Effect of Dietary Interventions on Endometriosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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This systematic review and meta-analysis of 11 RCTs found that antioxidant supplementation may reduce dysmenorrhea in women with endometriosis, but heterogeneity and risk of bias limit conclusions.

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This paper systematically reviewed randomized controlled trials evaluating dietary interventions for endometriosis, using database searches across PubMed, EMBASE, CENTRAL, CINAHL, and others, and included 11 RCTs (716 women) for the review and 6 RCTs (457 women) for meta-analysis, with duplicate blinded selection and risk-of-bias assessment. Most included studies reported improvements in endometriosis pain scores, but the overall evidence was limited by moderate to high risk of bias and substantial heterogeneity across trials. In the meta-analysis versus placebo, antioxidant use was associated with a reduction in dysmenorrhea, while supplementation did not show statistically significant effects on chronic pelvic pain or dyspareunia; low-risk-of-bias studies also did not show significant effects. This paper is centrally about endometriosis — it evaluates dietary interventions and antioxidants for pain outcomes in women with endometriosis via systematic review and meta-analysis of RCTs.

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Abstract

This study aimed to systematically review existing randomized clinical trials on the effect of dietary interventions on endometriosis. A search was performed on the Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinical Trials, EMBASE, PubMed, Lilacs, and Cielo databases. The search terms were used: “endometriosis”, “endometrioma”, “diet”, “supplements” and “nutrition”. Electronic literature searches through databases yielded 866 publications. Two authors performed The study selection independently (and blinded), and disagreements were discussed. Eleven RCTs were included in the systematic review, with 716 women randomized. Most studies reported a positive effect on endometriosis pain scores; however, they were characterized by moderate or high-risk bias. Of these, six RCTs, including 457 women with endometriosis, were included in the meta-analysis. Compared with Placebo, antioxidant use was associated with a reduction in dysmenorrhea (mean difference − 1.95 [CI 95%, -3.78 to -0.13]. Supplementation was not significant for reducing chronic pelvic pain (mean difference − 2.22 [95% CI, -4.99 to 0.55] and dyspareunia (MD − 2.56 [95% CI, − 5. 22 to 0.10]. Both analyses showed a high degree of heterogeneity. Moreover, studies with low risk of bias did not show significant results compared to those on Placebo. The effects of nutrient compounds seem to have the potential to reduce pain in women with endometriosis, mainly to reduce dysmenorrhea. However, the available studies present high heterogeneity and moderate/high risk of bias. More randomized clinical trials are needed to accurately determine dietary interventions’ short- and long-term efficacy and safety in managing endometriosis pain. Similar content being viewed by others Data Availability Data regarding any of the subjects in the study has not been previously published. Data will be made available to the journal editors for review or query upon request.

References

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Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Electronic Supplementary Material Below is the link to the electronic supplementary material. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Meneghetti, J.K., Pedrotti, M.T., Coimbra, I.M. et al. Effect of Dietary Interventions on Endometriosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Reprod. Sci. 31, 3613–3623 (2024). https://doi.org/10.1007/s43032-024-01701-w Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-024-01701-w

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mesh:D004412mesh:D004715mesh:D017699endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Randomized Controlled Trials as Topic Randomized Controlled Trials as Topic Randomized Controlled Trials as Topic

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