Condition
Breast Pain
Do any supplements help breast pain? For cyclic breast pain (mastalgia), the soreness that builds before a period, the best evidence is for chasteberry (Vitex agnus-castus). A review that pooled 6 placebo-controlled trials with 718 women found a moderate drop in pain. Vitamin E has limited evidence of a smaller benefit. Evening primrose oil, the most popular choice, did no better than placebo in a review of 13 trials. Breast pain on its own is rarely a sign of cancer, but see a doctor about a new lump, nipple discharge, skin changes or pain in one spot that doesn't go away. If you are pregnant or breastfeeding, ask a clinician before taking any of these.
Sources: PMID 31464546; PMID 34200727; PMID 31126540; PMID 15008609
- Supplements studied
- 5
- Graded outcomes
- 0
- Trials
- 5
- People studied
- 1,610
What the evidence says
- Chasteberry (Vitex agnus-castus) has the most support, and the evidence is moderate. A 2020 review found 25 studies; the 6 placebo-controlled trials it pooled, with 718 women, showed a moderate drop in breast pain. Typical doses were 20 to 40 mg a day for 3 months, but the review rated the risk of bias in most trials as unclear.
- In one trial of 159 women in Iran, both a chasteberry tablet and 25 g a day of flaxseed powder lowered breast pain more than placebo after 1 and 2 months. That is a single short trial, so the evidence for flaxseed is limited.
- Vitamin E has limited evidence. A 2019 review of 11 trials found it eased pain severity and shortened pain compared with placebo, but the trials differed a lot. One trial of 150 women found a benefit over placebo after 2 and 4 months, while a US trial of 85 women (41 finished) found no clear difference from placebo.
- Evening primrose oil is the best known option, but a 2021 review of 13 trials with 1,752 women found it relieved pain no better than placebo. It also caused no more side effects than placebo.
- Vitamin B6 (40 mg a day) and vitamin E (200 IU a day) eased pain by a similar amount in a trial of 80 women. There was no placebo group, so it can't show whether either works better than doing nothing.
- A Mayo Clinic review notes that when pain is a woman's only breast symptom, the risk of cancer is extremely low, and that most women do well with reassurance and non-drug measures after a check-up.
Safety and when to see a clinician
- See a doctor promptly for a new lump, nipple discharge, skin dimpling or redness, or pain that stays in one spot, and for any breast pain after menopause. A check-up comes first; supplements come after.
- High-dose vitamin E can raise the risk of bleeding, especially with blood thinners such as warfarin or aspirin. In a review of 9 long-term trials, vitamin E raised the risk of bleeding strokes by 22%. Ask your doctor or pharmacist before taking it with these medicines.
- Chasteberry's side effects in studies were mild and went away: nausea, headache, stomach upset, acne and rash. It should be avoided during pregnancy and breastfeeding, and it may interfere with medicines that act on dopamine.
- If you are pregnant, breastfeeding or under 18, ask a clinician before taking any supplement for breast pain.
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Breast Tenderness | Improves (the measure goes down) | 1 study | 80 people | |||
Studies that measured breast tenderness | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Breast Tenderness | Improves (the measure goes down) | 1 study | 150 people | |||
Studies that measured breast tenderness | ||||||
Yarrow
- Nipple Cracks: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Nipple Cracks | Improves (the measure goes up) | 1 study | 150 people | |||
Studies that measured nipple cracks | ||||||
Evening Primrose Oil
- Breast Tenderness
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Breast Tenderness No effect | NoneNo effect | 1 study | 1,752 people | |||
Studies that measured breast tenderness | ||||||
Chaste tree
- Breast Tenderness: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Breast Tenderness | Improves (the measure goes down) | 1 study | 159 people | |||
Studies that measured breast tenderness | ||||||
The Breast Pain (Mastalgia) Support protocol
2 primary supplements · 6 supporting supplements
- Evening Primrose Oil1,000–3,000 mg daily
- Vitamin E400–800 IU daily
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Studies cited
12 studies from PubMed
- Vitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis.
- Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trial.
- Effect of vitamin E on severity and duration of cyclic mastalgia: A systematic review and meta-analysis.
- Therapeutic effects of vitamin E on cyclic mastalgia.
- Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study.
- A Systematic Review and Meta-Analysis of the Efficacy of Evening Primrose Oil for Mastalgia Treatment.
- Clinical effectiveness of vitamin E and vitamin B6 for improving pain severity in cyclic mastalgia.
- Evaluation and management of breast pain.
- Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials.
- Vitamin E (α-Tocopherol): Emerging Clinical Role and Adverse Risks of Supplementation in Adults.
- Vitex agnus castus: a systematic review of adverse events.
- Comparing the Effects of Yarrow, Honey, and Breast Milk for Healing Nipple Fissure.