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Copyright: Copyright © 2017, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
Breast pain is a common complaint among women, but has no known etiologic or pathologic reason. According to reports it was observed in approximately 70% of women, and it is the most common complaint among patients with benign breast lesions (1). There are three main types of breast pain: a) cyclical breast pain, b) non-cyclical breast pain, and c) chest wall pain originating from outside the breast (2). Cyclical breast pain includes pain, tenderness before menstruation (a regular event during the luteal phase) and breast inflation, and lasts at least 5 - 7 days. As the menstrual cycle begins, the symptoms diminish (3, 4).
The reasons for this pain have not been completely determined (1). Inflammatory cytokines are considered a contributor, and a previous study demonstrated an interleukin and alpha tumor necrosis factor in patients with breast pain. The findings showed that during the luteal phase the cytokine levels are less in the patients, although the difference was not statistically.significant (5). Estrogen increases or progesterone reductions and impaired estrogen-progesterone balance are also probable causes of breast pain. Breast pain interferes with sexual activity (48% of respondents), physical (38%), social (21%), professional (8%), and educational (8%) activities (2).
Breast pain in women can be reduced through using a proper bra or more efficient painkillers such as acetaminophen or non-steroid anti-inflammatory drugs (NSAIDS) (3). If these practices don’t control the pain and interfere with sexual or professional activity, it is recommended that patients try Danazol, Tamoxifen, or Bromocriptine (2, 6-8). However, these drugs are associated with many side effects that limit their use by the public (3).
Non-hormonal treatments include nonsteroidal anti-inflammatory gel, iodide, and herbal products like evening primrose oil (EPO) and chasteberry (9). There is considerable discussion about selecting the best method for the primary management of breast pain (10). Dietary changes and herbal supplements such as vitamin E and evening primrose oil are conventional treatments for women with moderate-to-severe cyclical breast pain (4). Evening primrose oil contains...