Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 27;24(19):14601.
doi: 10.3390/ijms241914601.

Mediterranean Diet and Oxidative Stress: A Relationship with Pain Perception in Endometriosis

Michela Cirillo  1   2 , Flavia Rita Argento  3 , Matteo Becatti  3 , Claudia Fiorillo  3 , Maria Elisabetta Coccia  2   3 , Cinzia Fatini  1   2
Affiliations

Mediterranean Diet and Oxidative Stress: A Relationship with Pain Perception in Endometriosis

Michela Cirillo et al. Int J Mol Sci. .

Abstract

Background: Endometriosis is a chronic and inflammatory disease associated with pelvic pain. Dietary changes may be therapeutic for chronic inflammatory processes, reducing visceral input. The aim was to evaluate the role of dietary changes according to the Mediterranean Diet (MD) on pain perception in endometriosis and their relationship with oxidative stress.

Methods: in this prospective study, we included 35 endometriosis women. At baseline (T0) and after 3 (T1) and 6 (T2) months from the start of the diet, we investigated pain intensity with VAS (Visual Analogue Scale, from 0 to 10), vitamin profile, and oxidative stress.

Results: we found a significant increase in the diet score (p < 0.001). At T1, patients reduced pain in terms of dyspareunia (p = 0.04), non-menstrual pelvic pain (p = 0.06), dysuria (p = 0.04), and dyschezia (p < 0.001). Dyspareunia (p = 0.002) and dyschezia (p < 0.001) were further significantly reduced also at T2. We observed a significant positive correlation between lipid peroxidation and VAS non-menstrual pelvic pain and dysuria and a significant negative correlation between Oxygen radical absorbance capacity and VAS non-menstrual pain and dyschezia.

Conclusions: our findings show a clear tendency toward a relationship between pain relief in endometriosis and MD. This appears promising to treat endometriosis-related symptoms and could be considered a new effective strategy for chronic pain management in the long term.

Keywords: chronic pelvic pain; diet; endometriosis; inflammation; lifestyle; pain management.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mediterranean Score adherence (scores range from 0 to 18) from T0 to T2. * T0 vs. T1, ** T0 vs. T2. Values are expressed as median (range).
Figure 2
Figure 2
Changes in adherence to the Mediterranean Diet (expressed as percentages) for fruit and vegetable consumption from T0 to T1 (a,c) and from T0 to T2 (b,d). 0 = 0 points at the Mediterranean adherence score; 1 = 1 point at the Mediterranean adherence score; 2 = 2 points at the Mediterranean adherence score.
Figure 3
Figure 3
Changes in adherence to the Mediterranean Diet (expressed as percentages) for legumes and cereals consumption from T0 to T1 (a,c) and from T0 to T2 (b,d). 0 = 0 points at the Mediterranean adherence score; 1 = 1 point at the Mediterranean adherence score; 2 = 2 points at the Mediterranean adherence score.
Figure 4
Figure 4
Changes in adherence to the Mediterranean Diet (expressed as percentages) for meat and meat products and fish consumption from T0 to T1 (a,c) and from T0 to T2 (b,d). 0 = 0 points at the Mediterranean adherence score; 1 = 1 point at the Mediterranean adherence score; 2 = 2 points at the Mediterranean adherence score.
Figure 5
Figure 5
Changes in VAS Pain (scores range from 0 to 10) from T0 to T2. * T0 vs. T1, ** T0 vs. T2. Values are expressed as median (range).
See this image and copyright information in PMC

References

    1. Giudice L.C. Clinical practice. Endometriosis. N. Engl. J. Med. 2010;362:2389–2398. doi: 10.1056/NEJMcp1000274. - DOI - PMC - PubMed
    1. Zondervan K.T., Becker C.M., Missmer S.A. Endometriosis. N. Engl. J. Med. 2020;382:1244–1256. doi: 10.1056/NEJMra1810764. - DOI - PubMed
    1. Agarwal S.K., Chapron C., Giudice L.C., Laufer M.R., Leyland N., Missmer S.A., Singh S.S., Taylor H.S. Clinical diagnosis of endometriosis: A call to action. Am. J. Obstet. Gynecol. 2019;220:354.e1–354.e12. doi: 10.1016/j.ajog.2018.12.039. - DOI - PubMed
    1. As-Sanie S., Black R., Giudice L.C., Valbrun T.G., Gupta J., Jones B., Laufer M.R., Milspaw A.T., Missmer S.A., Norman A., et al. Assessing research gaps and unmet needs in endometriosis. Am. J. Obstet. Gynecol. 2019;221:86–94. doi: 10.1016/j.ajog.2019.02.033. - DOI - PubMed
    1. Becker C.M., Gattrell W.T., Gude K., Singh S.S. Reevaluating response and failure of medical treatment of endometriosis: A systematic review. Fertil Steril. 2017;108:125–136. doi: 10.1016/j.fertnstert.2017.05.004. - DOI - PMC - PubMed

LinkOut - more resources