Cyclical Mastalgia
Supplements studied for cyclical mastalgia.
Overview
Evening Primrose Oil is the most-studied supplement here (13 studies, WA 44), but better trials found no clear breast pain reduction versus placebo; some smaller studies suggested possible benefit at 1–4 g daily. One small trial reported more pain relief when combined with vitamin E.
Fish Oil (WA 32; very low effect size, low evidence, medium trust; one study) did not outperform placebo at 3 g daily for six months. Overall evidence is limited and inconsistent for cyclical mastalgia. See the heatmap and evidence reviews below for full ratings.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Evening Primrose Oil | ★★★★★ | Very Low / None |
| Fish Oil | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
2 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Evening Primrose OilView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Most research shows that taking evening primrose oil by mouth does not clearly reduce breast pain in people with mastalgia.
- While some smaller or lower-quality studies suggested taking 1 to 4 grams daily for a few months may help, better studies found no difference compared with placebo.
- One review of trials also found no clear pain improvement with evening primrose oil.
- One small study found that taking evening primrose oil with vitamin E for 6 months reduced breast pain more than placebo, and doing both together worked better than either alone.
- It is unclear how much this pain relief helps in everyday life.
Browse 13 studies·1 meta-analysis
RCTEffectiveness of Evening Primrose and Vitamin E for Cyclical Mastalgia: A Prospective Study2024n=126
A 6-month study including 126 women with premenstrual breast pain given evening primrose oil (1000 mg twice daily), vitamin E (400 mg once daily) or their combination found that the combination group experienced the greatest reduction in breast pain severity compared to placebo. [10707]
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 1000 mg 2×/day
- Population
- Women
- Participants
- 126
- Ages
- 18+
MetaA Systematic Review and Meta-Analysis of the Efficacy of Evening Primrose Oil for Mastalgia Treatment2021n=1,752
A meta-analysis of 13 studies including 1752 participants with mastalgia found that evening primrose oil (1-4 g/day for 3-12 months) was similarly effective to topical NSAIDS, danazol, vitamin E and placebo. Evening primrose oil did not increase the likelihood of adverse events including nausea, headache, weight gain and altered taste. [10708]
- Effect
- No Benefit
- Duration
- 3–12 months
- Dose
- 4 g/day
- Population
- Women
- Participants
- 1,752
ObservationalClinical Factors Affecting the Therapeutic Efficacy of Evening Primrose Oil on Mastalgia2020n=581
In 1,015 mastalgia patients, evening primrose oil 2,600 mg/day relieved pain more than paracetamol 1,000 mg/day; hormone replacement therapy, levonorgestrel IUD use, and iron deficiency affected EPO responsiveness.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 2600 mg/day
- Population
- Women with mastalgia
- Participants
- 581
- Avg age
- ~42
RCTCompare the effect of flaxseed, evening primrose oil and Vitamin E on duration of periodic breast pain2017n=90
In 90 women with cyclical breast pain over two menstrual cycles, daily flaxseed powder, evening primrose oil 2,000 mg, or vitamin E 400 IU all reduced pain duration compared with baseline, with group differences assessed at cycle end.
- Effect
- No Benefit
- Duration
- 2 menstrual cycles
- Dose
- 400 IU/day
- Population
- Women
- Participants
- 90
- Ages
- 18–45
The comparison of evening primrose oil, fructus agni casti and reassurance in the treatment of mastalgia2016
A comparative clinical study evaluated evening primrose oil, fructus agni casti, and reassurance alone for mastalgia treatment, comparing symptomatic relief across the three management approaches.
RCTMastalgia cured! Randomized trial comparing centchroman to evening primrose oil2012
A randomized trial compared centchroman with evening primrose oil for mastalgia treatment, assessing relative efficacy of the two agents for cyclical breast pain relief.
RCTVitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study2010n=85
In 85 women with cyclical mastalgia over 6 months, intent-to-treat analysis showed EPO 3,000 mg/day, vitamin E 1,200 IU/day, or combined therapy improved worst-pain scores versus baseline, but group comparisons with placebo were nonsignificant.
- Effect
- No Benefit
- Duration
- 6 months
- Dose
- 200 IU/day
- Population
- Women
- Participants
- 85
DANAZOL VERSUS OIL OF EVENING PRIMROSE IN THE TREATMENT OF MASTALGIA2007
A comparative study assessed danazol versus evening primrose oil for mastalgia, evaluating relative effectiveness of the two treatments for cyclical breast pain.
RCTA randomized multicenter study of gamolenic acid (Efamast) with and without antioxidant vitamins and minerals in the management of mastalgia2005n=555
In 555 women with moderate-to-severe mastalgia over 4 blinded cycles, gamolenic acid (Efamast) with or without antioxidants did not reduce breast pain more than placebo fatty acids (40% response in placebo groups).
- Effect
- No Benefit
- Population
- Women
- Participants
- 555
RCTEvening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial2002n=20
In 120 women with severe chronic mastalgia over 6 months, evening primrose oil and fish oil each reduced painful days by ~12–16% with no significant benefit over respective control oils (P=0.73 and P=0.28).
- Effect
- No Benefit
- Duration
- 6 months
- Population
- Women
- Participants
- 20
ObservationalManagement of cyclical mastalgia in oriental women: pioneer experience of using gamolenic acid (Efamast) in Asia1999n=66
In 66 Asian women with cyclical mastalgia, gamolenic acid (Efamast) from evening primrose oil yielded a 97% useful response at 6 months with minor side effects in 12%, supporting first-line use in this population.
- Population
- Women
- Participants
- 66
ObservationalMastalgia: a 3 year Australian study1994n=170
In 170 Australian mastalgia clinic patients over 3 years (mean age 42), evening primrose oil produced only 26% response versus 18% for vitamin B6, while low-dose danazol achieved 67% complete response.
- Effect
- No Benefit
- Duration
- 3 years
- Population
- Women
- Participants
- 170
- Avg age
- ~42
Premenstrual syndrome and premenstrual breast pain (cyclical mastalgia): disorders of essential fatty acid (EFA) metabolism1989
A study proposed that premenstrual syndrome and cyclical mastalgia may reflect disorders of essential fatty acid metabolism, examining biochemical links between EFA abnormalities and these conditions.
Fish OilView supplement →
Do not purchase·★★★★★
How we scored this▸
- Taking fish oil by mouth does not seem to help with long-lasting or severe breast pain.
- Taking 3 grams of fish oil daily for 6 months did not work better than a placebo.
Browse 1 study
RCTEvening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial2002n=20
A 6-mth study of 120 premenopausal women with severe chronic mastalgia (>=7 mean with at least 5 days with pain per menstrual cycle) found that neither evening primrose oil or fish oil were more effective than placebo (corn oil or corn oil with wheat germ oil) for reducing days with pain. [10623]
- Effect
- No Benefit
- Duration
- 6 months
- Population
- Women
- Participants
- 20
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Evening Primrose Oil | ★★★★★44% | 13 | 1 | 93% |
| Fish Oil | ★★★★★32% | 1 | 0 | 7% |