Mastodynia: pathogenesis, diagnosis, and treatment

Kulagina N.V., Odintsov V.A.

1) I.I. Mechnikov Northwestern State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia; 2) Northern State Medical University, Ministry of Health of Russia, Arkhangelsk, Russia; 3) Odintsov Clinic LLC, Saint Petersburg, Russia
Mastodynia is observed in 70% of women in the population and it occurs more frequently at the age of 30 to 50 years. We reviewed the papers published in the PubMed and RSCI database in the period from 2000 to 2022 in order to systematize the variants of the clinical course, the mechanisms of mastodynia development and individual approaches to the management tactics of patients with breast pain. Mastodynia may be associated with premenstrual syndrome, benign breast dysplasia, mastitis. The risk of breast cancer is extremely low in a situation where the only symptom is mastodynia. The examination of patients with mastodynia includes history taking, physical examination, imaging techniques aimed at identifying functional and organic disorders of the mammary gland. After appropriate clinical evaluation, most patients with breast pain respond positively to non-medication and medication treatment. The results of the clinical studies show the effectiveness of medications containing a dry extract of the fruits of Vitex agnus castus in the treatment of mastodynia in patients with diffuse benign breast dysplasia and premenstrual syndrome.
Conclusion: It is necessary to conduct a thorough examination of women with mastodynia in order to exclude proliferative formations of the mammary glands and to identify the cause of breast tenderness. Mechanism-based mastodynia therapy helps to reduce episodes of pain and improve the quality of life while minimizing side effects.


benign breast dysplasia
premenstrual syndrome
Vitex agnus castus


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Received 06.06.2022

Accepted 14.06.2022

About the Authors

Natalya V. Kulagina, Dr. Med. Sci., Professor, Department of Obstetrics and Gynecology, I.I. Mechnikov NWSMU, Ministry of Health of the Russian Federation,
+7(812)303-50-00,,, 191015, Russian Federation, St. Petersburg, Kirochnaya str., 41.
Vladislav A. Odintsov, Dr. Med. Sci., Professor, Department of Radiation Diagnostics, Radiation Therapy and Oncology, NSMU, Ministry of Health of the Russian Federation; Chief Physician, Odintsov Clinic, +7(812)748-22-10,,,
197345, Russian Federation, St. Petersburg, Touristskaya str., 22A.
Corresponding author: Natalya V. Kulagina,

Authors’ contributions: Kulagina N.V. – developing the concept and design of the study, editing; Kulagina N.V., Odintsov V.A. – collecting and processing the material, writing the text.
Conflicts of interest: The authors declare that they have no competing interests.
Funding: The study was performed without external funding.
For citation: Kulagina N.V., Odintsov V.A. Mastodynia: pathogenesis, diagnosis, and treatment.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 6: 33-39 (in Russian)

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