Treatment Of Cyclic Mastalgia Research Articles

Effectiveness of acupuncture in the treatment of cyclic mastalgia: a study protocol for a randomized controlled trial

BackgroundAbout 68% of women aged 18–44 years have experienced cyclic mastalgia (CM), which occurs during the luteal phase of the menstrual cycle when elevated hormone levels induce greater breast gland thickness. CM has a moderate-to-severe impact on a woman’s quality of life. Prior research has suggested that acupuncture may be beneficial for breast pain relief. In this study, we investigate the effectiveness of manual acupuncture (MA) in the treatment of CM compared with that of sham acupuncture (SA).MethodsThis is a multicenter, randomized, controlled trial. A total of 108 eligible CM patients will be randomly assigned to either MA (n = 54) or SA (n = 54) group using a 1:1 ratio and a stratified, blocked randomization. Acupuncture will be performed two weeks prior to menstruation and discontinued when menses begins. In both the MA and SA group, participants will be given acupuncture three times per week for 2 weeks per menstrual cycle for three consecutive menstrual cycles, encompassing a total of 18 sessions. The primary outcome will be the change in the average daily Breast Pain Visual Analog Scale (VAS-BP) over the first two weeks of menstruation from baseline to endpoints. The number of nominal days of breast pain (NDBP) two weeks before menstruation, World Health Organization Quality-of-Life Scale-Short Form scores, global patient assessment, breast glandular-section thickness, and breast-duct width three days before menstruation will also be measured as secondary outcomes.DiscussionThis prospective randomized trial will help evaluate the efficacy of acupuncture in treating CM. The results of this study will provide evidence of the therapeutic effectiveness of acupuncture on CM.Trial registrationClinicalTrials.gov Identifier: NCT05408377, registered on June 7, 2022.

Comparison of Efficacy of two Dosages Regimens of Centchroman (Ormeloxifene) with Tamoxifen in Treatment of Cyclical Mastalgia: a Randomized Controlled Trial

Comparison of Efficacy of two Dosages Regimens of Centchroman (Ormeloxifene) with Tamoxifen in Treatment of Cyclical Mastalgia: a Randomized Controlled Trial

Effect of Evening Primrose Oil and Vitamin B6 on Pain Control of Cyclic Mastalgia Associated with Fibrocystic Breast Changes: A Triple-Blind Randomized Controlled Trial

Background: Mastalgia is the most common symptom of fibrocystic breast changes. It causes concern and fear of breast cancer and has negative effects on quality of life. The study aimed to compare the effectiveness of evening primrose oil (EPO) and vitamin B6 in the pain control of cyclic mastalgia. Methods: This triple-blind randomized controlled clinical trial was conducted on 94 patients with mastalgia referring to the breast clinic of Milad hospital, Tehran, Iran. The participants were randomly assigned to three groups: EPO (n = 33), vitamin B6 (n = 31), and placebo (n = 30). The mastalgia severity in the three groups was measured using Visual analogue scale (VAS) before intervention and at the first, second, and third months after the beginning of the intervention using SPSS 18. Results: The results of this study showed that the mean severity of breast pain significantly reduced at the first, second, and third months after the intervention in the EPO (2.61 ± 2.35) and vitamin B6 groups (2.81 ± 1.97) (P < 0.001). However, the mean score of pain severity in the placebo group before and after the intervention did not show a statistically significant difference (5.38 ± 2.28) (P = 0.815). In addition, the difference in the mean score of pain severity between the two groups of EPO and vitamin B6 was not statistically significant (P = 0.999). Conclusions: The results of this study showed that vitamin B6 and EPO have the same therapeutic effects in the treatment of cyclic mastalgia. Because of the low cost and more availability of vitamin B6 compared to EPO, it can be used in the first line of treatment.

Evaluation of a dietary supplement in the treatment of cyclical mastalgia

Evaluation of a dietary supplement in the treatment of cyclical mastalgia

Role of tamoxifen and danazol in mastalgia: prospective controlled trial

Background: Mastalgia is one of the most common presenting symptoms of benign breast diseases, which may be cyclical or continuous. Mastalgia is the commonest breast symptom presenting in surgical clinics. Mastalgia is a symptom of great importance to those who experience it. These have been tendencies to ignore the condition, however, the relative reluctance of the patient due to the nature of disease and the antipathy towards the disease that has prevailed in our society has led to little scope of therapy. Works of some senior have added to misery of such patients. To study role of tamoxifen and danazol in mastalgia is the main objective of the present study. Methods: This was a prospective randomized control trial done in outpatient department (OPD) of Department of Surgery, UP, RIMS & R, Saifai, Etawah from July 2014-December 2015 i.e. 18 months. All patients coming to OPD in first 15 days of month s were given danazol 200 mg/day for a period of two months. All those coming in next half were treated with tamoxifen 20 mg/day for two months. Results: Danazol when used is effective in achieving complete or partial response in 70.83% of cyclic mastalgia when given in dose of 200 mg/day for two months. However 29.17% patients did not respond to it. Tamoxifen when used is effective in achieving complete or partial response in 66.67% of cyclical mastalgia when given in dose of 20 mg/day for two months. However 33.33% patients did not respond to it. Conclusions: Our study shows danazol treatment is more effective in treatment of cyclic mastalgia. Non cyclic mastalgia is difficult type to be cured by drug therapy.

Effectiveness of Topical Nigella sativa Seed Oil in the Treatment of Cyclic Mastalgia: A Randomized, Triple-Blind, Active, and Placebo-Controlled Clinical Trial.

Cyclic mastalgia is common in women and has no optimal therapy. Analgesic effects of Nigella sativa have been reported. Thus, the effect of a standardized N. sativa seed oil (600 mg applied to the site of pain bis in die for 2 months) on the 10-centimeter visual analog scale scores of pain severity in 52 women with cyclic mastalgia was compared to that of topical diclofenac (20 mg bis in die) (n = 51) and placebo (n = 53). There was no significant difference between the 1- and 2-month pain scores in the active treatment groups (p > 0.05). The pain scores of the active treatment groups did not differ significantly at 1 and 2 months (p > 0.05). The endpoint pain scores of the active treatment groups decreased significantly compared with the baseline (both p < 0.001). The pain scores of the active treatment groups at 1 and 2 months were significantly smaller than those of the placebo group (both p < 0.001). The pain scores of the placebo group at 1 and 2 months were not significantly different from the baseline (p > 0.05). No adverse effect was observed. In conclusion, topical N. sativa seed oil is safe, more effective than placebo, and has clinical effectiveness comparable to topical diclofenac in the treatment of cyclic mastalgia.

Comparing the effects of dietary flaxseed and omega-3 Fatty acids supplement on cyclical mastalgia in Iranian women: a randomized clinical trial.

Considering the negative side effects of chemical drugs, there is a great need for effective alternative treatment strategies to manage cyclical mastalgia. Therefore, this study aimed at comparing the effects of flaxseed diet and omega-3 fatty acids supplement on treatment of cyclical mastalgia. In this study, 61, 60, and 60 women, respectively, received flaxseed as bread, omega-3 fatty acids as pearl, and wheat bread as their diet for two menstrual cycles. At the baseline cycle and end of both interventional cycles, intensity of mastalgia was measured using visual analogue scale. Analysis of covariance showed a significant difference among the three groups regarding the mean intensity of cyclical mastalgia in the first and second cycles of the interventions (P < 0.001). Also, repeated measures analysis of covariance with adjustment of two variables of age and mastalgia intensity of the baseline cycle demonstrated that flaxseed bread was more effective compared to omega-3 and wheat bread (P < 0.001). The results of this study demonstrated that flaxseed bread diet was an effective approach in decreasing cyclical mastalgia and could be prescribed to women as a simple treatment with few complications.

Comparison of fructus agni casti and flurbiprofen in the treatment of cyclic mastalgia in premenopausal women.

Cyclic mastalgia is described as a diffuse, periodic and bilateral breast pain that can not be localized. Although there are several methods of treatment, the most efficient treatment method is still controversial. The aim of this study is to determine, compare and discuss the results of the patients under 40 years old age with a complaint of cyclic mastalgia and without any clinical signs, family history and ultrasonography finding, treated with fructus agni casti extract or flurbiprofen. One hundred and fourteen premenapousal patients younger than 40 years old with a complaint of cyclic mastalgia and without any clinical, family or ultrasonography findings were analyzed prospectively. Fructus agni casti extract (Group 1) or flurbiprofen (Group 2) were administered to the patients. VAS scores were accepted as full recovery whit a score of zero, as significant healing when the score improved more than 50%, as mild-moderate healing when the improvement was less than 50% and as no healing in case of no improvement. The mean age in group 1 was 28.29±5.81, and in group 2 was 29.09±4.49. The mean number of days with pain was 6.0±1.70 days in group 1, and was 6.3±1.63 in group 2. There was no significant difference in VAS scores between the two groups after treatment. Fructus agni casti extract and flurbiprofen are commonly used medications in the treatment of cyclic mastalgia. Both of these medications significantly reduce the complaints and have acceptable side-effects. There is no proven superiority over each other. Further clinical and laboratory studies are necessary to determine the ideal medication fort he treatment of cyclic mastalgia.

Comparison of the effect of fish oil and vitamin E on the duration of Cyclic mastalgia

Background: One of the most common causes of referal of women of childbearing age to physician is the cyclic mastalgia. The present study was performed due to the similar mechanism of action of fish oil and vitamin E in reducing this pain. Aim: To determine the effect of fish oil and vitamin E on duration of Cyclic mastalgia. Methods: This Triple-blind clinical trial was performed on 70 women (15 to 49 years) suffered from cyclical mastalgia. Patients were divided into two study groups with 35 patients in each group, included: 1. Fish oil 3gr/day, 2. Vitamin E 400 unit daily. Breast pain duration was evaluated before the study and 1 and 2 months after the intervention, In addition, medication side effects were assessed after an intervention. Data after collected by registration table of breast pain duration was analysed by SPSS statistical software (version16). Chi-square, repeated measures ANOVA, independent and paired-t tests were performed. Results: The mean of breast pain duration in fish oil group before an intervention was 9/3±3/4 and was decreased to 2/5±4/5 2 months after the fish oil consumption. Also in Vitamin E group this mount decreased from 9/5±3/3 to2/2±3/5. Overally the mean scores of breast pain duration decreased before and after the intervention in both groups (P<0/001). Conclusion: According to the findings of this study and the absence of serious drug side effects, fish oil and Vitamin E with similar therapeutic effects in the treatment of cyclic mastalgia, can be a viable alternative to other hazardous drugs in this field.

Comparison of surgical and medical treatment methods for women with recurrent miscarriages

In a placebo-controlled, randomized, 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 × 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.

Therapeutic Effects of Vitamin E on Cyclic Mastalgia

Cyclic mastalgia is one of the most prevalent disorders among fertile women. To date, hormonal agents, despite their side effects, have been widely used for treatment of this ailment. This study was performed to clarify the therapeutic effects of Vitamin E (Vit E) as a safe treatment for cyclic mastalgia among fertile women. This study was conducted as a double blind clinical trial; 150 women with cyclic mastalgia, referred by three public health centers in Qazvin City in Iran, were enrolled in the trial and randomly divided into two distinct case and control groups; each containing 75 patients. The severity and duration of breast pain were measured according to both the Cardiff Breast Pain Chart and the Visual Analog Scale. Simple, chewable tablets of either Vit E or a placebo were prescribed twice a day for 4 months for case and control participants, respectively. Follow-up was performed at the end of both the second and the fourth months and, at that time, the severity, duration and side effects of intervention were evaluated. The administration of Vit E had significant curative results as tested at both the 2- and 4-month benchmarks. Chi-square testing indicated that after both 2 and 4 months of therapy, the efficacy demonstrated by the Vit E recipient case group was superior to that of the group that received a placebo. Applying the Mc Nemar Test, it also was shown that there was no significant difference in the benefits received between treatment courses of 2 versus 4 months. A 2-month prescription of Vit E has positive therapeutic effects on cyclic mastalgia. Given its lack of significant side effects, Vit E, therefore, can be considered a safe alternative to hormonal therapies currently being used in the treatment of cyclic mastalgia.

Can Vitex Agnus castus Be Used for the Treatment of Mastalgia? What Is the Current Evidence?

There have been many treatments suggested for the management of mastalgia; one of these is the fruit extract of Vitex Agnus castus L. commonly known as Agnus castus, an extract of a deciduous shrub native to Mediterranean Europe and Central Asia. It is postulated that A. castus suppresses the stress-induced latent hyperprolactinemia which is a release of supra-physiological levels of prolactin in some patients in response to stressful stimuli. It is postulated that A. castus could be effective in the treatment of cyclical mastalgia by inhibiting the release of excess prolactin by blocking Dopamine-2 receptor type on pituitary. The adverse events following A. castus treatment are mild and reversible. The aim of this review is assess the efficacy of A. castus in the treatment of mastalgia. Data from randomized and non-randomized studies regarding the efficacy and safety of A. castus is reviewed in a systematic fashion. It is concluded that A. castus can be considered as an efficient alternative phytotherapeutic agent in the treatment of mastalgia.

Mastalgia cíclica pré-menstrual: placebo versus outras drogas

To compare therapeutic effects of placebo with intake of low doses of acetyl-salysilic acid (aspirin) and a compound of retinol, pyridoxine chlorhydrate and tocopherol acetate. The study is a prospective, controlled, triple blinded, randomized trial. From 259 patients, 81 were selected in order to follow rigid criteria of inclusion. They were divided into three groups of 27 patients, taking aspirin, vitamins or placebo respectively. The number of patients in each group was considered satisfactory for statistical analysis. Pain was scored as Grade 1 (without pain), Grade II (moderate pain) and Grade III (severe pain). The Tukey test was applied for comparison of results (statistical significance 5%). Clinical parameters, age, weight, BMI, parity and lactation period were similar for each group. There was a decrease of pain intensity in all groups, that was even more pronounced for the placebo group. Emphasis was given to symptomatic treatment of cyclic premenstrual mastalgia with symptoms considered to be the expression of a physiological process that can be treated with simple drugs or placebo. Usual therapeutic approaches with several drugs are criticized, including results and contraindications. This study based upon acceptable trial methodology (randomized, triple blinded, placebo controlled, prospective) did not show significant differences in the treatment of cyclic mastalgia.

A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia

Cyclical mastalgia is very common in Western populations and is believed to have an hormonal basis. Simple measures such as vitamins or evening primrose oil are not very effective, yet the disease rarely warrants anti-oestrogen therapies. Isoflavones are a subgroup of phytoestrogens which we hypothesized might be a simple and effective means of therapy as they act as a weak anti-oestrogen in pre-menopausal women and have no side-effects.A double-blind randomized control trial of either placebo, 40 mg or 80 mg of isoflavones was undertaken after an initial 2 month single-blind ‘Placebo Lead-in’ to exclude women with a significant placebo response. Eighteen women were randomized to the treatment phase of the trial. Nine of the 12 women on treatment had a worthwhile improvement in their pain compared to only two of six on placebo. The reduction in pain was 13% for placebo, 44% for 40 mg of isoflavone per day and 31% for 80 mg per day.There have been no previous clinical studies of isoflavones for the treatment of mastalgia and the benefit demonstrated in this study adds another valuable arm to therapy.

The effect of tamoxifen on the proliferative activity of fibroadenomas

Ž . For almost three decades, tamoxifen TAM has been used in the adjuvant treatment of breast cancer 1 . It has also proven effective in the chemoprophylaxis of this disease and in the treatment of cyclical mastalgia 2,3 . As a fibroadenoma is a benign hormone-dependant neoplasm, which bears levels of estrogen receptors higher than in the mammary lobule 4 , an evaluation of the effect of this drug on the proliferative activity of both the epithelium and the stroma of fibroadenomas in premenopausal women following the administration of 10 and 20 mg day during 22 days was proposed. Forty females with fibroadenoma were selected for a randomized double-blind trial. They had regular menstrual cycles and had neither received hormones nor become pregnant 12 months prior

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, randomized, 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 × 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.

Danazol versus cabergolina for the treatment of cyclic mastalgia

Danazol versus cabergolina for the treatment of cyclic mastalgia

Update on Clinical and Research Issues in Cyclical Mastalgia

Abstract: The most common breast complaint presented to primary care and breast clinic providers is pain, and the majority of such pain is cyclical. Cyclical mastalgia is poorly understood, inadequately assessed, and not systematically treated in the United States, although it is a recognized, and commonly treated disorder in Britain. Over 60% of premenopausal women regularly experience some premenstrual breast discomfort. Approximately 10--15% of these women have clinically significant mastalgia each month, which can interfere with usual activities and is associated with elevated use of mammography among young women. The etiology of cyclical mastalgia and its relationship to other disorders have not been established. Well-substantiated effective treatment options are somewhat limited, often associated with adverse effects, and rarely prescribed by physicians in the United States. This article reviews the literature on the prevalence, impact, etiology, assessment, relationship to other disorders, and treatment of cyclical mastalgia, including recent findings from research in our Obstetrics and Gynecology clinic and Comprehensive Breast Care Center. Approaches to assessment and management are suggested, as are directions for further research. We suggest that understanding and effective management of cyclical mastalgia will be fostered by a systematic biopsychosocial, interdisciplinary approach to research.

Multicentre study of gestrinone in cyclical breast pain FRIEDOLF PETERS

Although the aetiology of cyclical mastalgia is poorly understood, the consistent finding of an increased prolactin stimulation response probably due to oestrogen dominance has led to the use of treatment with prolactin-lowering drugs and anti-oestrogens. The efficacy and safety in cyclical mastalgia of gestrinone, which has androgenic, anti-oestrogenic, and antiprogestagenic properties, were investigated in a multicentre study. In a double-blind randomisation procedure, 72 patients were allocated placebo and 73 treatment with gestrinone (2·5 mg twice a week) for 3 months. The patients recorded the severity of breast pain on a visual analogue scale before and during treatment and scored other breast symptoms as not present (0), mild (1), moderate (2), or severe (3). The gestrinone group had significantly greater reductions than the placebo group in breast pain score at months 1, 2, and 3 of treatment (mean reduction 59·5 [SD 22·6] to 11·7 [17·0] vs 58·2 [17·6] to 36·7 [23·0] at month 3; p<0·0001). All six breast symptoms had lower scores in the gestrinone than in the placebo group by the end of treatment. In a subset of 30 participants (15 from each group), serum concentrations of oestradiol, progesterone, and tri-iodothyronine were significantly lower than baseline after 3 months of gestrinone, but concentrations of luteinising hormone, follicle-stimulating hormone, prolactin, thyroid-stimulating hormone, and thyroxine did not change. 41% of gestrinone-treated and 14% of placebo-treated patients reported at least one side-effect; most of these were androgen-mediated. 11 placebo-treated patients and 4 on gestrinone discontinued treatment. Thus, gestrinone was very effective in the treatment of cyclical mastalgia and was well tolerated

Treatment of cyclical mastalgia.

Bromocriptine can significantly improve the symptoms of cyclical mastalgia, researchers from Manchester and Turin say.