Successful treatment of mastodynia with the prolactin inhibitor bromocryptine (CB 154)

Abstract

Mastodynia has previously been treated with gestagens or gestagen-based ovulation inhibitors with only marginal success. No other satisfactory therapy was available and in the search for a better treatment, the effectiveness of long term administration of the prolactin inhibitor bromocryptine (CB 154) to 15 patients was evaluated. Five of the subjects exhibited mammary secretion as well as mastodynia which, accorind to palpatorial, cytological and X-ray criteria, was not caused by intraductal pathology. After two to four weeks treatment with 5 mg CB 154 per day ten patients recovered fully, three showed some improvement and two were totally resistant to the treatment. Plasma prolactin levels during the follicular stage measured prior to treatment were in the normal range. All the patients continued to ovulate during the course of treatment despite the irrefutable fact that prolactin release from the pituitary was inhibited. Since there was a similar inhibition of prolactin secretion in the two patients who were resistant to treatment, it would seem that prolactin though probably very important, cannot be the only decisive factor in the hormonal control of mystodynia. Further observations showed that the premenstrual syndrome can also be successfully treated with CB 154. Upon withdrawal of treatment the possibility or relapse must be considered.

The premenstrual syndrome, premenstrual mastodynia, fibrocystic mastopathy and infertility have often common roots: effects of extracts of chasteberry (Vitex agnus castus) as a solution

“…This observation confirms and extends earlier reports which demonstrated also a higher prolactin release in women with fibrocystic mastopathy in response to a TRH stimulus [3].…”

“…2) which is a common reason for infertility. These findings confirm and extend earlier results demonstrating increased prolactin and low progesterone levels in women suffering from premenstrual mastodynia [3,6,7].…”

“…When this discomfort is extreme it is classified as mastalgia (severe mastodynia) [1][2][3]. There is evidence that in women suffering from premenstrual mastodynia or mastalgia a latent hyperprolactinemia is one of the major reasons for the development of the complaints [3,4].…”

“…This has led to development of synthetic drugs with dopaminergic activity which were all derivatives of ergot alkaloids. It became soon clear that decreased prolactin levels under treatment with the dopamine receptor agonist bromocriptine ameliorated the severity of premenstrual mastodynia, an effect not seen in the placebo treated patients [3,10]. Also, a study addressing the question whether the synthetic dopamine agonist lisuride ameliorates also other PMS symptoms yielded positive results [11].…”

Herbal Medicinal Products in a Treatment of Mastalgia in Gynecologic Patients

“…Многие пациентки, страдающие предменструаль-ной мастодинией, имеют высокие стрессовые уровни пролактина, что снижает выработку лютеинизирую-щего и фолликулостимулирующего гормонов, при-водя к диспропорциям стероидных гормонов в лю-теиновую фазу цикла [8][9][10]. Это может влиять на изменения в тканях МЖ, увеличивая ее плотность, …”