The Effect of Combined Vitamin C and Vitamin E Supplementation on Oxidative Stress Markers in Women with Endometriosis: A Randomized, Triple-Blind Placebo-Controlled Clinical Trial.

Leila Amini, Razieh Chekini, Mohammad Reza Nateghi, Hamid Haghani, Tannaz Jamialahmadi, Thozhukat Sathyapalan, Amirhossein Sahebkar

Journal: Pain research & management 2021;2021():5529741

PMID: 34122682

Plain Language Summary

plain language summary logo

Endometriosis (EMS) is a chronic and estrogen-dependent pelvic inflammatory disease that arises from ectopic endometrial implantation and growth outside the uterus cavity. Oxidative stress, an imbalance between reactive oxygen spices and biological antioxidants, could play a key role in EMS pathophysiology. The aim of this study was to evaluate the effect of vitamin C and vitamin E coadministration on oxidative stress (OS) markers as well as pain severity in women with endometriosis. This study is a randomized placebo-controlled clinical trial on 60 reproductive-aged (15–45 years) women with pelvic pain and 1–3 stages of laparoscopic-proven endometriosis. The participants, researchers, and statistician were blind about the groups. The participants were randomly assigned to two groups by the simple randomization method: group A - intervention (n = 30) or group B - palcebo (n = 30). Results show that supplementation with vitamin C and vitamin E effectively reduces systemic OS indices in women with endometriosis. Authors conclude that their findings further support the potential role of antioxidants in the management of EMS.

Abstract

BACKGROUND

Endometriosis is a chronic and estrogen-dependent pelvic inflammatory disease, which may have various causes, such as oxidative stress. Dysmenorrhea, dyspareunia, and pelvic pain are well-known symptoms of endometriosis. The present clinical trial assessed the role of supplementation with antioxidant vitamins on the indices of oxidative stress as well as the severity of pain in women with endometriosis.

MATERIALS AND METHODS

We enrolled 60 reproductive-aged (15-45 years) women with pelvic pain in this triple-blind clinical trial. They had 1-3 stages of laparoscopic-proven endometriosis. The participants were randomized to group A ( = 30), given vitamin C (1000 mg/day, 2 tablets of 500 mg each) and vitamin E (800 IU/day, 2 tablets of 400 IU each) combination, or group B ( = 30), given placebo pills daily for 8 weeks.

RESULTS

Following treatment with vitamin C and vitamin E, we found a significant reduction in MDA and ROS compared with the placebo group. There was no significant decline in total antioxidant capacity after treatment. However, the severity of pelvic pain ( value <0.001), dysmenorrhea ( value <0.001), and dyspareunia ( value <0.001) significantly decreased in the treatment group after 8 weeks of supplementation.

CONCLUSIONS

The present findings support the potential role of antioxidants in the management of endometriosis. The intake of vitamin C and vitamin E supplements effectively reduced dysmenorrhea severity and improved dyspareunia and severity of pelvic pain.

Copyright © 2021 Leila Amini et al.

Address: Nursing Care Research Center (NCRC), Iran University of Medical Sciences, Tehran, Iran.; Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.; School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.; Sarem Fertility & Infertility Research Center (SAFIR), Iran University of Medical Sciences, Tehran, Iran.; Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.; Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran.; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.; Academic Diabetes Endocrinology and Metabolism, Hull York Medical School, University of Hull, United Kingdom of Great Britain and Northern Ireland, Hull, UK.; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.; School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

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