Mastalgia: most effective dietary supplements

Mastalgia, or breast pain, is a sensation of pain felt in the breasts that can be cyclical (related to the menstrual cycle) or noncyclical. Cyclical mastalgia is often associated with hormonal fluctuations of the menstrual cycle and mainly affects premenopausal women, whereas noncyclical mastalgia has no link with the menstrual cycle and can affect women of any age. The pain can range from mild to severe, and it may be felt in one or both breasts, sometimes radiating to the armpit or the arm. In some countries, the incidence of mastalgia may reach up to 70% of women during their lifetime, although it is less common in Asian countries.

Etiology

The etiology of mastalgia is not fully understood. Hormonal variations, notably fluctuations in estrogen and progesterone, are often involved, especially in cyclical mastalgia. It is also suggested that factors such as pregnancy, breastfeeding, menopause, and the use of oral contraceptives or hormone replacement therapy may influence the onset of breast pain. Furthermore, some studies have identified abnormalities in lipid metabolism and an increased prolactin response to stimulation by thyrotropin-releasing hormone (the hormone that stimulates the pituitary to produce prolactin) as possible contributory factors.

Diagnosis

Diagnosis of mastalgia is based on clinical evaluation and the distinction between cyclical and noncyclical mastalgia. It is important to differentiate mastalgia from other causes of breast pain, such as musculoskeletal or referred pain. Additional examinations, such as ultrasound or mammography, may be necessary to rule out other underlying pathologies, such as breast cancer. Although mastalgia may rarely be the only symptom of breast cancer, isolated breast pain is not generally associated with an increased risk of cancer.

Treatment

• Information and Reassurance: Providing clear information and reassuring the patient are the first essential steps. This approach is often sufficient for mild to moderate cases of mastalgia. • Wearing a Well-Fitted Bra: A bra that provides good support can greatly help relieve pain, for both cyclical and noncyclical mastalgia. • Adjustment of Hormone Replacement Therapy (HRT): In some cases, adjusting the dose, formulation, or dosing schedule of hormonal treatments can reduce mastalgia. Stopping HRT may be necessary if the pain persists. • Use of Flaxseed: Flaxseed is recommended as a first-line treatment for cyclical mastalgia because of its proven efficacy in clinical trials. • Nonsteroidal Anti-Inflammatory Gels (NSAID gels): Topical application of an anti-inflammatory gel, such as diclofenac, is recommended for the management of localized pain in mastalgia. • Tamoxifen and Danazol: These two medications are recommended for cases where first-line treatments are not effective. Tamoxifen, at a dose of 10 mg per day, is particularly effective at reducing pain.