The Role Of Dietary Supplements in The Management Of Endometriosis-Related Symptoms: Current Evidence Based on A Systematic Review Of Randomized Controlled Trials

INTRODUCTION: Endometriosis is characterized by a persistent inflammatory process and is commonly shown to be associated with pelvic pain, dysmenorrhea, and a deterioration in overall quality of life. Due to limitations and side effects of current medical and surgical treatments, nutrition-based adjunctive strategies have gained attention. The purpose of this research is to critically examine the latest scientific evidence based on randomized controlled trials about dietary supplement treatment and the therapeutic management of endometriosis-related symptoms. METHODS: The conduct of this systematic review adhered to PRISMA methodological principles, with prior registration of the protocol in PROSPERO (CRD42024624094). PubMed, Scopus, and Web of Science databases were comprehensively explored. RESULTS: Eleven randomized controlled trials involving 739 participants were included. The mean intervention duration was 12.3 ± 6.03 weeks. Eight trials evaluated vitamin supplementation and three assessed herbal or bioactive compounds. Combined vitamin C and E supplementation consistently demonstrated reductions in pain-related outcomes across five trials. In contrast, findings regarding vitamin D were inconsistent, with only one of three studies reporting significant improvement compared to placebo. Among herbal interventions, two of three trials reported significant reductions in pain-related symptoms. CONCLUSION: Overall methodological quality ranged from good to fair. However, the available literature restricts conclusions due to limited sample sizes and methodological differences. Larger, well-designed trials with standardized protocols and biomarker-guided approaches are needed.