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.

Pain research & management. 2021;2021:5529741
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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 (n = 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 (n = 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 (p value <0.001), dysmenorrhea (p value <0.001), and dyspareunia (p 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.

Lifestyle medicine

Fundamental Clinical Imbalances : Hormonal ; Structural
Patient Centred Factors : Mediators/Endometriosis
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Blood

Methodological quality

Jadad score : 5
Allocation concealment : Yes

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