 A study on the effect of flax seed ingestion on the menstrual cycle found a tablespoon a day of ground flax seeds lengthened the luteal phase, meaning flax can delay one's next period by about a day, and resulted in fewer anovulatory cycles. These are the same kind of improvements in ovarian function seen in women eating plant-based diets, a longer luteal phase and fewer anovulatory cycles, fewer failed ovulations. An indication that vegetarian women have fewer disturbances in their cycles. In fact, those eating vegan in this study never failed to ovulate at all, similar to women eating daily flax. Since those same hormonal changes associated with eating plant-based diets seem to improve premenstrual and menstrual symptoms, such as breast pain, maybe flax seeds would help too. The effects of dietary flax seed in women with breast pain associated with their cycles. Although hormone treatments such as tamoxifen may be helpful, they often cause unpleasant side effects, and there may be risks associated with long-term use of hormonal therapy. Dietary flax seed is therefore an attractive alternative for controlling these symptoms. So, 116 young women with severe cyclical nostalgia, severe menstrual breast pain over a pre-study period of six months were randomized in a double-blind manner with either a muffin containing about 3.5 tablespoons of flax seed, or a placebo muffin, and followed for a few cycles. There was some placebo muffin effect, but there was a significantly greater reduction in reported breast pain, breast swelling, and breast lumpiness in the flax seed group. It is concluded that flax seed is effective in relieving symptoms of cyclical nostalgia without significant side effects, women might be considered an alternative treatment for cyclical breast pain. But if it works, and there are only good side effects, why is it an alternative treatment, and not the primary, first-line treatment? Well, the American Congress of Obstetricians and Gynecologists has not issued treatment guidelines, but the Society of Obstetricians and Gynecologists of Canada has. They first dispel the myth that caffeine is to blame, vitamin E supplements are helpful. Instead, dietary flax seed should be considered as a first-line therapy for menstrual breast pain, and only then consider drugs if flax doesn't work. Oh, and breast pain should not be treated by use of mastectomy.