By the time they’ve reached their mid-forties or so, almost half of all women develop some degree of a condition called fibrocystic breast syndrome (FBS) in which their breast tissue becomes either more dense (“fibrous”) or it contains fluid-filled cysts, which can be tender or “lumpy.” In addition, because these cysts are under hormonal control, they often change size during a woman’s cycle and become exquisitely tender and painful during the week or so before her menstrual flow begins.
Conventional medicine offers very little in terms of therapy, only the reassurance that the condition is benign and does not lead to cancer. One of the nicest surprises I’ve had as a physician happened when I was learning nutritional medicine and saw how dramatically supplements and lifestyle changes could improve FBS.
The toughest change is usually giving up coffee and other foods with caffeine (caffeine is a known trigger of FBS). But if you use the supplements we recommend at WholeHealth Chicago and work on your diet, once your symptoms have improved, you may be able to return to a morning cup without any painful flare-ups.
What are Fibrocystic Breast Changes?
Many women experience the breast pain and lumps that doctors call fibrocystic breast changes. The condition was once known as fibrocystic breast disease, but since research has shown that it’s normal and natural, affecting as many as 60% of women, it’s no longer referred to as a disease. Fibrocystic breast changes are most common in women between the ages of 25 and 50, and they’re rare in postmenopausal women not on hormone replacement therapy. Typically, breast tissue in younger women is dense, containing more glandular tissue and less fat than the breasts of older women, and having more tissue can make breasts feel firm or lumpy.
The lumps may be fluid-filled cysts or fibrous areas, which respond to hormonal signals and can become particularly tender just before the menstrual period. Sometimes this monthly pain is so intense that it intrudes upon daily life. Other times, lumps are painless.
Although breast lumps can make diagnosing breast cancer difficult, fibrocystic lumps themselves are benign and don’t increase your breast cancer risk. Unlike cancerous lumps, fibrocystic lumps come and go with the menstrual cycle and move under the pressure of a finger.
Key Symptoms
- Lumpy breasts that may or may not be painful
- Increased breast discomfort and more noticeable lumps in the week before menstruation
What Causes Fibrocystic Breast Changes?
The exact cause isn’t known. Fibrocystic changes in the breast tend to arrive with the shift in monthly menstrual hormones in the second half of the menstrual cycle. Changes may be more pronounced in women with higher peak estrogen levels before ovulation and steeper drops in progesterone after ovulation. This hormonal environment may then lead to excess production of prolactin, a lactation hormone from the pituitary gland that can make the breasts swell and feel tender in non-breast-feeding women.
Researchers have long suspected that caffeine is an accomplice in the formation of breast lumps and cysts, since some women do feel more comfortable when they cut caffeine from their diets. But no one has identified a precise mechanism to explain this.
Treatment and Prevention
There are medical treatments to relieve the discomfort of fibrocystic breast changes, but they aren’t always effective and may produce undesirable side effects. Danocrine (Danazol), the same drug used to induce menopause in the treatment of endometriosis, is also used for very severe and painful fibrocystic breasts. Unfortunately, the side effects (basically severe menopausal symptoms plus some signs of masculinization) make it seem an unnecessarily harsh treatment for a benign condition.
Supplements may offer relief and can safely be used together whenever they’re needed. As with many therapies, supplements work gradually with the body and so may take a few menstrual cycles before breast tenderness and lumpiness diminish.
Just a reminder: If you have a serious medical condition or are taking medication, it always a good idea to check with your doctor before beginning a supplement program.
How Supplements Can Help
Vitamin E brings relief to many women with fibrocystic changes. Its exact mechanism is a mystery, but one theory is that vitamin E counteracts the effects of caffeine.
Chasteberry, also called vitex, adjusts imbalances between the menstrual hormones estrogen and progesterone and can stop excess production of prolactin, thereby reducing discomfort. It helps with painful bloating and may clear up PMS-related complaints, such as irritability and depression, in the process. The chasteberry formulation you choose should either be a powder standardized to contain at least 0.5% agnuside (the active ingredient) or the concentrated liquid herbal extract. Another good option is a PMS herbal combination product that combines chasteberry with other helpful botanicals. This helps balance estrogen and progesterone, which is the basis of this condition and may be a welcome alternative to taking many separate supplements.
Essential fatty acids (EFAs) have an anti-inflammatory action that soothes breast pain and also helps the body absorb iodine. An iodine deficit is associated with fibrocystic breast changes. Good sources of EFAs are evening primrose oil, flaxseed oil, and borage oil.
Magnesium is a versatile mineral that appears to reduce the pain and inflammation of fibrocystic breast changes and may also help with PMS and menstrual cramps. It’s less likely to upset the stomach if taken with food; cut the dose if diarrhea develops.
Vitamin B6 helps the liver process any extra estrogen and, like some of the supplements above, also can relieve PMS symptoms. Though this vitamin is essential to nerve health, it can cause nerve damage when taken in very high doses (over 500 mg a day) for a long period of time. Vitamin B6; will be most effective for this condition if used during the two weeks before your menstrual period.
A coenzyme Q10 deficiency has been reported in some cases of both breast cancer and fibrocystic breast changes. Supplementing with this high-potency antioxidant may be helpful in the prevention and treatment of these and other disorders in the body.
Self-Care Remedies
Cut caffeine from your diet. It’s commonly found not only in coffee and tea but also in cola, chocolate, and some over-the-counter remedies (read the label). It may take as long as six months from the time you eliminate caffeine from your diet to get results. Although one report was not impressed with the effect of eliminating caffeine, some nutritionally oriented physicians believe the subjects involved had not really been thorough in caffeine elimination.
Wear a supportive bra during the day and all night as well when breasts are tender.
Note: There is such a strong connection between fibrocystic breast changes and premenstrual syndrome that you might also want to explore the WholeHealth Chicago Healing Center for PMS as well.
When to Call a Doctor
- If an existing lump gets larger and harder or doesn’t shrink after menstrual periods, especially if it is painless
- If a new lump grows in the breast or under the arm (especially if you tend to not have lumpy breasts)
- If either nipple has a discharge
- If breasts change in size or symmetry
Supplement Recommendations
From David Edelberg, M.D. at WholeHealth Chicago: You can start taking supplements at once, but be patient. They may relieve other premenstrual syndrome (PMS) symptoms within a cycle or two, but fibrocystic breast pain may take several more months to subside.
How to Take the Supplements
I suggest you take virtually all of the supplements listed as “Most Effective.” These have been used widely by practitioners of natural medicine with good results.
The herb chasteberry (Vitex) or, even better, a PMS herbal combination, can be very helpful for correcting the hormonal imbalance between estrogen and progesterone, which is thought by many doctors to be the basis for this condition.
Along with these herbs, add the essential fatty acid evening primrose oil, which was shown to be effective for FBS in clinical studies. Vitamin E has had mixed results in research but continues to be popular among patients themselves. In addition, the antioxidant effect of vitamin E is useful for heart disease prevention. Allow two or three cycles for the supplements to take effect.
If you experience improvement but not full relief, move on to the “Also Helpful” supplement suggestions. Since magnesium and vitamin B6 are both useful for PMS, correcting the PMS component of your FBS may be an advantage therapeutically.
Coenzyme Q10, a potent antioxidant found in virtually every cell in the body and involved in energy production, was found to be deficient among women with breast changes. A daily supplement can correct this problem.
Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions. Note: There is such a strong connection between fibrocystic breast changes and premenstrual syndrome that you might also want to explore the WholeHealth Chicago Healing Center for PMS as well.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
Be well,
David Edelberg, MD