COMPARATIVE STUDY OF BODY MASS INDEX VERSUS MENSTRUAL IRREGULARITY/HORMONAL IMBALANCE AS DETERMINANTS OF MASTALGIA SEVERITY IN PATIENTS PRESENTING TO A BREAST CLINIC OF A TERTIARY CARE CENTRE: A CROSS-SECTIONAL STUDY

Abstract

Background: Mastalgia is a common breast complaint in premenopausal women and can markedly affect quality of life. Although elevated body mass index (BMI) and hormonal or menstrual factors are implicated in its pathogenesis, evidence comparing their influence on pain severity is limited. Aim: To compare the relative contribution of BMI and menstrual irregularity/hormonal imbalance to mastalgia severity in women attending a tertiary care breast clinic. Methods: This analytical cross-sectional study included 60 premenopausal women aged 18–55 years with cyclic mastalgia over six months. Pain severity was assessed using the Visual Analogue Scale (VAS). BMI, menstrual history, hormonal contraceptive use, and premenstrual symptoms (PMS) were recorded. Logistic regression identified predictors of moderate-to-severe mastalgia (VAS >4). Results: Mean age was 31.8 ± 7.4 years and mean BMI was 25.3 ± 3.9 kg/m². Moderate-to-severe pain was seen in 43.3% of participants. BMI was significantly higher in women with moderate-to-severe pain than in those with mild pain (28.1 ± 3.4 vs. 22.4 ± 2.3 kg/m²; p < 0.001). Menstrual irregularity (p = 0.031), hormonal contraceptive use (p < 0.001), and PMS (p < 0.001) were also associated with higher pain scores. On logistic regression, BMI was the only independent predictor (OR 1.71; 95% CI: 1.23–2.38; p = 0.001). Conclusion: Both BMI and hormonal/menstrual factors are associated with mastalgia severity, but BMI is the strongest independent predictor. Weight management should form part of routine mastalgia care.