but evidence on variation across contraceptive types, doses and formulations remains limited.

We conducted a cross-sectional study among Safe Choice survey respondents aged 18-39 years. Associations between hormonal contraceptive use and self-reported breast tenderness were assessed using logistic regression.

We included 112,558 women (median age 26), of whom 17,478 had experienced breast tenderness (15.5 %). Combined oral contraceptives were associated with lower odds of breast tenderness compared with non-use (OR 0.72, CI 95 % 0.69-0.76), whereas low-dose progestin-only tablets (OR 1.56, CI 95 % 1.33-1.83), intrauterine devices (OR 1.14, CI 95 % 1.10-1.19) and progestin-only injections or implants (OR 1.25, CI 95 % 1.09-1.43) were associated with higher odds. Combined oral contraceptives were associated with lower odds after six months of use (OR 0.71, CI 95 % 0.62-0.82). Low-dose progestin-only tablets were associated with higher odds during the first six months and after 12 months of use (OR 1.72, CI 95 % 1.32-2.24 and OR 1.63, CI 95 % 1.28-2.07), whereas IUDs were associated with higher odds after 12 months (OR 1.18, CI 95 % 1.13-1.23).

Combined oral contraceptives were associated with lower odds of breast tenderness, whereas progestin-only contraceptives were associated with higher odds. These findings support that hormonal contraceptive use, including newer progestin-only products, may affect breast tissue.