 Breast pain accompanying one's period, called premenstrual nostalgia, was dismissed in the 70s as merely an expression of psychoneurosis of women. They're just frustrated and unhappy, because they haven't given their husbands children yet. Now we know what women always knew. Breast pain is all too common, maybe severe enough to interfere with usual daily activities, and its effect on quality of life is often underestimated. Though pain can be severe, the cause and optimal treatment remain undefined. Approximately 60 to 70% of women experience some type of breast pain at some stage of their lives, and in 10 to 20% of cases it is severe. Now some breast tenderness during one's cycle is normal, but breast pain is not. In many cases, surgery was prescribed. Thankfully by 1999, we were evidently living in an era of evidence-based surgery. What a concept, where we have to justify the surgery we undertake, and so the profession stopped cutting off the breasts of women in pain. The hormone prolactin is considered a central factor. As women with cyclical breast pain were found to have elevated levels, and a prolactin inhibitor drug was found to be an effective treatment. The side effects, though, were so bad that some women couldn't even finish the study. There has to be a better way. Well, while up to two-thirds of Western women suffer from breast pain in their lifetimes, it apparently may affect as few as 5% in Asian cultures. Maybe it has something to do with diet. Women eating traditional plant-based diets, all their lives, like rural Ben-2 African women, have lower prolactin levels. How do we know the difference isn't just genetic? Well, when you take those women and feed them a Western diet, meat, butter, milk, eggs, bread, and sugar for a few weeks, they experience a significant rise in prolactin. In fact, hormonal changes were comparable to those found in women with menstrual irregularities more common in the West. They got just as bad as they started eating like us. But part of the Western diet was responsible, though. Maybe it was the bread and sugar? To see if it was the meat, researchers took some New Yorkers, put them on a vegetarian diet for two weeks, and that alone brought their prolactin levels down, suggesting that the removal of meat and meat products from the diet can reduce the release of prolactin. So let's give it a try for breast pain. The first pilot study involved 10 women with severe cyclical nostalgia, put on a low-fat diet for three months, either vegetarian or mostly vegetarian, and all 10 women got better. There was no control group, though, so part of their improvement may have just been the placebo effect. So a randomized controlled trial was undertaken. This Canadian research group had been carrying out a clinical trial of dietary fat reduction in patients with precancerous breast changes, and they noted that patients with cyclical breast problems frequently experience striking relief of symptoms after reduction of dietary fat. So they randomized women into two groups, and again, a significant improvement in symptoms was found. Since then, we've learned that vegetarian women have fewer menstrual disturbances than non-vegetarian women. Only about 5% of their cycles were an ovulatory, meaning they failed to release an egg compared to 15% of non-vegetarian menstrual cycles. Those eating more plant-based, low-fat diets may also experience significantly less bloating, and compared to placebo, women with painful menstrual cramps placed on a vegan diet experienced significant relief. This was a so-called crossover study, where they put meat-eating women on a plant-based diet for two cycles and then switched them back to their regular diet with some placebo supplement, so you can show changes before and after, and then back to baseline. The problem is that several participants felt so much better on the plant-based diet they refused to go back to their regular diet, thereby screwing up the study. Bottom line is that a plant-based diet may offer relief from breast pain, as well as significant reductions in menstrual pain duration, pain intensity, and duration of pre-menstrual symptoms related to concentration, behavioral change, and water retention.