Phytotherapy as an alternative endometriosis treatment

An up-to-date review of the use of medicinal plants in endometriosis

Key Points

Highlight:

• Dr. Garzon group suggests that properly constructed clinical trials are mandatory to achieve more conclusive results about the promising role of phytotherapy in the management of endometriosis.

Background:

• The efficacy of conventional medical treatments is limited or intermittent in most patients with endometriosis, therefore, alternative options are highly required.
• Phytotherapy, with the use of medicinal plants, has shown positive effects in the treatment of menopausal symptoms or sexual dysfunction.
• Some studies investigated important pathways in endometriosis as possible targets of phytotherapy such as angiogenesis, inflammation and invasion and so on.

Key points:

• Several specific phytochemicals extracted from plants were investigated as a single agent in endometriosis, including curcumin and resveratrol.
• Curcumin
• It is a major chemical compound of turmeric.
• It was related to the reduction of both estrogen levels and stromal cells in endometriotic implants.
• It was also reported to induce apoptosis and inhibit angiogenesis and invasiveness, and modulate inflammatory signaling.
• Resveratrol
• It is a polyphenol produced by many plants.
• It is associated with antioxidant, anti-inflammatory, and anti-angiogenic functions.
• It was also reported to increase antioxidant capacity, apoptosis and cell differentiation in endometriosis in vivo rat models.

Conclusions:

• Phytotherapy may have promising effects in endometriosis, and most of the effects are mainly due to the phenolic compounds and estrogen-modulating effects.
• To confirm the effect in the clinical setting, well-conducted clinical trials are mandatory

Lay Summary

Endometriosis is an estrogen-dependent gynecological disease that affects 5–10% of women in fertile age. Different therapeutic strategies are available to treat this disease, such as surgery, hormonal therapies, and nonsteroidal anti-inflammatory drugs. 

Medical therapy usually consists of different hormonal drugs, including combined hormonal contraceptives, progestogens, anti-progestogens, and so on. To date, there is no robust evidence to support a specific hormonal therapy over the others. Although multiple pharmacological strategies are available, a recent systematic review showed that the efficacy of conventional medical treatments is limited or intermittent in most patients. 

Phytotherapy, with the use of medicinal plants, is an alternative source of new strategies to manage endometriosis. Previous researches demonstrated the positive effects of phytotherapy in the treatment of menopausal symptoms or sexual dysfunction. Some studies investigated important pathways in endometriosis as possible targets of phytotherapy. These pathways include angiogenesis mediated by the vascular endothelial growth factor, altered inflammatory microenvironment involving cytokines and immune cells, oxidative stress, and the attachment and invasion mechanisms.

Given the understanding, it is clear to investigate the different plants as a complex group of molecular compounds effective in endometriosis. Dr. Garzon group recently published the up-to-date review of Phytotherapy in the journal “Journal of Complementary and Integrative Medicine”.Several specific phytochemicals extracted from plants were investigated as a single agent in endometriosis, including curcumin and resveratrol. Curcumin is the major chemical compound of Curcuma longa. It was related to the reduction of both estrogen levels and stromal cells in endometriotic implants. It was also reported to induce apoptosis and inhibit angiogenesis and invasiveness. Furthermore, it has shown to modulate inflammatory signaling.

Another example is resveratrol, which is a polyphenol produced by many plants. It is associated with antioxidant, anti-inflammatory, and anti-angiogenic functions. It was also reported to increase antioxidant capacity, apoptosis and cell differentiation in endometriosis in vivo rat models.

In conclusion, phytotherapy may have promising effects in endometriosis, and most of the effects are mainly due to the phenolic compounds and estrogen-modulating effects. To confirm the effect in the clinical settings, well-conducted clinical trials are mandatory.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/31532753