RESULTS Reassurance plus bra-fitting advice provides relief for most women .
There is some benefit in reducing dietary coffee and fat intake .
Dopamine agonists are useful , but less effective than endocrine treatments such as Danazol or Tamoxifen .
Of the Selective Oestrogen Receptor Modulator drugs , Ormeloxifene appears most effective , but is not licenced in the United Kingdom .
Relaxation therapy , acupuncture and kinesiology may be useful but currently lack good evidence of effectiveness .
Subsequent drug therapy should be balanced against its side-effects ; topical NSAIDs and Ormeloxifene show greatest benefit with least side-effects .
INTRODUCTION Idiopathic mastalgia ( benign breast pain of unknown origin ) is often poorly managed because of its subjective nature and unclear aetiology .
Mastalgia is a reason for up to 50 % of breast outpatient referrals .
Existing systematic review s discuss date d treatment options that provide limited symptomatic relief .
Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study.
OBJECTIVE To evaluate the effectiveness of vitamin E , evening primrose oil ( EPO ) , and the combination of vitamin E and EPO for pain control in women with cyclical mastalgia . PROCEDURE A double-blind , r and omized , placebo-controlled trial was conducted at two U.S. academic medical centers . Eighty-five women with premenstrual cyclical breast discomfort were enrolled . Participants were r and omly assigned to one of four six-month oral treatments : vitamin E ( 1,200 IU per day ) , EPO ( 3,000 mg per day ) , vitamin E ( 1,200 IU per day ) plus EPO ( 3,000 mg per day ) , or double placebo . The primary outcome measure was change in breast pain , measured by the modified McGill Pain Question naire at enrollment and at six months . RESULTS Forty-one patients completed the study . Intent-to-treat analysis ( pretesting and post testing ) showed a difference in worst-pain improvement with the treatments EPO ( p=0.005 ) , vitamin E ( p=0.04 ) , and EPO plus vitamin E ( p=0.05 ) , but no difference with placebo ( p=0.93 ) . Results from two- sample t-test showed a nonsignificant decrease in cyclical mastalgia individually for the three treatment groups compared with the placebo group ( EPO , p=0.18 ; vitamin E , p=0.10 ; and EPO plus vitamin E , p=0.16 ) . The data were also analyzed with the separation test by Aickin , which showed a trend toward a reduction of cyclical mastalgia with vitamin E and EPO individually and in combination . CONCLUSION Daily doses of 1,200 IU vitamin E , 3,000 mg EPO , or vitamin E and EPO in combination at these same dosages taken for six months may decrease the severity of cyclical mastalgia
RESULTS Reassurance plus bra-fitting advice provides relief for most women .
There is some benefit in reducing dietary coffee and fat intake .
Dopamine agonists are useful , but less effective than endocrine treatments such as Danazol or Tamoxifen .
Of the Selective Oestrogen Receptor Modulator drugs , Ormeloxifene appears most effective , but is not licenced in the United Kingdom .
Relaxation therapy , acupuncture and kinesiology may be useful but currently lack good evidence of effectiveness .
Subsequent drug therapy should be balanced against its side-effects ; topical NSAIDs and Ormeloxifene show greatest benefit with least side-effects .
INTRODUCTION Idiopathic mastalgia ( benign breast pain of unknown origin ) is often poorly managed because of its subjective nature and unclear aetiology .
Mastalgia is a reason for up to 50 % of breast outpatient referrals .
Existing systematic review s discuss date d treatment options that provide limited symptomatic relief .