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Breast Pain (Mastalgia)

Read on for detailed information about how various oils may help alleviate breast pain.

Evening Primrose Oil
Lowered levels of gamma-linolenic acid (GLA) metabolites, especially arachidonic acid (AA), have been reported in patients with cyclical and non-cyclical mastalgia (breast pain) (1, 2). Evening Primrose Oil is commonly used as a first- and second-line treatment for breast pain, in part because of its very low association with side-effects compared with more conventional treatments(3, 4, 5).

Currently, clinical trials and reports from clinical practices do not give a clear picture of EPO’s effectiveness as a treatment for mastalgia. One randomized controlled clinical trial of EPO, 3g/day for 3-6 months, reported significant improvements in tenderness and nodularity (according to both patients and physicians) in cyclical mastalgia, and significant improvements in tenderness (according to physician but not to patient) in non-cyclical mastalgia, compared to no changes in placebo (6). Conversely, another randomized controlled trial at the same dose of EPO for 6 months reported no difference in pain severity, number of painful days, or patient evaluation of treatment, compared with placebo (3). A non-controlled trial of EPO at 3g/day showed a remarkable 97% improvement rate over 6 months (7). According to 2 reports from clinics and a survey of physicians, EPO treatment results in a positive result in 44-60% of women treated (4, 5, 8); however, another similar clinical report9concluded that only 10% of those treated with EPO saw a positive result, and that EPO was little better than placebo. In a related issue, a randomized controlled trial of EPO treatment for benign breast cysts reported that 3g/day treatment for 1 year produced no change in the recurrence of aspirated (surgically treated) cysts when compared with placebo (10).

The information presented here is for educational purposes only and is not intended as curative or prescriptive advice.

Bibliography
1. Horrobin DF. The effects of gamma-linolenic acid on breast pain and diabetic neuropathy: possible non-eicosanoid mechanisms. Prostaglandins Leukot Essent Fatty Acids 1993;48(1):101-4.
2. Gateley CA, Maddox PR, Pritchard GA, Sheridan W, Harrison BJ, Pye JK et al. Plasma fatty acid profiles in benign breast disorders. Br J Surg 1992;79(5):407-9.
3. Blommers J, de Lange-De Klerk ES, Kuik DJ, Bezemer PD, Meijer S. Evening primrose oil and fish oil for severe chronic astalgia: a randomized, double-blind, controlled trial. Am J Obstet Gynecol 2002;187(5):1389-94.
4. McFayden IJ, Forrest AP, Chetty U, Raab G. Cyclical breast pain--some observations and the difficulties in treatment. Br J Clin Pract 1992;46(3):161-4.
5. Pain JA, Cahill CJ. Management of cyclical mastalgia. Br J Clin Pract 1990;44(11):454-6.
6. Preece PE, Hanslip JI, Gilbert L, Walker D, Pashby NL, Mansel RE et al. Evening Primrose Oil (EFAMOL) for Mastalgia. Horrobin D.F. (Ed). Clinical Uses of Essential Fatty Acids. 1982;147-54.
7. Cheung KL. Management of cyclical mastalgia in oriental women: pioneer experience of using gamolenic acid (Efamast) in Asia. Aust N Z J Surg 1999;69(7):492-4.
8. Gateley CA, Miers M, Mansel RE, Hughes LE. Drug treatments for mastalgia: 17 years experience in the Cardiff Mastalgia Clinic. J R Soc Med 1992;85(1):12-5.
9. Wetzig NR. Mastalgia: a 3 year Australian study. Aust N Z J Surg 1994;64(5):329-31.
10. Mansel RE, Harrison BJ, Melhuish J, Sheridan W, Pye JK, Pritchard G et al. A randomized trial of dietary intervention with essential fatty acids in patients with categorized cysts. Ann N Y Acad Sci 1990;586:288-94.

 
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