Treatments - Evening Primrose Oil
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What is Evening Primrose Oil?

Evening primrose is a native American wildflower, named for the late afternoon opening of its delicate flowers. Its seeds are considered the best natural source of cis-gamma-linolenic acid (GLA).

Evening primrose oil (EPO) has become a medically accepted treatment for fibrocystic breast disease in the United States and Europe. It is commonly used for PMS and symptoms of menopause. Evening primrose oil is widely used in Europe for diabetic neuropathy, cyclic mastitis, and eczema.

Evening primrose oil has also been suggested as a treatment for Raynaud's disease, Sjogren's disease, endometriosis, prostate disease, chronic fatigue syndrome, and many other conditions, but the research evidence for these uses is negligible.

What are the uses of Evening Primrose Oil?
Cyclic Mastitis / Fibrocystic Breast Disease. Fatty acid metabolism is known to be disturbed in women with cyclical mastitis [Horrobin, 1991]. In open studies performed at the Cardiff Mastalgia Clinic in the Britain, EPO has been found to produce positive effects in 44% of women with cyclical mastalgia [Pye et al., 1985; Gately, 1990]. According to the same researchers, this was about the same benefit as seen with a prescription drug bromocriptine, but danazol was somewhat more effective (70% response rate).

In a double-blind placebo-controlled study, 73 patients with mastalgia randomly received evening primrose oil 3 g/day or placebo for 3 months. Over the course of the study, 3 patients in the treated group and 16 patients in the control group dropped out. Discomfort was significantly reduced in women with either cyclical or noncyclical mastalgia, while no significant improvement was seen in the control. Nodularity improved only in the cyclic group [Pashby et al., 1981]. However, in another double-blind study of 200 women treated for 1 year, EPO did not prove effective in the treatment of recurrent breast cysts [Mansel et al., 1990].

Other Conditions. Although several small studies suggest that EPO is helpful in reducing overall PMS symptoms, there are serious flaws in the design of these studies. [Budeiri et al., 1996].

A trial of menopausal women found no benefit for hot flash relief over six months.

What are the recommended Preparations/Dosages?
For cyclic mastitis, the standard dose of evening primrose oil is 3 g daily in two or three divided doses. 2-8 grams daily is utilized in PMS and menopause symptoms.

It must be taken for at least 4 to 6 weeks for discernible effect, and maximum benefits may require 4 to 8 months to develop.
Evening primrose oil should be given with food to minimize gastrointestinal distress. Vitamin E is often recommended to be taken concurrently to prevent excessive lipid peroxidation and the creation of counterproductive substances [Reddy et al., 1994]. Dietary reduction of less preferred fatty acids (e.g., saturated fats) has also been suggested in the treatment of fibrocystic breast disease.

What about Side Effects?
Evening primrose oil appears to be nontoxic, nonteratogenic, and noncarcinogenic, according to animal studies [Horrobin, 1992]. Over 4,000 patients have participated in trials of GLA, primarily in the form of EPO. No adverse effect has been attributed to this treatment, and in the double-blind studies of EPO there have been no significant differences in rate of side effects between the treated group and the placebo group [Horrobin, 1992].

Are there any Contraindications?
Evening Primrose Oil is not recommended for use during pregnancy or breast feeding. Do not use if currently on phenothiazine antipsychotics or diagnosed with schizophrenia. Do not use if being treated for epilepsy.