Cyclical mastalgia: premenstrual syndrome or recurrent pain disorder?

Approximately 8-10% of premenopausal women experience moderate to severe pe rimenstrual breast pain or cyclical mastalgia, monthly. This mastalgia can occur regularly for years until menopause, can interfere with usual activit ies, and is associated with elevated utilization of mammography among young women. Although mastalgia is a well documented symptom in premenstrual syn drome (PMS), if is unknown whether PIS is necessarily present in women with cyclical mastalgia. The present study prospectively examined mastalgia and its relationship to PMS, Thirty-two premenopausal women reporting recent m astalgia completed breast pain and menstrual symptom stales daily for 3-6 m onths. Eleven women (34.4 %) met criteria for clinically significant cyclic al mastalgia, reporting an average of 10.2 days of moderate severe mastalgi a monthly. Five women (15.6%) met criteria for PMS. Mastalgia was not signi ficantly associated with PMS: 82 % of women with clinical cyclical mastalgi a did trot have PMS. Cyclical mastalgia, although by definition associated with the menstrual cycle, is not simply premenstrual symptom, and,merits fu rther investigations as a recurrent pain disorder whose presentation, etiol ogy, and effective treatment are likely to differ from those of PMS.