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Cyclical breast pain, also called mastalgia, is such a common premenstrual symptom that many women and quite a few doctors - consider it to be a "normal" part of life. Surveys have shown that at least 60% of women under 55 experience some degree of discomfort in their breasts each month, vyhile 15% to 25% experience pain that is severe enough to be "life-altering," because it interferes with regular activities.

There are many theories regarding the cause, but the best evidence points to a heightened sensitivity of breast tissue to the reproductive hormones prolactin and/or estrogen. Environmental estrogens, synthetic compounds found in plastics, pesticides and cosmetics, may also playa role in that they mimic some of the effects of estrogen in the body.

Prolactin, a protein primarily secreted by the pituitary gland, is sometimes called the "parenting hormone," because it stimulates the breast tissue to increase milk production. While this effect is essential during breast-feeding, prolactin levels that are increased at inappropriate times can cause pain and swelling, not to mention infertility, mood swings and irritability. Since emotional and physical stress may increase prolactin production, that might explain why relaxation therapies, stress reduction and aerobic exercise can help relieve cyclical breast pain. Prolactin secretion may also be increased by estrogensthose produced by the reproductive glands as well as the synthetic ones that come from our environment.

The good news is that the herb chas!eberry is very effective at lowering prolactin levels. Studies show that regular use of the herb can be quite helpful for alleviating cyclical breast pain along with related symptoms of premenstrual syndrome (PMS). I've had good results with an extract standardized to contain 0.5% agnusides in a dose of 450 mg per. day. Side effects a_e uncommon, and it is safe to use for extended periods of time.

Any strategies that lower the overall amount of estrogens in the bloodstream are also potentially beneficial. Diets low in saturated fat may improve cyclical breast pain, presumably because of their possible estrogen-lowering effect. Studies show that nutritional supplements containing EPA and DHA from fish oil, along with GLA from evening primrose or borage oil, may also be quite helpful. A typical dose is 1 to 3 gm per day of combined EPA and DHA, and 250 to 600 mg of GLA.

Flax contains a group of health-promoting compounds called lignans that could lessen the stimulatory effects of estrogen on breast and other tissues. Preliminary studies suggest that taking 1 to 3 capsules per day of a highly concentrated form of flax (sold under the brand name Brevail) may work just as well as eating several tablespoons of ground seeds daily.

You should eat at least one serving per day of cruciferous vegetables, such as broccoli and brussels sprouts. Vegetables from this family contain glucosinolates, chemicals that help thf.' liver detoxify estrogens so that they are less likely to overstimulate breast tissue. One of those chemicals, diindolylmethane (DIM), is available in supplement form called BioResponse-DIM. A preliminary study found that women with cyclical mastalgia who took two BioResponse-DiM capsules for three months experienced a significant reduction in the duration and severity of pain.