When initial non-pharmacological management fails to achieve the expected reduction in cyclic breast pain, tenderness, and swelling, a structured pharmacological next step becomes the appropriate course. This protocol addresses that specific clinical threshold.
Reassurance, education and counseling; guidance on a properly fitted supportive bra; dietary changes including a fat-restricted diet and restriction of methylxanthines (caffeine) and nicotine — did not achieve the expected improvement or reduction in cyclic breast pain, tenderness, and swelling.
Owing to its rich content of omega-6 essential fatty acid, GLA, evening primrose oil has been an important treatment for FBD.
Early studies on EPO found a good response rate in patients with mastalgia and nodularity and went on to recommend it as the first line therapy.
Flaxseed oil, a source of alpha-linolenic acid, has also been shown to reduce breast pain in randomized placebo-controlled trials.
Though not many studies have been carried out to establish its efficacy, some authorities have recommended it as the first-line therapy.
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