Mastalgia, cyclical

New vancomycin-type glycopeptide antibiotics are in clinical trials to combat methicillin-resistant bacteria (2612, 2613) such as the deadly Staphylococcus aureus (2614). For the first time, extracts of marine algae indigenous to Japan have shown activity against methicillin-resistant Staphylococcus aureus bacteria (2615, 2661). The therapeutic use of iodine has been rejuvenated (2616). For example, in the treatment of cyclic mastalgia (2617). 

Kessler JH (2004) The Effect of Supraphysiologic Levels of Iodine on Patients with Cyclic Mastalgia. Breast J 10 328... 

The first ER modulators studied clinically were clomiphene (4) and tamoxifen (5), which exemplify the triphenylethylene (TPE) structural class. TPEs were originally investigated as contraceptives, but molecules such as tamoxifen (5) and toremifene (6) were found to display strong antagonism of estrogen in mammary tissue, leading to their development for the treatment of breast cancer. A more recent member of this structural class, afimoxifene (7) is currently under development as a transdermal gel formulation for the treatment of cyclical mastalgia.1 13... 

Cyclical breast pain or mastalgia, when severe, may respond to continuous use of gamolenic acid (Efamast) (orally) it is an essential unsaturated fatty acid for cell membranes (patients have low concentrations) it may act by reducing cellular uptake of prolaction and ovarian hormones. Danazol and bromocriptine also help. 

Use of more than 4 g OEP daily (300-600 mg y-linolenic acid) is not recommended (6). However, adult doses of 3-8 g/day have been used for various conditions (2). For a OEP product with a standardized y-linolenic acid content of 8%, the following dosages are recommended for the following conditions (7) atopic eczema, 4 to 8 g daily for adults, 2 to 4 g daily for children cyclical and noncyclical mastalgia, 3 to 4 g daily PMS, 3 g daily. 

Ader DN, South-Paul J, Adera R, Deuster PA. Cyclic mastalgia Prevalence and associated health and behavioral factors. J Psychosom Obstet Gynecol 2001 22 71-76. 

Clinical trials of standardized extracts of the berries (double-blind, placebo-controlled) have shown significant benefits in the treatment of women with latent hyperprolactinemia, abnormal menstrual cycles, and corpus luteum insufficiency, cyclical mastalgia, premenstrual syndrome, and premenstrual tension syndrome (mckenna). 

Two products have been licensed as pharmaceuticals Efamast for relief of cyclical mastalgia and Epogam for treatment of atopic eczema. There is also a range of pre-term and full-term infant formulations on the market (particularly in Europe) containing GLA from various sources at levels up to 0.9% (w/w of formula). 

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