Prevalence and impact of cyclic mastalgia in a United States clinic-based sample,☆☆,,★★,

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Abstract

OBJECTIVES: A descriptive study was conducted to examine the prevalence of premenstrual breast symptoms, the impact of cyclic mastalgia on various activities, and associated patterns of health care utilization. STUDY DESIGN: Patients at an obstetrics and gynecology clinic (n = 1171) completed a questionnaire. RESULTS: Sixty-nine percent of women reported regular premenstrual discomfort; 36% had consulted a health care provider about the symptoms. Current moderate-to-severe cyclic mastalgia was found in 11%. Women <36 years old with cyclic mastalgia were 4.7 times as likely as asymptomatic young women to have had a mammogram. Mastalgia interferes with usual sexual activity in 48% of women and with physical (37%), social (12%), and work or school (8%) activity. CONCLUSIONS: Cyclic mastalgia is a common problem, sometimes severe enough to interfere with usual activities, and it is associated with high use of mammography among young women. Largely ignored both scientifically and clinically in the United States, this disorder merits further biopsychosocial investigation. (Am J Obstet Gynecol 1997;177:126-32)

Section snippets

Participants

The Walter Reed Army Medical Center Institutional Review Board approved this research. A convenience sample of women seen in the obstetrics and gynecology clinic at Walter Reed Army Medical Center was recruited to participate in the study. Clinic staff were instructed to solicit participation from all patients checking in at the appointment desk and to obtain informed consent from each participant. To minimize potential recall difficulties, only women <55 years old (n = 1171) were included in

Sample demographics

Participants ranged in age from 18 to 54 years; mean age was 33.1 years, SD 9.3 years. The sample was 48.5% white and 40.3% black; 71.5% were married. Forty percent had college degrees or postgraduate education; 5% had not finished high school.

The most commonly listed reasons for the clinic appointment were checkup (23.7%), Papanicolaou smear (20.9%), and follow-up visit (5.3%). Only 20 women listed breast-related reasons for the appointment: biopsy (n = 8), breast lump (n = 6), breast

Comment

The reported prevalence of premenstrual breast pain or tenderness is remarkably consistent across samples and among subgroups of women. Although our 69% prevalence rate is comparable to rates reported in the British literature, it is higher than the 41% reported by a previous U.S. study. This difference may result from the different questions asked in the two studies. Boyle et al.3 asked only whether women had breast pain; we asked women to specify swelling, tenderness, or pain or other

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  • Cited by (0)

    From the Department of Psychiatry, Uniformed Services University of Health Sciences,a and the Department of Obstetrics and Gynecology, Walter Reed Army Medical Center.b

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    Supported in part by a Uniformed Services University of Health Sciences grant (D.N.A.).

    The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Department of Defense, Walter Reed Army Medical Center, or the Uniformed Services University of Health Sciences.

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    Reprint requests: Deborah N. Ader, PhD, Department of Psychiatry, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799.

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