Some womens breasts are unusually tender and lumpy, with symptoms of pain
and dull heaviness that vary with the menstrual cycle. This condition is called
cyclic mastalgia or mastitis and is often associated with premenstrual stress
syndrome (PMS). When the lumps become significant enough to be called cysts,
this condition is sometimes called fibrocystic breast disease.
Besides discomfort, perhaps the worst problem of this condition is that it can
mimic the appearance of breast cancer on mammograms, leading to false alarms. To
make matters worse, fibrocystic changes can also hide true cancers, and women
with fibrocystic breast disease may also have a greater tendency toward breast
cancer (although this is controversial).
Conventional treatment of cyclic mastalgia has incorporated many staples of
alternative medicine. After screening carefully for breast cancer, physicians
typically recommend reducing animal fats, avoiding chocolate and caffeine, and
supplementing with vitamin E (400 IU daily) and vitamin B6 (50 mg daily). Some
physicians have begun to use evening primrose oil as well. These treatments are
more likely to be successful in cases that involve pain but no cysts. Even so,
the response to therapy is slow, often requiring over 6 months for full results.
If these natural methods dont work, physicians may prescribe various hormone or
hormone-like medications.
Treatment
Principal Proposed Treatments for Cyclic Mastalgia:
Cyclic mastalgia often occurs in connection with PMS. (See the article on PMS
for information on related treatments.)
Chasteberry
In Germany, the herb chasteberry is frequently used to treat cyclic mastalgia
and other symptoms of PMS because of its effect on the pituitary gland to
suppress the release of prolactin.
What Is the Scientific Evidence for Chasteberry
A double-blind placebo-controlled trial of 97 women with symptoms of cyclic
mastalgia found that treatment with chasteberry extract significantly reduced
pain intensity by the end of one menstrual cycle. The reduction continued to
increase throughout the second menstrual cycle, and at the end of both the first
and second cycle, women in the treated group were doing better than those
receiving placebo.
However, something interesting happened in the third cycle. The benefits of
chasteberry treatment reached a plateau, while the placebo group continued to
improve. At the end of the third cycle, those receiving chasteberry were still
doing better, but the difference was no longer statistically significant.
Another double-blind trial of 104 women compared placebo against two forms of
chasteberry (liquid and tablet) for at least three menstrual cycles. The results
showed statistically significant and comparable improvements in the treated
groups as compared to placebo.
Benefits were also seen in a double-blind trial that enrolled 160 women with
cyclic breast pain. The women were given either chasteberry, a drug related to
progesterone, or placebo, and were followed for at least four menstrual cycles.
Although there were many dropouts, the results again suggest that chasteberry is
superior to placebo.
Finally, a double-blind placebo-controlled study of 178 women found that
treatment with chasteberry over three menstrual cycles significantly reduced PMS
symptoms, including breast tenderness.
For more information, including dosage and safety issues, see the full
chasteberry article.
Evening Primrose Oil (Source of GLA)
European physicians commonly use evening primrose oil to treat cyclic mastalgia,
and the practice has come to be popular among some physicians in the United
States as well. Evening primrose contains relatively high concentrations of the
essential fatty acid gamma-linolenic acid (GLA). Fatty acid metabolism is known
to be disturbed in women with cyclic mastalgia, and abnormalities in essential
fatty acid levels have been found in women with PMS and with nonmalignant breast
disease. It appears that supplementation with evening primrose oil may be able
to correct this imbalance.
What Is the Scientific Evidence for Evening Primrose Oil?
In uncontrolled studies, evening primrose oil has been found to produce
significant benefits in about 44% of women with cyclic mastalgia.
Improvement was also seen in a double-blind placebo-controlled study of 73 women
suffering from cyclic breast pain. Discomfort was significantly reduced in the
group taking evening primrose oil, whereas no significant improvement was seen
in the placebo group.
However, evening primrose oil does not seem to be helpful when there are breast
cysts rather than just pain. In a 1-year, double-blind study of 200 women with
breast cysts, evening primrose oil did not prove effective.
For more information, including dosage and safety issues, see the full GLA
article.
Ginkgo
Although the herb ginkgo is primarily used to enhance memory and mental function
(see the article on Alzheimers disease), it may be helpful for breast
tenderness as well. A double-blind placebo-controlled study evaluated 143 women
with PMS symptoms, 18 to 45 years of age, and followed them for two menstrual
cycles. Each woman received either the ginkgo extract (80 mg twice daily) or
placebo on day 16 of the first cycle. Treatment was continued until day 5 of the
next cycle, and resumed again on day 16 of that cycle.
As compared to placebo, ginkgo significantly relieved major symptoms of PMS,
especially breast pain.
For more information, including dosage and safety issues, see the full ginkgo
article.
Other Proposed Treatments for Cyclic Mastalgia:
A small and poorly reported double-blind placebo-controlled trial provides weak
evidence that red clover isoflavones might reduce symptoms of cyclic mastalgia.
Very weak evidence suggests the supplement iodine may also be helpful for cyclic
mastalgia.
Like chasteberry, the herb bugleweed appears to reduce prolactin levels, and for
this reason has also been tried for the treatment of cyclic mastalgia. However,
this herb affects the thyroid gland, and we do not recommend it.