<b>Exploring the Impact of Physical Activity Level and Body Mass Index on Cyclic Mastalgia in Reproductive-Aged Females</b>

Background: Cyclic mastalgia is a common benign breast condition affecting women of reproductive age and can significantly impair quality of life despite its non-malignant nature. The role of modifiable lifestyle factors such as physical activity and body mass index (BMI) in influencing mastalgia severity remains inconsistently reported, particularly in young populations. Objective: To examine the association of physical activity level and BMI with cyclic mastalgia severity among reproductive-aged female university students. Methods: A cross-sectional study was conducted among 142 female students aged 18–25 years in Lahore, Pakistan. Cyclic mastalgia was assessed using the Breast Pain Questionnaire, physical activity was measured using the International Physical Activity Questionnaire (short form), and BMI was calculated from measured height and weight. Associations were evaluated using ANOVA, correlation analysis, and multivariable linear regression with adjustment for demographic variables. Results: The mean age was 22.04 ± 1.77 years and mean BMI was 22.54 ± 4.08 kg/m². Higher physical activity levels were significantly associated with lower breast pain scores (p = 0.021), with the high activity group showing a mean reduction of -1.32 (95% CI: -2.01 to -0.63; p = 0.001) compared to the low activity group. BMI was not significantly associated with mastalgia severity (r = 0.112, p = 0.182). In multivariable analysis, high physical activity remained an independent predictor of lower pain severity (β = -1.08, p = 0.003). Conclusion: Higher physical activity levels are associated with reduced severity of cyclic mastalgia, while BMI shows no significant relationship in this population. Promoting regular physical activity may serve as a practical, non-pharmacological approach for symptom management.