Antioxidant Agent to Improve Endometriosis Related Pain (Dysmenorrhea, Dyspareunia, Pelvic Pain): A Systematic Review and Meta-Analysis

Vanessa Pradna Adyana Daud, Kadiota Rasika Dyarma, Leny Silviana Farida
In: Asian Journal of Health Research · 2024 · vol. 3(1) , pp. 79–86 · doi:10.55561/ajhr.v3i1.142 · W4396781805
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review and meta-analysis found that antioxidant agents significantly improved pelvic pain, dyspareunia, and dysmenorrhea in endometriosis patients compared to placebo.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper is a systematic review and meta-analysis evaluating whether antioxidant agents—specifically vitamin D, vitamin C, vitamin E, silymarin (livergol), garlic tablets, resveratrol, and melatonin—improve endometriosis-related pain outcomes (pelvic pain, dysmenorrhea, and dyspareunia), using mean changes from baseline on VAS pain scales across 12 included studies (n=695). Compared with placebo, antioxidants showed significantly greater improvement in pelvic pain (MD −2.21), dyspareunia (MD −1.47), and dysmenorrhea (MD −1.92). A key limitation explicitly noted is that the underlying mechanism is not fully understood, which constrains interpretation of why antioxidants may relieve symptoms. This paper is centrally about endometriosis — it specifically synthesizes evidence on antioxidant agents to reduce endometriosis-related dysmenorrhea, dyspareunia, and pelvic pain.

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Abstract

Introduction: Endometriosis is a chronic condition characterized by the presence of endometrial-like tissue outside the uterus, which causes estrogen-induced inflammation. Pelvic severe pain, dysmenorrhea, and dyspareunia are known as the most common symptoms in endometriosis patients. Antioxidants can help alleviate endometriosis-related pain. However, the mechanism is not fully understood. A study is needed to elucidate the inherent potential of an antioxidant in women with endometriosis. Material and Methods: The literature search was conducted in two databases. The outcome of interest is to measure mean changes based on pain severity using the VAS score in endometriosis-related pain, including dysmenorrhea, pelvic pain, and dyspareunia. Some of the antioxidant agents formed in this study are vitamin D, vitamin C, vitamin E, livergol (silymarin), garlic tablets, resveratrol, and melatonin compared to placebo. Meta-analysis was done using RevMan 5.4 using mean change from baseline data with their 95% confidence intervals (CI) provided. Results: Twelve studies meeting the inclusion criteria were considered relevant for assessing the potencies of antioxidants in endometriosis patients (n=695). The antioxidant group had significantly better pelvic pain improvement (MD: -2.21, 95%CI: -3.40 to -1.03, p=0.0003), reduction in dyspareunia symptoms (MD: -1.47, 95% CI: -2.68 to -0.27, p=0.02) as well as improvement in dysmenorrhea with a mean difference -1.92 (95% CI: -3.41 to -0.43, p=0.01) than the placebo group. Antioxidants showed excellent potential to be an alternative treatment in managing endometriosis-related pain, particularly pelvic pain, dyspareunia, and dysmenorrhea. Conclusion: The efficacy of antioxidant agents can be a potential treatment to alleviate pain associated with endometriosis, such as pelvic pain, dysmenorrhea, and dyspareunia.
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Keywords

Antioxidant, Endometriosis, Dysmenorrhea, Dyspareunia, Pelvic PainAbstract

Introduction

Endometriosis is a chronic condition characterized by the presence of endometrial-like tissue outside the uterus, which causes estrogen-induced inflammation. Pelvic severe pain, dysmenorrhea, and dyspareunia are known as the most common symptoms in endometriosis patients. Antioxidants can help alleviate endometriosis-related pain. However, the mechanism is not fully understood. A study is needed to elucidate the inherent potential of an antioxidant in women with endometriosis.

Material and methods

The literature search was conducted in two databases. The outcome of interest is to measure mean changes based on pain severity using the VAS score in endometriosis-related pain, including dysmenorrhea, pelvic pain, and dyspareunia. Some of the antioxidant agents formed in this study are vitamin D, vitamin C, vitamin E, livergol (silymarin), garlic tablets, resveratrol, and melatonin compared to placebo. Meta-analysis was done using RevMan 5.4 using mean change from baseline data with their 95% confidence intervals (CI) provided.

Results

Twelve studies meeting the inclusion criteria were considered relevant for assessing the potencies of antioxidants in endometriosis patients (n=695). The antioxidant group had significantly better pelvic pain improvement (MD: -2.21, 95%CI: -3.40 to -1.03, p=0.0003), reduction in dyspareunia symptoms (MD: -1.47, 95% CI: -2.68 to -0.27, p=0.02) as well as improvement in dysmenorrhea with a mean difference -1.92 (95% CI: -3.41 to -0.43, p=0.01) than the placebo group. Antioxidants showed excellent potential to be an alternative treatment in managing endometriosis-related pain, particularly pelvic pain, dyspareunia, and dysmenorrhea.

Conclusion

The efficacy of antioxidant agents can be a potential treatment to alleviate pain associated with endometriosis, such as pelvic pain, dysmenorrhea, and dyspareunia. Downloads Published Issue Section License Copyright (c) 2024 Vanessa Pradna Adyana Daud, Kadiota Rasika Dyarma, Leny Silviana Farida This work is licensed under a Creative Commons Attribution 4.0 International License.

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Outcome instruments

VAS-pain

Condition tags

endometriosisdysmenorrheadyspareunia

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (26)

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