It is believed that breast pain is caused by abnormal sensitivity of breast tissue to normal levels of the hormones prolactin and oestrogen. There is increasing evidence that this abnormality is related to low levels of essential fatty acids, high levels of saturated fatty acids, and a defect in lipid metabolism.
Breast pain appears to be common in countries where people eat a lot of saturated fat, and it has been shown that breast symptoms improve if the amount of saturated fat is reduced.
Women with breast pain may have lower than normal levels of GLA and its metabolites, and higher than normal levels of saturated fatty acids. This pattern is likely to sensitize tissues to oestrogen, since oestrogen receptors have a greater affinity for the hormone if they are in a membrane environment which is rich in saturated fats and low in polyunsaturated essential fatty acids, such as GLA and its metabolites.
The changes in fatty acid composition could explain why the breast appears to be unduly sensitive to normal amounts of oestrogen.
There is an interesting relationship between heart disease in men and mastalgia and PMS in women. In societies where there is a high rate of death from heart disease among young
And middle-aged men, there is a correspondingly high rate of breast disease and PMS in young and middle-aged women, ST wherever saturated fat intake is high relative to the intake of essential fatty acids, breast and menstrual cycle disorders become common.
If a high intake of saturated fat is associated with benign breast disease and other disorders, then increasing the intake of polyunsaturated fatty acids may reverse or prevent the development of mastalgia and PMS.
Women with breast disease tend to have high rates or sebum production, which is a marker of EFA deficiency. Also, PGE1 inhibits some of the peripheral actions of prolactin, a hormone which has been implicated in both breast and menstrual cycle problems.
A shortage of essential fatty acids in the diet leads to excessive amounts of fibrous tissue. Cysts, which are another common symptom of mastalgia, may form because for some reason the body is making too much of the hormone prolactin, and is also short of prostaglandin EX.
The idea behind giving evening primrose oil as a treatment for breast pain is that PGE1 can dampen down the effects of prolactin, may help the development of cysts, and can help remove lumpiness in the breasts.

*9/60/5*
WOMEN’S HEALTH

Breast pain is very common in women, and the most common problem for which women seek help, with something like 500,000-800,000 GP consultations each year. Indeed, it has been estimated that 40% of all women suffer from breast pain to some degree.
Breast pain can be associated with the menstrual cycle. It can occur as part of the premenstrual syndrome, in some cases lasting as long as two weeks in every four. Or it can have nothing to do with a woman’s menstrual cycle. In such cases the woman can have the pain continuously, feeling irritable and depressed as a result.
Typically, the breasts feel heavy and tender, with a lumpy, granular sort of texture.
In severe cases – about 15% of the total – breast pain can seriously affect a woman’s lifestyle. Women with breast pain hate to have their breasts touched. Breast pain can interfere with her work, prevent her from hugging her children or be hugged, and it can intrude on her sex life as she shies away from fondling.
Women with breast pain can suffer psychologically because of this. Here are some of the things women suffering from breast pain said: ‘You can’t bear anyone touching your clothes or anything’; T can’t sleep, I have to lie on my stomach’; ‘they hurt when I get up in the morning’; ‘it destroys your life’; ‘it affects your sex life – as soon as you see the hands coming for you, you back off!’; ‘even when you’re out shopping, you’re worried someone will bump into you’; ‘when I’m driving I wont wear seat belts’; ‘I hate keep saying to him “I’ve got it again”
Historically, women with breast pain were not taken seriously by doctors, but mow a more sensitive attitude is gaining ground. Breast pain is now treated as a medical condition, and no longer dismissed as a neurosis.
Many women who suffer from breast pain usually go to see their doctor because they fear breast cancer – although pain is rarely the presenting symptom of operable breast cancer In order to exclude cancer, such patients can be sent for further investigations, such as a clinical examination, fine needle cytology, or a mammogram-
However being reassured that they do not have cancer will not make the pain go away. Yet, until very recently, doctors’ have only had hormone-related drugs – with many side effects – to treat breast pain. Now, however, evening primrose oil is an effective alternative with none of the side effects.

*8/60/5*
WOMEN’S HEALTH

Case 1. A 26-year-old domestic manager, who gave a clear history of PMS from ten to 14 days before each period. This had gone on for the last six years. The main symptoms were severe breast discomfort, irritability, tearfulness, and poor coordination and concentration. Various hormone treatments had been tried without success. B6, 75mg twice daily, had shown good results at first. The woman improved when she took Efamol, three capsules twice a day, plus six tablets of Efavite a day.

Case 2. A 40-year-old school helper. She had attended the PMS clinic for four years. She gave a history of irritability, anxiety depression, poor co-ordination, loss of libido, and moderate fluid retention for two weeks before each period. She had tried a hormone treatment and an anti-depressant, both without success. But when she took Efamol, two capsules twice a day, plus one Efavite a day, plus l00 mg of B6 a day, her symptoms disappeared.

Case 3. A 34-year-old school secretary. She had suffered from PMS since coming off the pill five years previously, and it had worsened after she had been sterilized three years later. She complained of severe breast pain, swelling of the stomach and face, irritability and depression. This happened for the last 14 days of a regular 28 to 29 day cycle. Tranquillizers, diuretics, and B6 had not helped. She was put on Efamol; four capsules a day, plus B6, 80mg a day. This improved her mood, the swelling and breast discomfort.

Case 4. A 34-year-old housewife. She had suffered from PMS since the birth of her first child eight years ago. The symptoms were lethargy and mood swings, irritability and depression, general bloating, very painful breasts and loss of co-ordination for 14 days before her period. Various drugs had not worked. Efamol, four capsules a day, plus Efavite, four tablets a day, have given her complete relief of her symptoms.

*7/60/5*
WOMEN’S HEALTH

Doctors who run PMS clinics do not use the same doses of evening primrose oil. The best dose for the individual woman may have to be found by simple trial and error to see what works.
The lowest dose is used by Drs Nazzaro and Lombard in the USA. When patients have shown side effects of lethargy, or headaches, they have lowered the dose of evening primrose oil. These doctors also found that evening primrose oil occasionally had the side-effects of making the menstrual cycle longer, from 28 days to 31 or 32 days or even longer. It could also make people forgetful, with a feeling of being ‘out of it’.
Drs Nazzaro and Lombard were getting an overall 70% success rate on doses as low as one or two capsules of 500mg evening primrose oil a day.
The Women’s Nutritional Advisory Service in Hove, Sussex, reached their results of 83% improved on evening primrose oil when women were taking eight capsules a day.
The St Thomas’s study used three 500mg capsules twice a day only in bad cases. The usual dose was two capsules twice a day, after food. In the St Thomas’s study, three patients complained of minor skin blemishes during treatment, and three had passing phases of excessive mood quietening.
Efamol PMP, especially designed for PMS sufferers, suggests a dose of two capsules of evening primrose oil 500mg twice a day, together with one tablet of Efavite twice a day (containing the vitamin and mineral co-factors). This should be taken for ten days leading up to the period.

*6/60/5*
WOMEN’S HEALTH

The results of trials have been good, with upwards of 60% of women with PMS (premenstrual syndrome) improving on evening primrose oil.
The most recent scientific trial (1985-1987) on evening primrose oil and PMS was at the Royal Free Hospital and St Thomas’s Hospital in London. There has also been a recent study on PMS at the Universities of Helsinki and Oulu in Finland.
The Royal Free and St Thomas’s trial involved 60 women with PMS in a double-blind, placebo-controlled trial, which assessed the effects of evening primrose oil compared with a placebo on the six common symptoms of PMS – depression, irritability, breast pain, clumsiness, bloating, and headache.
The results showed that all the six symptoms improved considerably. Overall, 60% improved on evening primrose oil (Efamol), compared with only 30% who took the placebo.
The Royal Free trial did not include any vitamins, minerals, dietary or lifestyle recommendations. The response rate is likely to increase if these are included.
In Sweden, evening primrose oil has had very good results on a wide range of PMS symptoms.
During 1981, a study was done at one of the major PMS clinics in the UK, at St Thomas’s Hospital in London.  In this study, 65 women with bad PMS were treated with evening primrose oil (Efamol). All of them had tried one or more other standard treatment, and all of them had failed.
The results were good, with 61% of the women experiencing complete relief of their symptoms, and 23% partial relief. The other 15% said there had been no change as a result of taking evening primrose oil.
One particular symptom – breast discomfort – was helped considerably, with 72% saying this had improved. Other common symptoms that showed improvement after taking evening primrose oil were mood swings, anxiety, irritability, headaches, and fluid retention.
In the Finnish study it was found that Efamol particularly helped in relieving depression in the pre-menstrual syndrome.
Dr Michael Brush, the biochemist who did the St Thomas’s study, liked the idea of using a natural product with a nutritional approach as many of the drugs for PMS can have undesirable side effects.
In almost all cases, the starting dose was two capsules twice a day after food. Although a few patients were given treatment all through their menstrual cycle, most of them started treatment three days before the symptoms were expected to arrive and carried on until the start of their period. In a few very severe cases, the dose was increased to three capsules twice a day. Some of the patients were given Vitamin B6 (pyridoxine) at the same time.

*5/60/5*
WOMEN’S HEALTH