The Use of Resveratrol as an Adjuvant Treatment of Pain in Endometriosis

The authors concluded that resveratrol is not an effective treatment to reduce pain in endometriosis.

Key Points

Highlights:

• The effect of resveratrol in reducing pain level in patients with endometriosis was studied using a randomized, double-blind, and placebo-controlled study design.

What’s done here:

• The primary objective was to verify whether the use of a monophasic contraceptive pill (COC) plus 40 mg per day of resveratrol is sufficient to reduce pain in patients with endometriosis.
• The use of medication for pain in both groups was also compared.
• The level of biomarkers such as carcinoembryonic antigen (CA-125) and prolactin was monitored after the treatments.

Key results:

• No difference was observed in pain scores between the groups after 42 days of treatment.
• The pain values were [3.9 (2.2 to 5); n=22] in the placebo and [3.2 (2.1 to 4.3); n=22] in the resveratrol groups, respectively (P = 0.7; Mann-Whitney U test).
• CA-125 levels were reduced significantly in both groups, but no difference was observed between the groups.
• Prolactin levels did not vary by treatment type or over time in both groups.
• No difference was observed in final pain scores between groups by use or not of analgesics.

Limitations:

• A more prolonged or different course of treatment (>42 days) is required.
• Pain scores are prone to recall bias.

Lay Summary

Endometriosis is considered a predominantly estrogen-dependent disease, and therefore hormonal suppression might be an attractive medical approach to treat this disease and its symptoms. Resveratrol is a natural phytoestrogen synthesized by plants and has known to have side effects such as mild, mainly related to a headache and drowsiness. The use of resveratrol has been suggested to treat endometriosis, due to its anti-proliferative action, but the potential benefits and harms have not been demonstrated in endometriosis patients. Therefore, this group wanted to verify whether the use of resveratrol is efficient to reduce pain in patients with endometriosis using a randomized, double-blind, placebo-controlled study design.

For each group, 22 subjects were analyzed as ITT (intention to Treat). After seven days of treatment, pain scores were significantly reduced in the resveratrol group, compared with the placebo group. After 42 days of treatment, however, no difference was observed in pain scores between the groups. The pain values were [3.9 (2.2 to 5); n=22] in the placebo and [3.2 (2.1 to 4.3); n=22] in the resveratrol groups after treatment. Median (95% CI) difference between groups was 0.75 (–1.6 to 2.3). They also compared the effect of medication, the level of biomarkers such as CA-125 and prolactin in both groups. CA-125 levels were reduced after 42 days of treatment in placebo (P = 0.01; RM-2 Way ANOVA) and the resveratrol group (P = 0.02; RM-2 Way ANOVA), but no difference was observed between the groups. Prolactin levels did not vary by treatment type or over time, and the use of analgesics had no effects on final pain scores between two groups.

In conclusion, the authors found that the use of resveratrol is not superior to placebo for treatment of pain in endometriosis. However, further studies using a longer course of therapy (>42 days) and a better system to measure pain are required.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29264492