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"We have read for you": antioxidants against oxidative stress caused by endometriosis

To deal with endometriosis is a real challenge. We have already seen together that endometriosis can be managed with drugs or surgery, but the recurrence rate is very high. Researchers have been "exploring" the world of antioxidants for some years to use them as a possible tool to reduce the progression of the disease and reduce pain and inflammation associated with this condition.

What are antioxidants?

Antioxidants are substances, both artificial and natural, that protect the body from oxidative processes and possible metabolic alterations, as well as cellular damage and cell death. The term "oxidative process" or "oxidative stress" or "REDOX imbalance" indicates the set of alterations that occur in tissues, cells and biological macromolecules when they are exposed to an excess of oxidizing agents. These chemical reactions are triggered by free oxygen and produce so-called "free radicals", which can cause serious damage to the body.

Antioxidants can be found in fruits, vegetables and food supplements. Antioxidants, as the name also suggests, are opponents of this oxidation.

How can antioxidants counteract endometriosis?

It is believed that an internal chemical imbalance caused by oxidative stress contributes to the development of endometriosis and many other medical conditions. Antioxidant intake has been shown to reduce both pelvic pain associated with endometriosis and oxidative stress.

Are antioxidants a valid treatment option?

Some studies have shown that antioxidant supplementation reduces oxidative stress and pelvic pain.

Let's see two recent studies together.

In the study "Effect of alpha-lipoic acid on an experimental rat model" some researchers led by Pınar observed the antioxidant and anti-inflammatory effects of alpha-lipoic acid (ALA) in the treatment of endometriosis in an experimental model of rat evaluating the biochemical and histopathological parameters. Experimental endometriosis was induced by peritoneal implantation of autologous endometrial tissue (it means that endometriosis was artificially triggered).

Rats were divided with causality criteria into two groups of eight rats each. In group 1, ALA 100 mg/kg/day was administered intraperitoneally for 14 days. In group 2, a saline solution was administered intraperitoneally at the same dosage and in the same period. The volume of endometrial implants was measured in both groups, both before and after treatment. Total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) were evaluated in serum while tumor necrosis factor alpha (TNF-α) was measured in peritoneal fluid.

At the end of the administration in the Group 1 group, that is to say the one who took ALA, the serum TOS and OSI levels, the endometrial implant volumes, the serum and peritoneal fluid levels of TNF-α and the histopathological scores were significantly lower than the control group. Researchers have concluded that alpha-lipoic acid, thanks to its antioxidant and anti-inflammatory effects, can have therapeutic potential in the treatment of endometriosis.

In another study by Lete and his team "Effectiveness of an antioxidant preparation with N-acetylcysteine, alpha lipoic acid and bromelain in the treatment of endometriosis-associated pelvic pain: LEAP study" of the Autonoma University of Barcelona, published in the european journal of Obstetrics, Ginecology and Reproductive Biology, a total of 398 patients with an average age of 34.6 years were examined where 92.7% reported pelvic pain associated with moderate or intense endometriosis. For the study, patients were given a combination of N-acetylcysteine 600 mg, alpha-lipoic acid 200 mg, bromelain 25 mg and zinc 10 mg for 6 months at a dose of 2 tablets a day.

The results showed a significant decrease in the percentage of patients with pelvic pain associated with endometriosis, from 92.7% before treatment to 82.7% after the 6-month treatment. Furthermore, there was also a significant reduction in the pain scale of the VAS score, with severe pain reported in 40.2% at baseline at 3.6% at 6 months. Therefore, the authors concluded that the combination of bromelain, alpha-lipoic acid and N-acetylcysteine represents a promising approach to improve pelvic pain associated with endometriosis.

Studies have confirmed that oxidative stress increases inflammation and associated pain. The results of both studies showed that patients with endometriosis who had taken antioxidants for a few months, the pain had significantly reduced. Furthermore, subjects period resorted significantly less to the use of pain medication during the study.

So how can antioxidants fit into the prescriptions of the future?

The researchers propose the hypothesis that endometriosis is a condition caused by oxidative stress. Several studies have confirmed that antioxidants can reduce chronic pelvic pain and peritoneal inflammatory markers in women with endometriosis. We have already seen how also quercetin, a famous flavonoid, has a strong antioxidant power. The idea of scholars is that other antioxidants, not just those tested, should be able to suppress oxidative stress that causes pain and improve the general condition of women with endometriosis. For this reason, new "antioxidant cocktails" are being studied and researched. The promising ingredients are many, much hope is turned to Quercetin, Alpha Lipoic Acid, Bromelain and Morinda Citrifolia.

Obstetrician Sara Furno

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