Abstract: Background: Endometriosis is a chronic, estrogen-dependent, inflammatory disease, whose pivotal symptoms are dysmenorrhea, dyspareunia, and chronic pelvic pain (CPP). Besides the usual medical treatments, recent evidence suggests there are potential benefits of oral N-acetylcysteine (NAC) on endometriotic lesions and pain. The primary objective of this prospective single-cohort study was to confirm the effectiveness of NAC in reducing endometriosis-related pain and the size of ovarian endometriomas. The secondary objective was to assess if NAC may play a role in improving fertility and reducing the Ca125 serum levels. Methods: Patients aged between 18–45 years old with a clinical/histological diagnosis of endometriosis and no current hormonal treatment or pregnancy were included in the study. All patients received quarterly oral NAC 600 mg, 3 tablets/day for 3 consecutive days of the week for 3 months. At baseline and after 3 months, dysmenorrhea, dyspareunia and CPP were assessed using the Visual Analog Scale score (VAS), while the size of the endometriomas was estimated through a transvaginal ultrasound. Analgesics (NSAIDs) intake, the serum levels of Ca125 and the desire for pregnancy were also investigated. Finally, the pregnancy rate of patients with reproductive desire was evaluated. Results: One hundred and twenty patients were recruited. The intensity of dysmenorrhea, dyspareunia and CPP significantly improved (p < 0.0001). The use of NSAIDs (p = 0.001), the size of the endometriomas (p < 0.0001) and the serum levels of Ca125 (p < 0.0001) significantly decreased. Among the 52 patients with reproductive desire, 39 successfully achieved pregnancy within 6 months of starting therapy (p = 0.001). Conclusions: Oral NAC improves endometriosis-related pain and the size of endometriomas. Furthermore, it decreases Ca125 serum levels and may improve fertility in patients with endometriosis.

Efficacy of n-acetylcysteine on endometriosis-related pain, size reduction of ovarian endometriomas, and fertility outcomes / Anastasi, Emanuela; Scaramuzzino, Sara; Viscardi, MARIA FEDERICA; Viggiani, Valentina; Piccioni, Maria Grazia; Cacciamani, Laura; Merlino, Lucia; Angeloni, Antonio; Muzii, Ludovico; Porpora, Maria Grazia. - In: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH. - ISSN 1660-4601. - 20:6(2023), pp. 1-8. [10.3390/ijerph20064686]

Efficacy of n-acetylcysteine on endometriosis-related pain, size reduction of ovarian endometriomas, and fertility outcomes

Emanuela Anastasi;Sara Scaramuzzino;Maria Federica Viscardi;Valentina Viggiani;Maria Grazia Piccioni;Laura Cacciamani;Lucia Merlino;Antonio Angeloni;Ludovico Muzii;Maria Grazia Porpora
2023

Abstract

Abstract: Background: Endometriosis is a chronic, estrogen-dependent, inflammatory disease, whose pivotal symptoms are dysmenorrhea, dyspareunia, and chronic pelvic pain (CPP). Besides the usual medical treatments, recent evidence suggests there are potential benefits of oral N-acetylcysteine (NAC) on endometriotic lesions and pain. The primary objective of this prospective single-cohort study was to confirm the effectiveness of NAC in reducing endometriosis-related pain and the size of ovarian endometriomas. The secondary objective was to assess if NAC may play a role in improving fertility and reducing the Ca125 serum levels. Methods: Patients aged between 18–45 years old with a clinical/histological diagnosis of endometriosis and no current hormonal treatment or pregnancy were included in the study. All patients received quarterly oral NAC 600 mg, 3 tablets/day for 3 consecutive days of the week for 3 months. At baseline and after 3 months, dysmenorrhea, dyspareunia and CPP were assessed using the Visual Analog Scale score (VAS), while the size of the endometriomas was estimated through a transvaginal ultrasound. Analgesics (NSAIDs) intake, the serum levels of Ca125 and the desire for pregnancy were also investigated. Finally, the pregnancy rate of patients with reproductive desire was evaluated. Results: One hundred and twenty patients were recruited. The intensity of dysmenorrhea, dyspareunia and CPP significantly improved (p < 0.0001). The use of NSAIDs (p = 0.001), the size of the endometriomas (p < 0.0001) and the serum levels of Ca125 (p < 0.0001) significantly decreased. Among the 52 patients with reproductive desire, 39 successfully achieved pregnancy within 6 months of starting therapy (p = 0.001). Conclusions: Oral NAC improves endometriosis-related pain and the size of endometriomas. Furthermore, it decreases Ca125 serum levels and may improve fertility in patients with endometriosis.
2023
endometriosis; n-acetylcysteine; nac; pelvic pain; infertility; pregnancy
01 Pubblicazione su rivista::01a Articolo in rivista
Efficacy of n-acetylcysteine on endometriosis-related pain, size reduction of ovarian endometriomas, and fertility outcomes / Anastasi, Emanuela; Scaramuzzino, Sara; Viscardi, MARIA FEDERICA; Viggiani, Valentina; Piccioni, Maria Grazia; Cacciamani, Laura; Merlino, Lucia; Angeloni, Antonio; Muzii, Ludovico; Porpora, Maria Grazia. - In: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH. - ISSN 1660-4601. - 20:6(2023), pp. 1-8. [10.3390/ijerph20064686]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1676214
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