Big breasts may get blamed for sore shoulders, but are headaches part of the package? Researchers found signs of migraine in most women assessed before breast reduction, suggesting there may be more going on than muscle strain.
Finding a supportive bra can be a headache. For some women with enlarged breasts, the headaches are quite literal – and they may deserve more attention than they receive.
A recent study has raised questions about the headaches experienced by women with macromastia, the medical term for symptomatically enlarged breast tissue – meaning enlarged breast tissue associated with physical symptoms such as neck pain, shoulder grooves from bra straps or irritation beneath the breasts.
There is no simple cup-size cut-off that captures the condition. A cup letter alone does not indicate total breast volume, and the researchers note that breast structure, composition and symptoms also matter. This study focused on women whose breast-related problems had already led them to seek reduction surgery.
Yet among 34 women with macromastia and frequent headaches who were seeking breast reduction, 91% screened positive for migraine.
That does not mean large breasts cause migraine. It does suggest that blaming every headache on a heavy bust could overlook a more complicated problem.
Getting to the Head of It
The study, published in Cephalalgia Reports, followed 34 adult women scheduled for breast reduction surgery. All experienced at least four headache days a month.
Before surgery, they completed headache and health questionnaires and took part in an interview with a headache specialist. Researchers then collected follow-up surveys around three to four months after surgery and again 19 to 28 months afterwards.
At the start, the median headache frequency was 10 days a month – that’s a third of their lives! What was surprising was that 31 of the 34 women screened positive for migraine.
All participants already experienced frequent headaches and were seeking breast reduction. The findings therefore tell us about the type of headaches these women had, rather than how common migraine is in women with larger breasts in general.
Different Types of Headaches
A headache diagnosis can shape the treatment someone receives.
Migraine can involve throbbing pain, nausea, sensitivity to light or sound, and difficulty carrying on with everyday activities. Tension-type headaches are generally milder. Treating every headache as a consequence of tight muscles may leave migraine symptoms inadequately addressed.
For the 31 of 34 women who screened positive for migraine, which meant that their answers to a headache questionnaire showed features commonly associated with migraine, such as nausea, sensitivity to light and headaches that interfered with daily activities.
A positive screening result is a signal to investigate further. To diagnose migraine, a doctor also needs to consider whether another condition could better explain the symptoms. In this study, the diagnosis was not established. Still, the finding matters: headaches that might have been labelled tension-related showed features of migraine and deserved a closer look.
Fewer Headaches After Breast Reduction
Many participants reported that they found their headaches improving after breast reduction.
At the first follow-up, 26 of 33 respondents reported at least a 50% reduction in monthly headache days. Participants also reported improvements in pain intensity and the disruption headaches caused in daily life.
Improvements were still observed at the later follow-up, completed by 28 women. Many also reported better neck pain and sleep.
While these findings are encouraging, the study had no comparison group of similar women who did not undergo surgery. This meant that the effects of surgery could not be separated from other changes over time – such as changes in weight, sleep, mood and physical activity. Three participants also started preventive migraine medication after surgery.
Clearly, the results do not suggest scheduling for breast reduction as a headache treatment if you are a well-endowed lady. Larger, controlled studies are needed before drawing that as a meaningful conclusion.
More Than a Bra Problem
A fuller bust may get the blame for aching shoulders and a sore neck. But should it take the blame for every headache too? The findings suggest there may be more to the story: some headaches have features of migraine, while others need investigation for different causes.
Participants reported fewer headaches after breast reduction, although the study could not establish whether surgery was responsible for the improvement.
If headaches are frequent or interfere with daily activities, consult a healthcare professional rather than assuming breast size explains them. Describing their frequency, associated symptoms and any neck or shoulder pain can help a clinician assess the cause and advise on treatment.
