From the Guidelines
Evening primrose oil is not recommended for the treatment of mastalgia (breast pain). Despite its historical use as a natural remedy for breast pain, current evidence does not support its effectiveness. If you're experiencing mastalgia, better first-line options include:
- Wearing a well-fitted supportive bra
- Taking over-the-counter pain relievers like ibuprofen (200-400mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours)
- Applying warm compresses to the affected area For cyclical breast pain related to menstruation, hormonal treatments like oral contraceptives may be beneficial. Evening primrose oil contains gamma-linolenic acid, which was theorized to help balance fatty acids and reduce inflammation, but multiple clinical trials have failed to demonstrate significant benefits compared to placebo 1. If breast pain is severe or persistent, it's essential to consult a healthcare provider to rule out other causes and discuss prescription medication options if necessary.
From the Research
Oil of Evening Primrose for Mastalgia
- The effectiveness of evening primrose oil (EPO) for mastalgia treatment has been studied in several trials 2, 3, 4.
- A systematic review of current understanding and management of mastalgia found that gamma-linolenic acid or evening primrose oil, though commonly prescribed, is not effective 2.
- A systematic review and meta-analysis of the efficacy of evening primrose oil for mastalgia treatment found that EPO has no difference in reducing breast pain compared to topical NSAIDs, danazol, or vitamin E 3.
- The study also found that EPO does not increase adverse events compared to a placebo or other treatments, and is a safe medication with similar efficacy for pain control in women with mastalgia compared to a placebo, topical NSAIDs, danazol, or vitamin E 3.
- A meta-analysis of randomised trials on mastalgia found that EPO did not offer any advantage over placebo in pain relief 4.
- Another study found that reassurance, breast support, and lifestyle changes are the first line treatment for mastalgia, and that topical and oral NSAIDs, evening primrose oil, and vitamin E were frequently used as additional treatments to non-pharmacological methods 5.
Comparison with Other Treatments
- A study compared the effect of chamomile extract with placebo on pain control of cyclic mastalgia, and found that chamomile was a well-tolerated, secure, and effective drug for treating women with mild to moderate mastalgia 6.
- The study suggested that chamomile could be a safe alternative treatment for mastalgia, and that further research could compare the effect of chamomile extract with standard treatments such as danazol, bromocriptine, and tamoxifen 6.
- A meta-analysis found that tamoxifen achieved a relative risk of pain relief of 1.92, and was associated with the least side effects, making it a potential first-line treatment for mastalgia 4.