Role of Antioxidants (Vitamin E and Vitamin C) Supplementation for Management of Chronic Pelvic Pain Related to Endometriosis

Alnaggar, Mahmoud; Abdelfattah, Ahmed; Saeed, Ibtesam

doi:10.21608/zumj.2020.25329.1768

Cited by 2 publications

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“…Of 22 records screened for full-text eligibility, 17 studies were excluded based on the following reasons: seven articles were not using combination of vitamin C and vitamin E as the antioxidant component, six articles lacked data pertaining to the outcomes, and four articles were omitted as they were review articles. Ultimately, the remaining 5 randomized clinical trials (RCTs) [14][15][16][17][18] with a total of 338 endometriosis patients were included in the final analysis (Fig 1). One RCT had triple-blinding method, one RCT had double-blinding method, and the remaining three RCTs did not specify the blinding methods they used.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials

Bayu,

Wibisono

2024

PLoS ONE

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Background The primary challenge encountered by individuals diagnosed with endometriosis is the experience of pain. Emerging research indicates that oxidative stress is implicated in the initiation of pain associated with endometriosis. Vitamins C and E are known for their antioxidative properties. The primary objective of this study is to assess the efficacy of antioxidant supplementation, consisting of these vitamins, in the management of pain associated with endometriosis. Methods A comprehensive search was conducted on the ClinicalTrials.gov, Scopus, Europe PMC, and Medline databases up until August 23rd, 2023, utilizing a combination of relevant keywords. This review incorporates literature that examines the relationship between antioxidant supplementation and pain in endometriosis. We employed fixed-effect models to analyze the risk ratio (RR) and present the outcomes together with their corresponding 95% confidence intervals (CI). Results A total of five RCTs were incorporated. The results of our meta-analysis indicated that antioxidant supplementation with vitamin C and E combination was associated with higher proportion of endometriosis patients reporting reduced chronic pelvic pain (RR 7.30; 95%CI: 3.27–16.31, p<0.00001, I2 = 0%), alleviations of dysmenorrhea (RR 1.96; 95%CI: 1.25–3.07, p = 0.003, I2 = 39%), and dyspareunia (RR 5.08; 95%CI: 2.10–12.26, p = 0.0003, I2 = 0%) than patients only receiving placebo. Conclusions This study suggests the potential ability of vitamin C and E in alleviating pain symptoms experienced by individuals with endometriosis.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials

Bayu,

Wibisono

2024

PLoS ONE

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Antioxidant vitamins supplementation reduce endometriosis related pelvic pain in humans: a systematic review and meta-analysis

Zheng,

Chen,

Chen

et al. 2023

Reprod Biol Endocrinol

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Objective This study aimed to clarify the effect of antioxidant vitamins supplementation on endometriosis-related pain. Methods A systematic search of PubMed, Web of Science, Cochrane Library, Scopus, and China National Knowledge Infrastructure (CNK) databases was conducted to identify relevant studies published in English and Chinese up to 16 March 2023. The search terms used were "endometriosis" OR "endometrioma" OR "endometrium" AND "antioxidant" OR "Vitamin C" OR "Vitamin E" OR "Vitamin D" OR "25-OHD" OR "25(OH)D" OR "25-hydroxyvitamin D". Eligible studies were randomized controlled trials (RCTs) that assessed pain scores using the Visual Analogue Scale (VAS). Mean differences or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the effect of antioxidant vitamins supplementation on endometriosis. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results A total of 13 RCTs involving 589 patients were included in this meta-analysis. We identified 11 studies that evaluated the effect of antioxidant vitamins supplementation on endometriosis-related pain. The results indicated that the supplementation of antioxidant vitamins can effectively alleviate endometriosis-related pain. Subgroup analysis showed that the supplementation of vitamin E (with or without vitamin C) had a positive effect on improving clinical pelvic pain in patients with chronic pelvic pain. Conversely, supplementation of vitamin D was associated with a reduction in pelvic pain in endometriosis patients, but the difference was not statistically significant compared to the placebo. Additionally, we observed changes in oxidative stress markers following vitamin supplementation. Plasma malondialdehyde (MDA) concentration decreased in patients with endometriosis after antioxidant vitamin supplementation, and the plasma MDA level was inversely correlated with the time and dose of vitamin E and C supplementation. Furthermore, the inflammatory markers in peritoneal fluid, including RANTES, interleukin-6, and monocyte chemoattractant protein-1, significantly decreased after antioxidant therapy. These findings suggest that antioxidant vitamins may alleviate pain in endometriosis patients by reducing inflammation. Conclusions The included studies support the potential role of antioxidant vitamins in the management of endometriosis. Supplementation with antioxidant vitamins effectively reduced the severity of dysmenorrhea, improved dyspareunia and pelvic pain, and enhanced quality of life in these patients. Therefore, antioxidant vitamin therapy could be considered as an alternative treatment method, either alone or in combination with other approaches, for endometriosis-related pain. Trial registration PROSPERO registration number: CRD42023415198.

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Role of Antioxidants (Vitamin E and Vitamin C) Supplementation for Management of Chronic Pelvic Pain Related to Endometriosis

Cited by 2 publications

References 0 publications

Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials

Vitamin C and E antioxidant supplementation may significantly reduce pain symptoms in endometriosis: A systematic review and meta-analysis of randomized controlled trials

Antioxidant vitamins supplementation reduce endometriosis related pelvic pain in humans: a systematic review and meta-analysis

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