Drug therapy of diffuse mastopathy and PMS

According to the WHO definition (Geneva, 1984), mastopathy (fibrocystic disease, dyshormonal dysplasia of the mammary glands) is a dyshormonal hyperplastic process characterized by a wide range of proliferative and regressive changes in breast tissue with an abnormal ratio of epithelial and connective tissue components. Fibrocystic disease is very heterogeneous in its clinical, radiological and morphological manifestations. The etiology of the disease is also diverse. The occurrence of mastopathy is often associated with violations of the reproductive sphere of a woman, social and household problems, hormonal imbalance, various types of hepatopathies that lead to hormonal and metabolic disorders.

Clinically, fibrocystic disease is manifested primarily by mastalgia, varying in nature and degree of intensity. As a rule, pain in the mammary glands bothers the patient before menstruation or in the middle of the menstrual cycle. Often such complaints are accompanied by an increase in volume, swelling, swelling of the mammary glands. The tissues become heterogeneous, painful on palpation, seals form. When pressing on the nipples, discharge may appear.

Classifications of mastopathy

Despite the many proposed classifications of mastopathy, one of them does not fully reflect the full variety of morphological changes occurring in the mammary gland. In clinical practice, the classification proposed by N. I. Rozhkova (1993) is most often used, where the following forms of mastopathy are distinguished: diffuse mastopathy with a predominance of the glandular component (adenosis); diffuse fibrocystic mastopathy with a predominance of the fibrous component; diffuse fibrocystic mastopathy with a predominance of the cystic component; mixed diffuse fibrocystic mastopathy; sclerosing adenosis; nodular fibrocystic mastopathy.

According to the degree of severity of the detected changes, diffuse fibrocystic mastopathy (FCM) is divided into slightly, moderately and sharply expressed. According to the degree of proliferative activity of the epithelium, there are: mastopathy without proliferation (I degree); mastopathy with epithelial proliferation (II degree); mastopathy with atypical epithelial proliferation (III degree). Due to the presence of a wide range of clinical and histological manifestations, the treatment of diffuse mastopathy is very difficult and requires, first of all, the establishment of the main causes of the disease. Adequately selected therapy should be complex, long-term, taking into account the hormonal, metabolic characteristics of the patient’s body, concomitant diseases. According to modern concepts, the complex treatment program for diffuse mastopathy includes phytotherapy-collections of herbs of multidirectional action.

Treatment of mastopathy

One of the most effective means of treating mastopathy and premenstrual syndrome is the combined drug Mastodinone (manufacturer-the German company “Bionorica”). The main component of the drug is an extract of prutnyak fruit BN0 1095. In addition, it includes a basilisk-shaped stalk, an alpine violet, a bitter chestnut, a multicolored killer whale, a tiger lily. The use of ordinary prutnyak (synonym-Abraham’s tree; Lat. Vitex adpis castus) has a long history (the first description refers to the IV century BC). Vitex agnus castus is widely used in the treatment of gynecological diseases: menstrual cycle disorders, amenorrhea, luteal phase insufficiency, premenstrual syndrome. Since 1975, the extract of prutnyak fruits has been used in the form of the phytopreparation Mastodinon.

The main mechanism of action is a stimulating effect on the dopamine D2 receptors of the anterior pituitary lobe, which leads to a decrease in prolactin secretion. Hyperprolactinemia, which is not associated with pregnancy and lactation, has a direct stimulating effect on proliferative processes in peripheral target organs, which is realized by increasing the production of estrogens by the ovaries. The ability of prolactin to increase the content of estradiol receptors in the tissues of the mammary glands also plays a role. These mechanisms determine the development of the entire symptom complex characteristic of premenstrual syndrome and fibrocystic disease.


A decrease in the increased level of prolactin due to taking Mastodinone leads to a regression of pathological processes in the mammary glands and stops the cyclic pain syndrome in mastopathy or premenstrual syndrome. When the prolactin level is normalized, the rhythmic production and the ratio of gonadotropins are restored, the imbalance between estradiol and progesterone is eliminated, which contributes to the restoration of the menstrual cycle. The recommended regimen for taking Mastodinone is 30 drops (1 tablet) 2 times a day for 3 months without a break, regardless of the menstrual cycle. After that, you can take a break for 1-2 months, then resume taking the drug. Clinical improvement is noted after 4-6 weeks of use. Individual intolerance to the drug is extremely rare.

Unlike many dietary supplements advertised for the treatment of fibrocystic disease, the effectiveness of Mastodinone has been demonstrated in a number of scientific studies, the results of which have been published in domestic and foreign literature. The most satisfactory results were obtained in the group of patients with diffuse forms of mastopathy and premenstrual syndrome (n=1472). 1064 patients (72.3%) noted a significant improvement in well-being (a decrease in the density of breast tissue, a decrease or cessation of nipple discharge, normalization of the menstrual cycle, a decrease in headaches and abdominal pain), 397 women did not record changes in their condition and only 11 patients complained of increased symptoms.


Thus, the results of the conducted studies have shown the high effectiveness of Mastodinone and Cyclodynone in patients with benign diseases of the mammary glands and menstrual function disorders. It should be emphasized that the high effectiveness of the drugs in combination with a low frequency of adverse reactions makes them extremely attractive for wide use.

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