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Severe pain in breasts
I'm 31, had a partial hysterectomy a 1 1/2 years ago, I'm a 36DD and have always had breast pain it seems. It gets so bad that I have to hold myself more secure when I am driving or even walking. They told me it was probalby hormones, gave me naproxin. I've watched my caffiene intake and have noticed it doesn't seem to be a specific time of the month. I've tried the naproxen, Acetaminophen, ibuprofen, etc... When this effects the way I enteract with my son it's passed time to get more help. Any suggestions? Thank you.
Jane Harrison Hohner, RN, RNP responded:
Dear RHYLARSMOM: Yes, if you still have your ovaries you may be having some non-ovulatory cycles where there can be elevated estrogen levels. Estrogen has been linked to breast tenderness.

The best review citation on mastodynia/mastalgia (breast pain) at the National Library of Medicine site is almost 20 years old but it gives a good overview:

Obstet Gynecol Clin North Am. 1994 Sep;21(3):461-77.
BeLieu RM.

Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine.

The most important factors in the evaluation and treatment of breast pain consist of a thorough history, physical, and radiologic evaluation. These can be used to reassure the patient that she does not have breast cancer. In the 15% of mastalgia patients who have life-altering pain and still request treatment, therapy may consist of a well-fitting bra, a decrease in dietary fat intake, and discontinuance of oral contraceptives or hormone replacement therapy. Those women still resistant to therapy may experience relief from evening primrose oil supplements, bromocriptine, tamoxifen, or GnRH analogues. Predicting which treatment will be most useful for any particular woman may be challenging. No differences in success rates were found to be associated with factors such as reproductive history, presenting complaint, personal or family history of breast disease, or subsequent need for breast surgery. The peak (but not basal) serum prolactin levels in response to thyrotropin releasing hormone stimulus has been predictive of success for hormonal treatment but is relatively invasive. A survey of treatments actually used was obtained from 276 consultant surgeons in Britain in 1990. Of those, 75% prescribed danazol. Others used analgesia (21%), diuretics (18%), local excision (18%), bromocriptine (15%), evening primrose oil (13%), tamoxifen (9%), a well-fitting bra (3%), and no treatment (10%). Breast specialists were more likely to begin treatment with primrose oil, tamoxifen, vitamin B6, and analgesia, reserving other hormonal therapies for more difficult cases. To further evaluate the women who have severe mastalgia but do not complete treatment regimens, a questionnaire was sent to 79 patients who failed to return to the Longmore Breast Unit of Western General Hospital, Edinburgh. Seventy-one women responded. Of these, 36 said they felt better, 19 said they felt no more could be done, 18 learned to live with it, 14 were not worried even if the pain recurred, 2 were pregnant, 10 were postmenopausal, and 5 were still taking the medications previously prescribed. The prognosis for women with breast pain is not always predictable. Women with cyclic breast pain often are relieved by events that alter their hormonal milieu, whereas noncyclic breast pain may last only 1 to 2 years.

RHYLARSMOM, if holding your chest securely helps the pain either a more confining bra or a breast reduction MIGHT be helpful. If your pain continues I would urge you to see a breast surgeon or a specialty breast clinic. These MDs tend to see the more unusual breast cases.

Anon_6061 responded:
Removing caffeine from your diet can sometimes help. Also, evening primrose oil / capsules is helpful for some women. Here are a couple of links that mention EPO -
Anon_6061 replied to Jane Harrison Hohner, RN, RNP's response:
Sorry Jane - I didn't see your reply.
Jane Harrison Hohner, RN, RNP replied to Anon_6061's response:
Dear Anon_6061: Not to worry; your replies are always welcomed. They have been spot on-- and medically correct.

In Appreciation,
RHYLARSMOM replied to Jane Harrison Hohner, RN, RNP's response:
I thank you both for our time and expertise. I really appreciate it.

shirl responded:
I once had this problem big time. My gynecologist told me to stop drinking any caffeine and to take vitamin e. In about 2 months, I had no pain in my breasts.
geckomom35 responded:
I had the same problem for YEARS! I take magnesium 250 mg 1 each morning and 2 at bedtime. I take Vitamin B6 50 mg twice daily (I'm on Medicaid & Gluten & Lactose FREE, my doctor gave a script & it is COVERED in New York state, at a compounding pharmacy)! I'm on a GOOD B complex supplement called Blood Nutrients (made by Carlson, a brand name of vitamins, can be purchased online). I take Lovaza (an Omega 3 fatty acid) I take 2 capsules twice daily (My MediCARE plan PAYS for this), it HELPS with HIGH Cholesterol 2! However, after I changed my DEODERANT about 3 months ago, no MORE PAIN. I have been using Almay hypoallergenic roll on, which is ALUMINUM FREE! I decided this based on a book I read called: "What Your Doctor May Not Tell You About Fibromyalgia: The Revolutionary Treatment That Can Reverse the Disease " St. Amand, R. Paul, Marek, Claudia Craig Fibromyalgia and BREAST pain often co-exist! NEVER did I think the pain would "RESOLVE" itself in 1 simple change! It is strange b/c I set out to FIX the fibro symptoms, didn't even notice the breast pain was almost GONE until about 5 days ago. I'd also make sure & get a mammogram!! I had one 3 years ago. They said NO CANCER, come back when u turn 40!
DolphinBaby1369 replied to shirl's response:
I am going to have to look into Vitamin E was not aware that could help with pain thanks
DolphinBaby1369 replied to geckomom35's response:
wow interesting to know that your deodorant could be the culprit in your breast pain
msjmats responded:
I'm 62 and had problems with breast pain several years ago. I take vitamin E 400 and evening primrose oil 1000 and they work very well. I found that rubbing the sore places seemed to bring some relief too when the pain was bad.
Jane Harrison Hohner, RN, RNP replied to msjmats's response:
Dear All: Thanks for your input. For interested readers here is a recent, but very small study, on the use of Vitamin E, evening primrose oil, and a combination done at the Mayo Clinic. This citation comes from the National Library of Medicine site:

Altern Med Rev. 2010 Apr;15(1):59-67.
Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study.
Pruthi S, Wahner-Roedler DL, Torkelson CJ, Cha SS, Thicke LS, Hazelton JH, Bauer BA.

Breast Diagnostic Clinic, Mayo Clinic, Rochester, Minnesota 55905, USA.

To evaluate the effectiveness of vitamin E, evening primrose oil (EPO), and the combination of vitamin E and EPO for pain control in women with cyclical mastalgia.

A double-blind, randomized, placebo-controlled trial was conducted at two U.S. academic medical centers. Eighty-five women with premenstrual cyclical breast discomfort were enrolled. Participants were randomly assigned to one of four six-month oral treatments: vitamin E (1,200 IU per day), EPO (3,000 mg per day), vitamin E (1,200 IU per day) plus EPO (3,000 mg per day), or double placebo. The primary outcome measure was change in breast pain, measured by the modified McGill Pain Questionnaire at enrollment and at six months.

Forty-one patients completed the study. Intent-to-treat analysis (pretesting and post testing) showed a difference in worst-pain improvement with the treatments EPO (p=0.005), vitamin E (p=0.04), and EPO plus vitamin E (p=0.05), but no difference with placebo (p=0.93). Results from two-sample t-test showed a nonsignificant decrease in cyclical mastalgia individually for the three treatment groups compared with the placebo group (EPO, p=0.18; vitamin E, p=0.10; and EPO plus vitamin E, p=0.16). The data were also analyzed with the separation test by Aickin, which showed a trend toward a reduction of cyclical mastalgia with vitamin E and EPO individually and in combination.

Daily doses of 1,200 IU vitamin E, 3,000 mg EPO, or vitamin E and EPO in combination at these same dosages taken for six months may decrease the severity of cyclical mastalgia.

Readers, if a woman is considering this exact regimen she should consult with her GYN or clinic first. It's also important to note that the women in this study had breast pain that cycled (probably based upon menstrual cycle) rather than constant pain.


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