The Use of Resveratrol as an Adjuvant Treatment of Pain in Endometriosis: A Randomized Clinical Trial

Abstract

Context:Resveratrol has been used for the treatment of endometriosis.Objective:To compare resveratrol (40 mg/d) with monophasic contraceptive pill (COC) to COC with placebo for the reduction of pain scores.Design:A randomized clinical trial.Setting:University Hospital.Patients:Women (ages 20 to 50) with laparoscopic diagnosis of endometriosis were eligible for the study. Exclusion criteria: pregnancy, allergy to resveratrol, or contraindications to COC, use of agonists of gonadotropin release hormone or danazol in the last month, or had used depot medroxyprogesterone acetate or Mirena®.Intervention:Subjects were randomized using a computer-generated randomization list to receive COC for 42 days to be taken with identical capsules containing 40 mg of resveratrol or placebo in coded bottles (1:1 ratio). Allocation was concealed in coded, sequenced, opaque-sealed envelopes.Main Outcome:Median pain scores measured with a visual analog scale on day 42.Results:Between 18 June and 6 November 2015, 44 subjects were enrolled. Mean [95% confidence interval (CI)] pain scores on day 0 were 5.4 (4.2 to 6.6) in the placebo group and 5.7 (4.8 to 6.6) in resveratrol groups. After treatment, pain values were [3.9 (2.2 to 5); n = 22] and [3.2 (2.1 to 4.3); n = 22] in the placebo and resveratrol groups, respectively (P = 0.7; Mann-Whitney U test). Median (95% CI) difference between groups was 0.75 (–1.6 to 2.3).Conclusion:Resveratrol is not superior to placebo for treatment of pain in endometriosis.

Is Scientific Medical Literature Related to Endometriosis Treatment Evidence-Based? A Systematic Review on Methodological Quality of Randomized Clinical Trials

“…In addition, just four articles out of 30 were classified as having a low risk of bias in all four evaluated categories. Overlapping this result with the one above, we observed that the four articles with low risk of bias were also found in the list with the highest total scores [26,39,41,44] (Table 2 and Figure 2), thus being the most reliable of all 30 DB-RCTs. Since the presence of one or two unclear risks of bias could jeopardize the study’s validity, more details could be needed to interpret the reported findings properly.…”

“…Only seven articles [26,34,37,39,41,44,51] gained an overall score ≥23 points (approximatively 88% of the maximum possible total score). Thus, they were the closest to reaching a high-quality status according to the evaluated methodological items.…”

Therapeutic Approaches of Resveratrol on Endometriosis via Anti-Inflammatory and Anti-Angiogenic Pathways

“…Mendes da Silva et al [ 117 ] also conducted a randomized clinical trial to observe the effectiveness of resveratrol in the management of endometriosis, associated with monophasic contraceptive pills. They included in the study 44 women aged 20 to 50, who randomly received two pills for 42 days: one tablet was an oral contraceptive and the other 40 mg of resveratrol or placebo pills.…”

Anti-Angiogenic Alternative and Complementary Medicines for the Treatment of Endometriosis: A Review of Potential Molecular Mechanisms

“…Resveratrol could reduce the pain scores and the level of carcinoembryonic antigen (CA125) in the treatment of endometriosis-associated pain patients in randomized clinical trials. However, the effects of resveratrol combined with the combined oral contraceptive (COC) were not superior to those of COC alone after 42 days of treatment [ 85 ].…”