A comparative study of Centchroman, Tamoxifen and Danazol in management of cyclical mastalgia

Abstract

Background: Mastalgia is a common problem and 60-70% women encounter it at least once in their lifetime. Many drugs have been used and are been used with varying response, like Tamoxifen, Danazol, primrose oil, topical analgesics and recently Centchroman. The objective of the present study was to compare the three most commonly used drugs in the treatment of mastalgia, namely Centchroman, Tamoxifen and Danazol with a placebo.Methods: All consecutive female patients more than 25 years of age with history of mastalgia for more than 3 months were taken up for the study. Patients were distributed into four groups and administered Centchroman, danazol, tamoxifen and placebo, respectively.Results: In present study of 78 patients, the median visual analogue score (VAS) in Centchroman group were 3, 1 and 3 after treatment of 4, 12 and 24 weeks, respectively with a pre-treatment VAS of 8. Similarly, in the danazol group, VAS at 4, 12 and 24 weeks were 4, 1.5 and 5, respectively. In the Tamoxifen group it was 4, 1 and 3 after treatment for 4, 12 and 24 weeks. On comparison, Centchroman and Tamoxifen both had better pain relief than danazol at 24 weeks (p <0.001) while Centchroman and Tamoxifen had comparable results (p >0.05) despite Centchroman having a lower mean VAS score.Conclusions: Mild cyclical mastalgia can be treated with reassurance and lifestyle measures. Moderate to severe mastalgia usually require drug treatment. Centchroman, Danazol and Tamoxifen are effective. Centchroman appears to have better pain relief relative to the rest.