To assess the impact of an antioxidant preparation with N-acetyl cysteine, alpha lipoic acid and bromelain on endometriosis-associated pelvic pain.
Multicenter, open-label, non-comparative clinical trial in a representative sample of women with endometriosis-associated pelvic pain.
In total, 398 patients with a mean age of 34.6 ± 7.2 years were treated with a combination of N-acetyl cysteine, alpha lipoic acid and bromelain for 6 months. At baseline, 92.7% of the patients had pain intensity > 4 on the visual analogue scale (VAS); at 3 months of treatment, this percentage decreased to 87.2% (p = 0.074) and at 6 months the percentage was 82.7% (p < 0.05).
Women with endometriosis who wish to become pregnant and are treated with a preparation containing N-acetyl cysteine, alpha lipoic acid and bromelain experienced a significant improvement in endometriosis-associated pelvic pain and required lower intake of rescue analgesics.
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- Correlation between aromatase expression in the eutopic endometrium of symptomatic patients and the presence of endometriosis.Int J Womens Health. 2012; 4: 61-65
- The American College of obstetricians and gynecologists. Practice bulletin: management of endometriosis.Obstet Gynecol. 2010; 116: 223-236
- Nuevas perspectivas en la endometriosis: desde la fisiopatología al tratamiento médico de la enfermedad.Rev Iberoam Fertil. 2011; 28: 15-31
- Oxidation-sensitive nociception involved in endometriosis-associated pain.Pain. 2015; 156: 528-539
- Antioxidant supplementation reduces endometriosis-related pelvic pain in humans.Transl Res. 2013; 161: 189-195
- Effects of amifostine on endometriosis, comparison with N-acetyl cysteine, and leuprolide as a new treatment alternative: a randomized contolled trial.Arch Gynecol Obstet. 2014; 289: 193-200
- The combination of N-acetyl cysteine, alpha-lipoic acid, and bromelain shows high anti-inflammatory properties in novel in vivo and in vitro models of endometriosis.Mediat Inflamm. 2015; (ID 918089)
- Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International deep endometriosis analysis (IDEA) group.Ultrasound Obstet Gynecol. 2016; 48: 318-332
- Developing patient-reported outcome measures for pain clinical trials: IMMPACT recommendations.Pain. 2006; 125: 208-215
- Mechanistic and therapeutic implications of angiogenesis in endometriosis.Reprod Sci. 2009; 16: 140-146
- Antioxidants and free radical scavengers.New Compr Biochem. 1994; 28: 113-130
- Effects of oxidants and antioxidants on proliferation of endometrial stromal cells.Fertil Steril. 2004; 82: S1019-S1022
- Oxidative stress may be a piece in the endometriosis puzzle.Fertil Steril. 2003; 79: 1288-1293
- Increased expression of glutathione by estradiol, tumor necrosis factor-alpha, and interleukin 1-beta in endometrial stromal cells.Am J Reprod Immunol. 2009; 62: 352-356
- Quantitative and qualitative peritoneal immune profiles, T-cell apoptosis and oxidative stress-associated characteristics in women with minimal and mild endometriosis.BJOG. 2011; 118: 6-16
- Women with endometriosis improved their peripheral antioxidant markers after the application of a high antioxidant diet.Reprod Biol Endocrinol. 2009; 7: 54
- Role of N-acetylcysteine in the management of COPD.Int J Chron Obstruct Pulm Dis. 2006; 1: 425-434
- Molecular mechanisms of N-acetylcysteine actions.Cel Mol Life Sci. 2003; 60: 6-20
- Reactive oxygen species and synthetic antioxidants as angiogenesis modulators: clinical implications.Pharm Rep. 2016; 68: 462-471
- Vascular endothelial growth factor (VEGF) is an autocrine growth factor for VEGF receptor–positive human tumors.Blood. 2001; 98: 1904-1913
- Reactive oxygen species controls endometriosis progression.Am J Pathol. 2009; 175: 225-234
- More than antioxidant: N-acetyl-L-cysteine in a murine model of endometriosis.Fertil Steril. 2010; 94: 2905-2908
- Effects of amifostine on endometriosis, comparison with N-acetyl cysteine, and leuprolide as a new treatment alternative: a randomized controlled trial.Arch Gynecol Obstet. 2014; 289: 193-200
- A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine.Evid Based Complement Alternat Med. 2013; 2013: 240702
Published online: July 06, 2018
Accepted: July 2, 2018
Received in revised form: May 11, 2018
Received: March 16, 2018
© 2018 Elsevier B.V. All rights reserved.