Mystalgia (Breast Pain): Vitamin E and Primrose Oil May Work

Summary
A recent study done at the Mayo Clinic examined the utility of vitamin E and evening primrose oil in reducing the pain in cyclical mastalgia. Cyclical mastalgia is a condition in which women develop pain in breasts just before menstruation. Almost 70 percent of women who are premenopausal suffer from this disorder at some time in their lives.  The authors say that a daily dose of 1,200 IU of vitamin E, 3,000 mg of evening primrose oil, or a combination of the two in the same dosages, may bring down the severity of cyclical mastalgia. Whether taken singly or in combination, Vitamin E and primrose oil need to be given for six months.

Introduction
Some studies report prevalence as high as 69 percent of the common disorder cyclical mastalgia. Painkillers and support bras are used for alleviating pain in mild cases. Sometimes these measures fail to bring down the pain, and stronger drugs such as danazol and tamoxifen are advised. These drugs have many side effects. Some studies have shown vitamin E and evening primrose oil to be useful for such patients. Vitamin E and evening primrose oil have no side effects. This study was carried out to assess the effectiveness of vitamin E and evening primrose oil, individually and in combination, in reducing the severity of cyclical mastalgia.

Methodology
* The study included 85 participants who came to Mayo Clinic for the treatment of cyclical mastalgia.
* The participants were divided into four groups. The first group received only vitamin E, the second group received only evening primrose oil, and the third group received a combination of both, while the last group was given placebo treatment. The treatment was given for a period of six months.
* Severity of pain was assessed in all the participants using the “Modified McGill Pain Questionnaire”, before the start and after completion of six months of treatment.

Results
* The mean age of the subjects was 40.4 years. Out of 85 participants, only 41 completed the study. The number of participants who dropped out of the study in each group was almost same.
* There was not much reduction of pain in all the four groups.
* The difference of improvement of pain was also not much in between the groups. But when a statistical test known as the “separation test” was applied, it showed some benefit with the use of vitamin E and evening primrose oil – alone and in combination.

Shortcomings
The initial sample size of the study was very low; moreover, the dropout rate was also significantly high. According to the authors, the high dropout was because of a publication during the study, which stressed the adverse effects of vitamin E. In the present study, the alpha form of vitamin E was used. This is the most common form of vitamin E available in food. However, the gamma form is known to be more potent. Similar studies in the future need to use the gamma form of vitamin E to identify its beneficial effects.

Conclusion
This study failed to convincingly prove the beneficial effects of vitamin E and evening primrose oil in the management of cyclical mastalgia, because of the very small sample size. However, some specific statistical tests have shown that these agents may be useful, to some extent. According to the authors, “a larger, well-powered clinical trial may be indicated to further evaluate the effects of vitamin E and evening primrose oil on mastalgia.” As a form of alternative treatment, many other substances such as fish oil, diuretics and vitamin B6 are used for treating mastalgia. Further studies are necessary to examine their usefulness as well.

For More Information:
Vitamin E and Evening Primrose Oil for Treatment of Cyclical Pain in Breasts
Publication Journal: Alternative Medicine Review, 2010
By Sandhya Pruthi, MD; Dietlind L Wahner-Roedler, MD
From the Mayo Clinic, Rochester, Minnesota

*FYI Living Lab Reports Are Summaries of the Original Research.

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