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

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.