A. Fibrocystic disease. The major aim of therapy in fibrocystic disease is to relieve breast pain or discomfort. Symptomatic relief also may be achieved with a soft brassiere with good support, acetaminophen or a nonsteroidal anti-inflammatory drug, or both.

1. Breast pain or discomfort may be relieved with a thiazide diuretic.

2. Avoidance of caffeine may provide some patients with relief of pain.

3. Vitamin E, 400 IU twice daily reduces breast pain.

4. Evening primrose oil in doses of 1500-3000 mg daily, relieves breast pain in 30 to 80 percent.

5. Danazol in doses of 100 to 200 mg daily reduces breast pain. Common side effects include weight gain, acne, hirsutism, bloating, and amenorrhea.

6. Tamoxifen reduces breast pain in about 70 percent of women. It is safe and well-tolerated as 10 mg twice daily, or bromocriptine 1.25 to 5 mg daily can be tried.

7. Oral contraceptives. The frequency of fibrocystic changes decreases with prolonged oral contraceptive therapy. Oral contraceptives containing 19-norprogestins, such as norlutate, have androgenic properties that are beneficial.

References: See page 184.

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