Cyclic Mastalgia in Iranian Women: A Review

authors:

avatar Fatemeh Ghodsi 1 , avatar Forouzan Olfati ORCID 1 , * , avatar Nasim Bahrami 1 , avatar Maryam Farhad 2

Schools of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
Department of Surgery, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Journal of Inflammatory Diseases: Vol.24, issue 6; 566-581
article type: issue_documents_importer

how to cite: Ghodsi F, Olfati F, Bahrami N, Farhad M. Cyclic Mastalgia in Iranian Women: A Review. J Inflamm Dis. 2021;24(6):e156254. 

Abstract

Despite the high prevalence of cyclic mastalgia, there is much disagreement and uncertainties about its treatment methods. The present study aims to review studies conducted on cyclic mastalgia over the past two decades in Iran. In this regard, a search was conducted in Scopus, SID, PubMed, Google Scholar, ScienceDirect, and IranMedex databases on articles published in Persian and English from 1998 to 2018 using the following keywords: “Mastalgia”, “cyclic mastalgia”, “breast pain”, and “Mastodynia”. Initial search yielded 975 articles. Of these, 29 were selected for review based on inclusion criteria; 19 interventional and 10 non-interventional. Based on the results, most studies reported a mastalgia prevalence of about 30% in Iran. The most common age for cyclic mastalgia was 30 years. In most studies, a significant relationship between premenstrual syndrome and cyclic mastalgia was reported. The use of vitamins and herbal plants were the most common interventions for cyclic mastalgia, while counseling was the least common type. It seems that cyclic mastalgia affects the sleep quality and physical and sexual activities. Due to the high prevalence of cyclic mastalgia reported in various studies in Iran, and the lack a same treatment protocol, further study on cyclic mastalgia is recommended.

References

  • 1.

    Burkman RT. Berek & Novaks gynecology. JAMA. 2012; 308(5):516-7. [DOI:10.1001/jama.308.5.516].

  • 2.

    Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams ginecologa. New York: McGraw-Hill; 2017. [In Spanish] https://edimeinter.com/catalogo/ginecologia-y-obstetricia/williams-ginecologia-3a-edicion-2017/.

  • 3.

    Alvandipour M, Tayebi P, Alizadeh Navaie R, Khodabakhshi H. Comparison between effect of evening primrose oil and vitamin E in treatment of cyclic mastalgia. J Babol Univ Med Sci. 2011; 13(2):7-11. [In Persian] http://jbums.org/article-1-3734-en.html.

  • 4.

    Scurr J, Hedger W, Morris P, Brown N. The prevalence, severity, and impact of breast pain in the general population. Breast J. 2014; 20(5):508-13. [DOI:10.1111/tbj.12305] [PMID].

  • 5.

    Vaziri F, Samsami A, Rahimi Z, Rastgardoost N, Nick N. Prevalence, severity and factors related to mastalgia among women referring to health centers affiliate with Shiraz University of Medical Sciences. J Health Sci Surveill Syst. 2016; 4(2):64-9. https://jhsss.sums.ac.ir/article_42804.html.

  • 6.

    Olawaiye A, Withiam-Leitch M, Danakas G, Kahn K. Mastalgia: A review of management. J Reprod Med. 2005; 50(12):933-9. [PMID].

  • 7.

    Seraji A, Salehi A, Momeni H, Kerami A, Naeimi N. The effects of evening primrose and vitex agnus on pain scale of the women with cyclic mastalgia a clinical trial. Complement Med J. 2014; 3(4):639-53. [In Persian] http://cmja.arakmu.ac.ir/article-1-181en.html.

  • 8.

    Fakhravar S, Bahrami N, Olfati F. Effect of individual counseling on pain quality in the women with cyclic mastalgia: A clinical trial. J Inflamm Dis. 2018; 22(4):22-30. [In Persian][DOI:10.29252/qums.22.4.22].

  • 9.

    Hafiz SP, Barnes NL, Kirwan CC. Clinical management of idiopathic mastalgia: A systematic review. J Prim Health Care. 2018; 10(4):312-23. [DOI:10.1071/HC18026] [PMID].

  • 10.

    Sarayloo Kh, Najmabadi KM, Ghazanfarpour M. Effects of the evening primrose oil on women's mastalgia: A systematic review of randomized controlled trials. Malays J Nurs. 2017; 9(2):28-35. https://www.researchgate.net/publication/321168485.

  • 11.

    Gharaiy NR, Shahnazi M, Yavari Kia P, Javadzadeh Y. The effect of cinnamon on cyclical breast pain. Iran Red Crescent Med J. 2017; 19(6):e26442. https://www.sid.ir/en/journal/ViewPaper.aspx?id=560938.

  • 12.

    Delfan B, Zarei F, Iravani S, Ebrahimzadeh F, Adineh A, Sepahvand R, et al. Vitamin E and Omega-3, 6 and 9 combinations versus vitamin E in the treatment of mastodynia. Jundishapur J Nat Pharm Prod. 2015; 10(2):e18659. [DOI:10.17795/jjnpp-18659].

  • 13.

    Eren T, Aslan A, Ozemir IA, Baysal H, Sagiroglu J, Ekinci O, et al. Factors effecting mastalgia. Breast Care. 2016; 11(3):188-93.[DOI:10.1159/000444359] [PMID] [PMCID].

  • 14.

    Huseini HF, Kianbakht S, Mirshamsi MH, Babaei Zarch A. Effectiveness of topical Nigella sativa seed oil in the treatment of cyclic mastalgia: A randomized, triple-blind, active, and placebo-controlled clinical trial. Planta Med. 2016; 82(4):285-8. [DOI:10.1055/s-0035-1558208] [PMID].

  • 15.

    Jaafarnejad F, Hosseini F, Mazloom R, Hami M. Comparison of the effect of fish oil and vitamin E on the severity of cyclic mastalgia. Iran J Obstet Gynecol Infertil. 2013; 15(39):9-15. [In Persian] [DOI:10.22038/IJOGI.2013.541].

  • 16.

    Mirmolaei ST, Olfatbakhsh A, Fallahhosseini H, Kazemnejad E, Sotodeh A. The effect of vitagnus on cyclic breast pain in women of reproductive age. J Babol Univ Med Sci. 2016; 18(9):7-13.[DOI:10.22088/jbums.18.9.7].

  • 17.

    Mirmolaei ST, Olfatbakhsh A, Falah Huseini H, Kazemnezhad Leyli E, Sotoodeh Moridiani A. The effect of Nigella sativa syrup on the relief of cyclic mastalgia: A triple-blind randomized clinical trial. Hayat. 2017; 23(1):33-43. [In Persian] http://hayat. tums.ac.ir/article-1-1712-en.html.

  • 18.

    Shahverdi E. Flaxseed: A good idea for reduction of mastalgia (breast pain) and risk of breast cancer. Focus Med Sci J. 2017; 3(2):1-7. [DOI:10.21859/focsci-03021410].

  • 19.

    Olfati F, Parsay S, Kazemnejad S, Farhad M. Comparison of two-month and four-month effect of vitamin E on cyclic mastalgia. J Inflamm Dis. 2006; 10(2):60-4. [In Persian] http://journal.qums.ac.ir/article-1-154-en.html.

  • 20.

    Jafarnezhad F, Adib Moghaddam E, Emami SA, Saki A, Hami M, Mohammadzadeh Vatanchi A. Comparative effect of flaxseed and evening primrose oil with vitamin E on severity of cyclic mastalgia in women. Iran J Obstet Gynecol Infertil. 2016; 19(22):8-16. [In Persian] [DOI:10.22038/IJOGI.2016.7705].

  • 21.

    Vaziri F, Zamani Lari M, Samsami Dehaghani A, Salehi M, Sadeghpour H, Akbarzadeh M, et al. Comparing the effects of dietary flaxseed and Omega-3 fatty acids supplement on cyclical mastalgia in Iranian women: A randomized clinical trial. Int J Family Med. 2014; 2014:174532. [DOI:10.1155/2014/174532][PMID] [PMCID].

  • 22.

    Soltany S, hemmati Hr, Alavy Toussy J, Gholamaliyan E. Effect of vitamin B6 on mastalgia: A double blind clinical trial. Koomesh. 2016; 17(4):950-6. [In Persian] http://koomeshjournal.semums.ac.ir/article-1-3204-en.html.

  • 23.

    Kaviani A, Majidzadeh K, Vahdaninia MS. Mastalgia in females attending the Iranian center for breast cancer. Payesh. 2002; 1(1):25-32. [In Persian] http://payeshjournal.ir/article-1-887-en.html.

  • 24.

    Mirghafourvand M, Ahmadpour P, Rahi P, Salehiniya H. Relationship between depression and anxiety with the severity and length of cyclic mastalgia in women. Iran J Obstet Gynecol Infertil. 2016; 18(179):1-7. [In Persian] [DOI:10.22038/IJOGI.2016.6559].

  • 25.

    Shobeiri F, Oshvandi Kh, Nazari M. Cyclical mastalgia: Prevalence and associated determinants in Hamadan city, Iran. Asian Pac J Trop Biomed. 2016; 6(3):275-8. [DOI:10.1016/j.apjtb.2015.12.008].

  • 26.

    Sharami SH, Sobhani AR, Asgharnia M, Shabaani M. Prevalence of cyclic mastalgia and its relation with age, marriage and employment outside the house. J Guilan Univ Med Sci. 2000; 9 (33-34):111-6. [In Persian] http://journal.gums.ac.ir/article-1-2001-en.html.

  • 27.

    Ahmadinezhad M, Delfan B, Tarahi MJ, Pouria A, Hashemi SM, Taheri Tafti M, et al. Comparison of efficacy of local piroxicam and diclofenac in benign mastalgia. Iran J Surg. 2000; 15(3):32-7. [In Persian] http://www.ijs.ir/library/upload/article/ 4%20Piroxicam-Dr.Ahmadinejad.pdf.

  • 28.

    Yousefi Z, Farazmand T. The evaluation of the causes of 1000 referral patients to breast clinic of Ghaem hospital Mashhad University of Medical Sciences (2001-2003). Iran J Obstet Gynecol Infertil. 2005; 8(1):11-8. [In Persian] https://www.sid.ir/fa/journal/ViewPaper.aspx?ID=17692.

  • 29.

    Safarpour F, Agadjanzadeh M. Survey of factors associated with mastalgia. J Guilan Univ Med Sci. 2000; 9(35-36):68-72. [In Persian] http://journal.gums.ac.ir/article-1-2014-en.html.

  • 30.

    Sharifi F, Simbar M, Mojab F, Alavi Majd H. Comparison of the effects of Matricaria chamomila (chamomile) extract and mefenamic acid on the intensity of mastalgia associated with premenstrual syndrome. Womens Health Bull. 2014; 1(2):1-5. https://womenshealthbulletin.sums.ac.ir/article_45178.html.

  • 31.

    Olfati F, Kazemi Jaliseh H, Farhad M. Survey the relationship between BMI and cyclic mastalgia. J Guilan Univ Med Sci. 2009; 17(68):50-6. [In Persian] http://journal.gums.ac.ir/article-1-280-en.html.

  • 32.

    Zarei F, Pishdad P, Hatami M, Zeinali-Rafsanjani B. Can breast ultrasound reduce patients level of anxiety and pain? Ultrasound. 2017; 25(2):92-7. [DOI:10.1177/1742271X17690021][PMID] [PMCID].

  • 33.

    Mohammed AA. Evaluation of mastalgia in patients presented to the breast clinic in Duhok city, Iraq: Cross sectional study. Ann Med Surg. 2020; 52:31-5. [DOI:10.1016/j.amsu.2020.02.012].

  • 34.

    Sheidaei S, Irani M, Ghazanfarpour M. The effect of herbal medicines and supplements on mastalgia: A systematic review and meta-analysis of clinical trials in Iran. Iran J Obstet Gynecol Infertil. 2019; 22(3):87-98. [In Persian] [DOI:10.22038/IJOGI.2019.13397].

  • 35.

    Irani M, Sheidaei S, Ghazanfarpour M, Nosrati SF. Comparative evaluation of evening primrose oil and vitamin E on the severity of cyclic Mastalgia: A systematic review and metaanalysis. Iran J Obstet Gynecol Infertil. 2020; 23(3):91-8. [In Persian] http://ijogi.mums.ac.ir/article_16011.html.

  • 36.

    Sekhavat L, Zare Tarzejani T, Kholasezadeh P. The effect of vitex agnus-castus on mastalgia in women. Iran South Med J. 2009; 11(2):147-52. [In Persian] http://ismj.bpums.ac.ir/article-1-151-en.html.

  • 37.

    Kaviani A, Mehrdad N, Najafi M, Hashemi ES, Yunesian M, Ebrahimi M, et al. Comparison of naproxen with placebo for the management of noncyclical breast pain: A randomized, double-blind, controlled trial. World J Surg. 2008; 32(11):2464-2470. [DOI:10.1007/s00268-008-9731-5] [PMID].

  • 38.

    Jaafarnejad F, Hosseini SF, Mazlom SR, Hami M. Comparison of the effect of fish oil and vitamin E on duration of cyclic mastalgia. Evid Based Care J. 2013; 3(1):69-76. [In Persian][DOI:10.22038/EBCJ.2013.696].

  • 39.

    Naghizadeh S, Mohebi P, Hadizadeh P. Mammography and ultrasound in women with breast pain of Tabriz hospital. Iran J Breast Dis. 2012; 5(1):54-64. [In Persian] http://ijbd.ir/article-1-213-fa.html.

  • 40.

    alJbeery AS, alShaifani AA, alMutlaq SM, Salati SA. Mastalgia- A study from the Middle East. Online J Health Allied Sci. 2017; 16(4):14. https://www.researchgate.net/publication/323113833.

  • 41.

    Carmichael AR, Bashayan O, Nightingale P. Objective analyses of mastalgia in breast clinics: Is breast pain questionaire a useful tool in a busy breast clinic? Breast. 2006; 15(4):498-502. [DOI:10.1016/j.breast.2005.10.009] [PMID].

  • 42.

    Kanat BH, Atmaca M, Girgin M, Ilhan YS, Bozda A, zkan Z, et al. Effects of mastalgia in young women on quality of life, depression, and anxiety levels. Indian J Surg. 2016; 78(2):96-9.[DOI:10.1007/s12262-015-1325-5] [PMID] [PMCID].

  • 43.

    Ader DN, Browne MW. Prevalence and impact of cyclic mastalgia in a United States clinic-based sample. Am J Obstet Gynecol. 1997; 177(1):126-32. [DOI:10.1016/S0002-9378(97)70450-2].

  • 44.

    Ylmaz EM, elik S, Arslan H, Deer D. Relation between mastalgia and anxiety in a region with high frequency of posttraumatic stress disorder. J Breast Health. 2015; 11(2):72-5.[DOI:10.5152/tjbh.2015.2363] [PMID] [PMCID].

  • 45.

    Kataria K, Dhar A, Srivastava A, Kumar S, Goyal A. A systematic review of current understanding and management of mastalgia. Indian J Surg. 2014; 76(3):217-22. [DOI:10.1007/s12262-013-0813-8] [PMID] [PMCID].

  • 46.

    Parsay S, Olfati F, Nahidi Sh. Therapeutic effects of vitamin E on cyclic mastalgia. Breast J. 2009; 15(5):510-4. [DOI:10.1111/j.1524-4741.2009.00768.x] [PMID].

  • 47.

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

  • 48.

    Carmichael AR. Can vitex agnus castus be used for the treatment of mastalgia? What is the current evidence? Evid Based Complement Alternat Med. 2008; 5(3):247-50. [DOI:10.1093/ecam/nem074] [PMID] [PMCID].

  • 49.

    Stonemetz D. A review of the clinical efficacy of evening primrose. Holist Nurs Pract. 2008; 22(3):171-4. [DOI:10.1097/01.HNP.0000318026.45527.07] [PMID].

  • 50.

    Bayles B, Usatine R. Evening primrose oil. Am Fam Physician. 2009; 80(12):1405-8. [PMID].

  • 51.

    Qureshi S, Sultan N. Topical nonsteroidal anti inflammatory drugs versus oil of evening primrose in the treatment of mastalgia. Surgeon. 2005; 3(1):7-10. [DOI:10.1016/S1479-666X(05)80003-4].

  • 52.

    Blommers J, de Lange-de Klerk ESM, Kuik DJ, Bezemer PD, Meijer S. Evening primrose oil and fish oil for severe chronic mastalgia: A randomized, double-blind, controlled trial. Am J Obstet Gynecol. 2002; 187(5):1389-94. [DOI:10.1067/mob.2002.127377a] [PMID].

  • 53.

    Saghafi N, Rhkhshandeh H, Pourmoghadam N, Pourali L, Ghazanfarpour M, Behrooznia A, et al. Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: A double-blind randomised controlled trial. J Obstet Gynaecol. 2018; 38(1):81-4. [DOI:10.1080/01443615.2017.1322045] [PMID].

  • 54.

    Bennett BB, editor. Breast disease for clinicians [M. Zakeri Hamidi, Kh. Hatamipour, Persian trans]. Tehran: Jame-e-Negar; 2010. http://opac.nlai.ir/opac-prod/bibliographic/2006876.

  • 55.

    Ozenli Y, Ozturk AB, Ozturk SB, Seydaoglu G. The effects of psycho-education on the health-related quality of life on mastalgia patients. Appl Res Qual Life. 2014; 9(4):1097-105.[DOI:10.1007/s11482-013-9290-2]##.