In double-blind research, evening primrose oil (EPO) has reduced symptoms of FBD,^1,2 though only slightly.³ One group of researchers reported that EPO normalizes blood levels of fatty acids in women with FBD.⁴ However, even these scientists had difficulty linking the improvement in lab tests with an actual reduction in symptoms. Nonetheless, most reports continue to show at least some reduction in symptoms resulting from EPO supplementation.^5,6 Based on this research, many doctors recommend a trial of 3 grams per day of EPO for at least six months to alleviate symptoms of FBD.

Since many women with FBD and cyclical breast tenderness also suffer from PMS, there is often an overlap in herbal recommendations for these two conditions despite a lack of research dealing directly with FBD.

In one double-blind trial, a liquid preparation containing 32.4 mg of vitex and homeopathic ingredients was found to successfully reduce breast tenderness associated with the menstrual cycle (e.g. cyclic mastalgia).⁷ Vitex is thought to reduce breast tenderness at menses because of its ability to reduce elevated levels of the hormone, prolactin.⁸

Doctors typically suggest 40 drops of a liquid, concentrated vitex extract or 35–40 mg of the equivalent dried, powdered extract to be taken once per day in the morning with some liquid. Vitex should be taken for at least three menstrual cycles to determine efficacy.

Some doctors use iodine to treat FBD symptoms. In animals, iodine deficiency can cause the equivalent of FBD.⁹ What appears to be the most effective form—diatomic iodine¹⁰—is not readily available, however. Some people are sensitive to iodine and high amounts can interfere with thyroid function. Therefore, supplemental iodine should only be taken with the guidance of a healthcare practitioner.

While several studies report that 200–600 IU of vitamin E per day, taken for several months, reduces symptoms of FBD,^11,12 most double-blind trials have found that vitamin E does not relieve FBD symptoms.^13,14 Nonetheless, many women take 400 IU of vitamin E for three months to see if it helps.