Evening primrose oil for breast pain

During your attendance at the Cambridge Breast Unit, you will have had a full assessment of your breast pain symptom. This will have consisted of a clinical examination, along with a mammogram if you are over 40. There is no other radiological test that is helpful in assessing breast pain if no other symptoms are present. Following this assessment, you can be reassured there is no underlying breast problem causing your pain.

Breast pain not linked to periods (non-cyclical pain)

It is often unclear what causes non-cyclical breast pain:

• it may be continuous or intermittent (come and go)
• it may be a sharp stabbing pain, burning or prickling
• it can affect one or both breasts
• it can affect women both before and after the menopause.

Non-cyclical pain will often resolve itself over time.

Breast pain linked to periods (cyclical pain)

Linked to the menstrual cycle and changing hormone levels, many women will experience pain in their breasts in the week prior to their period.

Usually affecting both breasts, although it can affect only one, the pain may be burning, prickling or stabbing with sensations of fullness or heaviness.

Cyclical breast pain will often resolve once the period starts.

Evening primrose oil and gamolenic acid

Evening primrose oil contains gamma-limolenic acid (GLA).

GLA is a fatty acid involved in regulating tissue response to normal hormone levels.

While the evidence for its benefits are limited, some people find a benefit from taking evening primrose oil.

Evening primrose oil can be purchased from pharmacies, health food shops and some supermarkets.

For all types of breast pain, the recommended dose of GLA per day is 240mg-360mg.

The ingredient list on the packaging will confirm how much GLA is in each tablet, and you may need to take several tablets each day.

It will take a minimum of two months to see any appreciable improvement in your symptoms – do not expect an immediate effect.

After a minimum of three months if you have experienced improvement in your symptoms, you may be able to halve the dose for a further three months before stopping altogether.

Warnings

Pregnancy

It is advised that you do not take evening primrose oil when pregnant or trying to conceive.

Seizures

It is advised that people with epilepsy do not take evening primrose oil, although the evidence is limited.

Evening primrose oil has been associated with an increased risk of seizures in people taking antipsychotic medications, particularly phenothiazines (like prochlorperazine, chlorpromazine) used for conditions like schizophrenia. While the direct cause of seizures is not fully established, it is advisable to use evening primrose oil with caution if you are on these medications.

Anticoagulation (blood thinners) and antiplatelets

Evening primrose oil inhibits platelet aggregation. Patients taking blood-thinning medication or antiplatelets should discuss with their doctor before taking evening primrose oil as it may cause an increase in the tendency to bleed.

Medication interactions

Evening primrose oil may interact with other medication and we would advise discussing this further with a pharmacist.

Cambridge University Hospital Medicines Information Department can be contacted via the main switchboard, to check for medication interactions.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device.

More information is available on our website: MyChart

References/sources of evidence

Musculoskeletal chest wall pain ID 101225

Williamson E, Driver S, Baxter K. Stockley’s Herbal Medicines Interactions. Pharmaceutical Press, London 2013, 2nd Ed. pp. 206-208

Barnes J, Anderson LA, Phillipson JD. Herbal Medicines. Pharmaceutical Press, London 2007, 251-255