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 .
Treatment of cyclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study.
In a placebo-controlled , r and omized , double-blind study the efficacy of a Vitex agnus castus extract-containing solution ( VACS ) was investigated in patients suffering from cyclical mastalgia . Patients had mastalgia on at least 5 days in the pre-treatment cycle . During this cycle and during treatment ( 3 cycles ; 2 x 30 drops/day ) , the intensity of mastalgia was recorded once per cycle using a visual analogue scale ( VAS ) . After one/two treatment cycles , the mean decrease in pain intensity ( mm , VAS ) was 21.4 mm /33.7 mm in women taking VACS ( n=48 ) and 10.6 mm/20.3 mm with placebo ( n=49 ) . The differences of the VAS-values for VACS were significantly greater than those with placebo ( p=0.018 ; p=0.006 ) . After three cycles , the mean VAS-score reduction for women taking VACS was 34.3 mm , a reduction of ' borderline significance ' ( p=0.064 ) on statistical testing compared with placebo ( 25.7 mm ) . There was no difference in the frequency of adverse events between both groups ( VACS : n=5 ; placebo : n=4 ) . VACS appears effective and was well tolerated and further evaluation of this agent in the treatment of cyclical mastalgia is warranted
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 .