Mastodynia - Treatments For Cyclical Breast Pain

Treatments For Cyclical Breast Pain

While in many cases it would possible to predict which treatment will be most effective with a series of endocrinological investigations involving thyroid and complicated pituitary hormone testing, this is rarely done in practice.

Treatments which demonstrated some effectiveness:

• Vitex agnus-castus extract: there is convincing evidence that Vitex agnus castus is safe and efficient in the treatment of cyclical mastalgia. It is assumed, that like bromocriptine it works by reducing prolactin secretion from the pituitary gland.
• Topical and systemic NSAIDs, analgesics
• Progestin based birth control pills or topical progesterone application. This method is effective only in a minority of women but is often tried because of its well known safety profile. Cyclic progestin on days 14-25 did show promising results.
• Dopamine agonists, best results with a better side effect profile than bromocriptine can be achieved with Dostinex. The older bromocriptine has been found very efficient with relatively good safety, is however associated with many unpleasant adverse side effects. There is very little although promising data on lisuride and quinagolide.
• Iodine: supplementation with supraphysiologic levels of iodine has been shown effective in the treatment of breast pain. Not yet widely recommended until the long term effects of supraphysiologic doses of iodine on thyroid health are better understood.
• Danazol: very low dose danazol treatment has been found very efficient with modest side effects. The lowest dose tested in one trial produced the most favorable long term results and was associated with least adverse effects.
• Thyroid hormone supplementation, especially when hypothyroidism or subclinical hypothyroidism has been diagnosed. However even levothyroxin supplementation in normal patients has been shown effective.
• Tamoxifen has been shown effective but is very rarely used because of serious concerns about safety in premenopausal women.
• Ormeloxifene, a SERM showed some effectivity in treatment of mastalgia and fibroadenoma.
• Anthocyanins from bilberry.