Changing or stopping medication

• Changing current medication to treat breast pain is not advised as there is little evidence to suggest a link between any drug treatment and the onset of cyclical breast pain.
• There is no evidence to suggest that the use of combined oral contraceptives causes cyclical breast pain. Premenstrual breast pain may improve with oral contraceptive use.

Evening primrose oil

• There is evidence from a systematic review of four randomized controlled trials to show that evening primrose oil is no more effective than placebo at reducing the frequency and severity of breast pain. For this reason the Committee on Safety of Medicines withdrew the prescription licence from evening primrose oil to treat breast pain. However, the placebo effect is significant and, as the adverse effects are minor and the oil is not being used to treat a pathological disorder, women who believe it to be beneficial do not need to be advised against it.

Progestogen-only contraceptives

• There is weak evidence from a cross-sectional survey to suggest that parenteral medroxyprogesterone acetate reduces cyclical breast pain, but it is insufficient to recommend this as a treatment.
• There is weak evidence that oral progestogen (oral medroxyprogesterone) is no better than placebo at treating breast pain.

Diet changes

• There is little evidence to suggest that a diet low in fat and high in carbohydrate, or a diet low in caffeine, is beneficial for the treatment of cyclical breast pain.

Other medication

• There is a lack of evidence to suggest a benefit from the use of antibiotics, diuretics, pyridoxine, or vitamin E. Even though there is a placebo effect from these agents, they have potential adverse effects themselves and should not be used for the treatment of breast pain.