Dr Mark Trowell <[log in to unmask]> writes
>Anyone up to date on this subject? Very distressed lady seen today. All
>help gratefully received.
Assume breast examination normal, no nipple discharge or galactorrhoea.
Upper outer quadrant discomfort very common between 35 and 45.
Exessive stimulation causes aching.
Inadequate support causes aching.
Excessive checking for lumps causes soreness.
Is she on any hormones at all? - pill, HRT, Mirena?
Definitely not pregnant?
Evening primrose oil has greater than placebo effect but need to use
continuously for 3-6 months before noting improvement. Efamast comes in
40mg capsules, requiring 8 daily - more palatable to buy OTC 500mg ones.
Pyridoxine out of favour currently, though possibly better than placebo.
Bromocriptine - well, perhaps a bit excessive?
Psychological pathology?
Fear of breast cancer? Changing shape seen as loss? Sexual difficulties?
-- Law
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