Dietary Supplements for the Treatment of Endometriosis: Evidence and Perspectives
The pathogenesis of endometriosis involves the interplay of endocrine, immunologic, proinflammatory, and proangiogenic processes.
There are new endometriosis theories on these issues-immune cells, adhesion molecules, extracellular matrix metalloproteinases, and pro-inflammatory cytokines activate/alter the peritoneal microenvironment, creating conditions for differentiation, adhesion, proliferation, and survival of ectopic endometrial cells.
It remains uncertain whether these factors are causal or simply represent a feature of the pathophysiologic process measured years after the onset of symptoms.
In choosing treatment for endometriosis, it is critical to consider the patient’s predominant symptoms and preferences, age, drug side effect profile, and outcomes of possible surgery, as well as the extent and location of the disease, previous treatments, and cost-effectiveness.
The pathophysiology of endometriosis has yet to be elucidated, and the search for optimal treatment continues.
Nonsteroidal anti-inflammatory drugs, estrogen-progestin combination therapy, aromatase inhibitors, progestins, and selective progesterone receptor modulators are the main treatment options in current practice. The elaborate pathogenetic mechanisms of endometriosis challenge physicians to address each when it comes to treatment.
Although conventional medical and surgical therapies are essential, the help of dietary supplements can have a synergistic effect due to their anti-inflammatory, antioxidant, antiproliferative, and immunomodulatory characteristics.
Current surgical and medical approaches to endometriosis are ineffective for a considerable percentage of women; moreover, treatment may be associated with complications and morbidity.
Although superficial peritoneal lesions and ovarian endometriomas account for the majority of endometriotic implants within the pelvis, deep infiltrating endometriosis and extrapelvic endometriosis are the most difficult conditions to address. Although sometimes medical therapy is sufficient to reduce symptoms and signs, in a large number of patients complete eradication, with a nerve- and vessel-sparing approach, is required to restore normal pelvic anatomy and function.
With this in mind, as the search for new treatment options continues, the therapeutic benefits of dietary supplements with or without conventional treatment are being investigated. Different types of supplements can be effective in various ways. In this review, it was proposed to evaluate the effectiveness of using supplements for the treatment of endometriosis by compiling the most widely used and studied supplements.
As the search for optimal therapy for endometriosis continues, the help of dietary supplements is gaining attention. Supplements can be used for their anti-inflammatory, antioxidant, antiproliferative, and immunomodulatory characteristics.
The literature was reviewed, evaluated and synthesized the effects of vitamin D, zinc, magnesium, omega-3, propolis, quercetin, curcumin, N-acetylcysteine, probiotics, resveratrol, alpha-lipoic acid, vitamin C, vitamin E, selenium and epigallocatechin-3-gallate.
Based on the results of in vitro, animal and human studies, it can be said that dietary supplements can be used as an adjunctive treatment for endometriosis.
As in many diseases and conditions, the positive effects of dietary supplements have been demonstrated in endometriosis. Some types of supplements can be given as a complementary treatment for symptoms, while others are helpful in preventing the disease.
After a careful review of the literature, it is firmly established that lower levels of vitamin D, zinc, and vitamin E lead to an increased risk of endometriosis.
Magnesium, curcumin, resveratrol, and ECGC have been found to be useful in animal studies due to their antiangiogenic effects.
Omega 3 and alpha-lipoic acid improved pain associated with endometriosis in human studies.
Supplementation of curcumin, omega 3, NAC, vitamin C, and ECGC reduced the size of endometriotic lesions in human and animal studies.
Curcumin, omega 3 and NAC were found to prevent the pathogenesis or recurrence of the disease in animal studies.
The studies conducted are summarized in Table 1.
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Source: Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022 Mar 14;93(1):e2022159. doi: 10.23750/abm.v93i1.11237. PMID: 35315418; PMCID: PMC8972862.
