Razieh BEHZADMEHR, Tahmineh EZAZİ BOJNORDİ

The comparison of the therapeutic effects of piroxicam gel and oral vitamin E in cyclic mastalgia

Cyclic mastalgia is a common condition among women. There are different methods in reducing pain in such patients, but there is yet no consensus in this regard. This study aims to compare the therapeutic effects of topical piroxicam gel and oral vitamin E in patients with cyclic mastalgia. Seventy females with mild to moderate cyclic mastalgia were recruited from an outpatient clinic in this randomized, double-blind, placebo-controlled clinical trial. The patients received either topical 0.5% Piroxicam gel four times daily or vitamin E 400IU capsules once daily for two consecutive months. The visual analogue scale (VAS) was used to report pain one and two months later. Thirty-five patients completed the study in each group. Although both medications were effective and safe in reducing pain severity, topical piroxicam led to a significantly better pain control outcome. Almost half the patients required analgesics five months after the study stopped. In conclusion, comparing topical piroxicam gel and oral vitamin E in patients with cyclic mastalgia showed that the former is more efficient in pain control in mid-term. Both medications were safe and well-tolerated.

Keywords:

Mastalgia NSAIDs, Vitamin E,

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1. Niazi A, Rahimi VB, Hatami H, Shirazinia R, Esmailzadeh-Dizaji R, Askari N, et al. Effective Medicinal Plants in the Treatment of the Cyclic Mastalgia (Breast Pain): A Review. J Pharmacopuncture. 2019;22(3):131-9.
2. Lochner J, Larson M, Torell E, Schrager S. How best to address breast pain in nonbreastfeeding women. J Fam Pract. 2019;68(7):379;82;84;88.
3. Hafiz SP, Barnes NLP, Kirwan CC. Clinical management of idiopathic mastalgia: a systematic review. J Prim Health Care. 2018;10(4):312-23.
4. Stachs A, Stubert J, Reimer T, Hartmann S. Benign Breast Disease in Women. Dtsch Arztebl Int. 2019;116(33-34):565-74.
5. Ooi SL, Watts S, McClean R, Pak SC. Vitex Agnus-Castus for the Treatment of Cyclic Mastalgia: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt). 2020;29(2):262-78.
6. Jaafarnejad F, Adibmoghaddam E, Emami SA, Saki A. Compare the effect of flaxseed, evening primrose oil and Vitamin E on duration of periodic breast pain. J Educ Health Promot. 2017;6:85. .
7. Goyal A. Breast pain. BMJ Clin Evid. 2011;2011.
8. Scurr J, Hedger W, Morris P, Brown N. The prevalence, severity, and impact of breast pain in the general population. Breast J. 2014;20(5):508-13.
9. Cornell LF, Sandhu NP, Pruthi S, Mussallem DM. Current Management and Treatment Options for Breast Pain. Mayo Clin Proc. 2020;95(3):574-80.
10. Groen JW, Grosfeld S, Wilschut JA, Bramer WM, Ernst MF, Mullender MM. Cyclic and non-cyclic breast-pain: A systematic review on pain reduction, side effects, and quality of life for various treatments. Eur J Obstet Gynecol Reprod Biol. 2017;219:74-93.
11. Ahmadinejad M, Delfan B, Haghdani S, Hashemi M, Khan IA, Tafti MT. Comparing the effect of diclofenac gel and piroxicam gel on mastalgia. Breast J. 2010;16(2):213-4.
12. Irving AD, Morrison SL. Effectiveness of topical non-steroidal anti-inflammatory drugs in the management of breast pain. J R Coll Surg Edinb. 1998;43(3):158-9.
13. Colak T, Ipek T, Kanik A, Ogetman Z, Aydin S. Efficacy of topical nonsteroidal antiinflammatory drugs in mastalgia treatment. J Am Coll Surg. 2003;196(4):525-30.
14. Qureshi S, Sultan N. Topical nonsteroidal anti-inflammatory drugs versus oil of evening primrose in the treatment of mastalgia. Surgeon. 2005;3(1):7-10.
15. Ernster VL, Goodson WH, 3rd, Hunt TK, Petrakis NL, Sickles EA, Miike R. Vitamin E and benign breast "disease": a double-blind, randomized clinical trial. Surgery. 1985;97(4):490-4.
16. London RS, Sundaram GS, Murphy L, Manimekalai S, Reynolds M, Goldstein PJ. The effect of vitamin E on mammary dysplasia: a double-blind study. Obstet Gynecol. 1985;65(1):104-6.
17. Meyer EC, Sommers DK, Reitz CJ, Mentis H. Vitamin E and benign breast disease. Surgery. 1990;107(5):549-51.
18. Pruthi S, Wahner-Roedler DL, Torkelson CJ, Cha SS, Thicke LS, Hazelton JH, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Altern Med Rev. 2010;15(1):59-67.
19. Shobeiri F, Oshvandi K, Nazari M. Clinical effectiveness of vitamin E and vitamin B6 for improving pain severity in cyclic mastalgia. Iran J Nurs Midwifery Res. 2015;20(6):723-7.
20. Talimi-Schnabel J, Fink D. Praxis (Bern 1994). 2017;106(20):1101-6.