BREAST PAIN

FOR SOME WOMEN, BREAST PAIN or tenderness is so great that even a blouse brushing against the skin causes intense pain. This con­dition, also called mastalgia, is often misdiagnosed as fibrocystic breast disease, which is usually accompanied by one or more lumps in the breast.

But mastalgia is not a disease. It is a conditon caused by normal changes in breast tissue related to monthly fluctuations in levels of oestrogen and progesterone, which cause the glands and ducts in the breast to enlarge. As a result, the breasts become swollen, painful, tender and lumpy. For many women, these symptoms occur as part of the premenstrual syndrome and usually disappear during or after menstruation.

Breast pain can be present at other times when ovarian hormone levels change, such as during puberty, pregnancy, approaching the menopause and oestrogen replacement therapy. It can occur after pregnancy because of milk engorgement, but breastfeeding usually relieves this discomfort. During breastfeeding, however, painful infections or abscesses can form in the breast tissue. Pain can also be a side effect of certain drugs, such as diuretics used for high blood pressure and heart drugs. On rare occasions, pain can be a sign of breast cancer, so it's prudent to consult a doctor about breast pain.

MANY WAYS TO GET YOUR GLA

Evening primrose oil is a fine way to supplement your diet with gamma linolenic acid (GLA), but it can be costly. (It's also trendy, so your health food store might be out of it when you need it.) Other seed oils containing GLA are blackcurrant (Ribes nigrum) and borage (Borago officinalis).

Because linoleic acid, a common compound in some foods, can be converted to gamma-linolenic acid by the body, including such foods in your diet is another option. High sources of linoleic acid include safflower, soya, and flaxseed oils. Put a dressing made with one of these on a big salad filled with fibre and nutrients and you've done your body a world of good.

DRUG TREATMENT

Analgesics
Aspirin, ibuprofen, paracetamol.
Function: relieve pain.
Aspirin side effects: stomach upset.
Ibuprofen side effects: gastrointestinal irritation and bleeding, rash.
Paracetamol side effects: dizziness, excitement, disorientation, liver damage.

Hormone-Based Drugs
Oral contraceptives (many types and trade names).
Function: decrease the levels of hormones secreted by the ovaries, thereby easing breast pain.
Side effects: nausea, headache, vaginal bleeding, weight gain, vaginal infections, blood clots, changes in metabolism, increased blood pressure, skin pigment changes. Note: the side effects of oral contraceptives vary greatly depending upon the amount of oestrogen and progesterone in the preparation.

Synthetic Steroids
Danazol (Danol). Function: suppresses the function of the ovaries and mimics progesterone somewhat; typically used only in cases of severe breast pain.
Side effects: weight gain, decreased breast size, acne, increased male characteristics such as hair growth and deepening of the voice, headache, hot flushes, changes in libido, liver damage.

HERBAL REMEDIES

Evening Primrose (Oenothera biennis)
The seeds of the evening primrose furnish an oil that contains gamma­linolenic acid (GLA). In the body, this oil increases the level of a particular type of prostaglandin that helps fight inflammation. Some studies have shown that GLA significantly helps women with breast pain; others have shown that it doesn't. It seems that the oil may be useful for mild discomfort but not severe pain.
Typical dosage: capsules totaling 3,000 to 4,000 milligrams per day; or 1/2 teaspoon of the oil per day; take either for three months to see results.

Agnus Castus (Vitex agnus-castus)
The fruit of this herb, also known as chaste berry, has hormone-like effects on the body and normalises progesterone activity. It can make many symptoms of premenstrual syndrome, including breast pain, go away. As with evening primrose or other GLA products, agnus castus may need to be taken for three months before significant effects are seen.
Typical dosage: 200 milligrams of a standardised extract containing 0.5 per cent agnuside, one to three times per day. Caution: do not take if you are pregnant, or if you are on hormone replacement therapy. If you are taking other hormone-like drugs, consult your doctor before using agnus castus.

FOUR QUICK PAIN-EASERS

These strategies may not work for every woman, but they're all non-invasive, relatively inexpensive and natural.

1. Give yourself some support. Invest in good support bras, or make sure that the ones you have fit properly. You might be surprised at the difference this makes, especially for larger-breasted women.

2. Try a heat treatment. Many herbalists recommend warm castor-oil packs or just plain heat packs, which seem to help move fluid out of the breasts.

3. Trim the fat. Although not all doctors agree on this, some research indicates that high levels of dietary fat can contribute to breast pain.

4. Cut the caffeine. Again, doctors disagree, but eliminating or reducing your caffeine intake is definitely worth a try, especially if you describe yourself as a tea or coffee addict. Don't forget to count colas in your caffeine totals, especially if you're sensitive to this stimulant.