Clinical Efficacy Of Alternative Therapy For Adenomyosis
Main Article Content
Abstract
Relevance: Genital endometriosis is the most common disease of the female reproductive system. Currently, 190 million women and adolescent girls worldwide suffer from this disease. Although many aspects of genital endometriosis have been scientifically studied, there is still a clinical need to improve the methods of diagnosis and treatment of symptoms associated with this disease. These issues are particularly relevant to the management of patients with adenomyosis.
The aim of the study was to evaluate the clinical efficacy of indinol-3-carbinol and epigallocatechin-3-gallate in patients with adenomyosis.
Methods: The study enrolled 72 patients with adenomyosis (mean age 34.1±3.2 years) who received indinol-3-carbinol and epigallocatechin-3-gallate for 6 months. The treatment efficacy was evaluated on the basis of the change in clinical symptoms of the disease and the dynamics of ultrasound criteria of adenomyosis.
Results: After a 6-month course of therapy, there was a significant regression of disease symptoms and positive dynamics of changes in sonographic criteria of adenomyosis. No patient dropped out of the study and no patient experienced any significant side effects.
Conclusion: Therapy with indinol-3-carbinol and epigallocatechin-3 is a promising method of adenomyosis treatment, taking into account a significant improvement in patients’ quality of life and the possibility to implement reproductive plans.
Article Details
References
ESHRE Guide. Endometriosis. 02.02.2022. https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Endometriosis-guideline
Bulun S.E., Yilmaz B.D., Sison K., Miyazaki K., Bernardi L., Liu S., Kolmeyer A., Yin P., Milad M., Wei J. Endometriosis // Endocr. Ed. - 2019. - Vol. 40(4). - S. 1048-1079. https://doi.org/10.1210/er.2018-00242
Gunther R., Walker K. Adenomyosis. June 12, 2023 At: StatPearls [Internet]. Treasure Island (Florida): StatPearls Publishing; 2023 January–. PMID: 30969690
Cozzolino M, Tartaglia S, Pellegrini L, Troyano G, Rizzo G, Petraglia F. Impact of uterine adenomyosis on IVF outcomes: a systematic review and meta-analysis. Reproduction Scientific. November 2022;29(11):3177-3193. doi: 10.1007/s43032-021-00818-6. Epub, January 3, 2022. PMID: 34981458.
Moawad G., Hale M.H., Ayubi J.M., Klebanoff J.S., Rahman S., Sharara F.I. Adenomyosis and infertility. J Assist Reprod Genet. May 2022;39(5):1027–1031. doi: 10.1007/s10815-022-02476-2. Epub, March 28, 2022 PMID: 35347501; PMCID: PMC9107544.
Vannuccini S, Petraglia F. Adenomyosis: is it an endocrine dysfunction of the uterus? Gynecol Endocrinol. 2022 Dec;38(12):1017-1018. doi: 10.1080/09513590.2023.2172156. Epub, February 3, 2023. PMID: 36734253.
Bulun S.E., Yildiz S., Adly M., Chakravarty D., Parker J.B., Milad M., Yang L., Chaudhary A., Tsai S., Wei J.J., Yin P. Endometriosis and adenomyosis: general pathophysiology. Fertil Steril. May 2023;119(5):746-750. doi: 10.1016/j.fertnstert.2023.03.006. Epub, March 15, 2023. PMID: 36925057.
Guo Yuv. Unraveling the mystery of adenomyosis: an update on its pathogenesis and pathophysiology. Reproduction. October 10, 2022;164(5):R101-R121. doi: 10.1530/REP-22-0224. PMID: 36099328.
Juganawar A, Joshi KS. Chronic pelvic pain: a comprehensive review. Cureus. October 26, 2022; 14(10): e30691. doi: 10.7759/cureus.30691. PMID: 36465795; PMCID: PMC9709590.
.I. Yarmolinskaya, A.K. Beganova, A.S. Revenko Pain syndrome in endometriosis and new possibilities of therapy // Gynecology. 2022;24(6):444–450. DOI: 10.26442/20795696.2022.6.201975
Bulun S.E., Yildiz S., Adly M. The pathogenesis of adenomyosis: next generation sequencing data // Hum. Reproduction. Update. - 2021. - Vol. 27(6). - S. 1086-1097. https://doi.org/10.1093/humupd/dmab017
Chapron K., Vannuchini S., Santulli P., Abrao M.S., Carmona F., Fraser I.S., Gordts S., Guo S.V., Just P.A., Noe Il J. K., Pistofidis G., Van den Bosch T., Petraglia F. Diagnosis of adenomyosis: an integrated clinical imaging approach // Hum. Reproduction. - 2020. - Vol. 26. - R. 392-411. https://doi.org/10.1093/humupd/dmz049.
Shrager S., Yogendran L., Marques S.M., Sadovsky E.A. Adenomyosis: diagnosis and treatment. I am a famous doctor. January 1, 2022; 105(1): 33–38. PMID: 35029928.
Vannuccini S, Petraglia F. Recent advances in the understanding and treatment of adenomyosis // F1000Research. - 2019. - Vol. 8 (F1000 Faculty Editor). - Art. No. 283. https://pubmed.ncbi.nlm.nih.gov/30918629/
Khan KN, Fujishita A, Mori T. Pathogenesis of human adenomyosis: current understanding and its relationship to infertility. J. Clean Med. July 13, 2022; 11 (14): 4057. doi: 10.3390/jcm11144057. PMID: 35887822; PMCID: PMC9316454.
A.I. Neimark, N.V. Shelkovnikova Indinol and Epigallat in the treatment of pelvic pain syndrome in adenomyosis // Journal "Farmateka" 2011, No. 11
Tikhomirov A.L., Sonina T.A., Osetskaya E.A. The effectiveness of combined therapy with indole-3-carbinol in patients with hormone-dependent diseases of the uterus.// Obstetrics and gynecology/Obstetrics and gynecology. 2021; 6: 138-144 (in Russian) https://dx.doi.org/10.18565/aig.2021.6.138-144
Rudzitis-Aut J., Becker M., Scheuer S., Menger M.D., Lashke M.V. Indole-3-carbinol inhibits the growth of endometrial lesions by suppressing the formation of microvasculature. Nutrients. November 21, 2022; 14 (22): 4940. doi: 10.3390/nu14224940. PMID: 36432626; PMCID: PMC9696246.
Higham J.M., O'Brien P.M., Shaw R.V. Assessment of menstrual blood loss using a graphic chart. Br J Obstet Gynaecol. August 1990; 97(8): 734-9. doi: 10.1111/j.1471-0528.1990.tb16249.x. PMID: 2400752.
Xie T, Xu X, Yang Yu, Wu X, Liu X, Zhou L, Song Yu. The role of the abnormal junctional zone of the uterus in the occurrence and development of adenomyosis. Reproduction Scientific. October 2022;29(10):2719-2730. doi: 10.1007/s43032-021-00684-2. Epub, September 13, 2021. PMID: 34515984.
Harmsen M.Yu., Van den Bosch T., de Leeuw R.A., Duholm M., Exakustos K., Valentin L., Heenkamp W.J.K., Groenman F., De Bruyne K., Rasmussen C., Lazzeri L., Jokubkiene L., Yurkovich D., Naphthalene J., Tellum T., Born T., Timmerman D., Khuirn J.A.F. Consensus on Revised Definitions of Adenomyosis Features in Uterus Morphological Sonographic Assessment (MUSA): Results of the Modified Delphi Procedure. Ultrasound obstetrician-gynecologist. July 2022;60(1):118-131. doi: 10.1002/uog.24786. PMID: 34587658; PMCID: PMC9328356.
Harmsen M.Yu., Trommelen L.M., de Leeuw R.A., Tellum T., Euffermans L.J.M., Griffioen A.V., Thomassin-Naggara I, Van den Bosch T., Huirne JF. Uterine transition zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology. Ultrasound obstetrician-gynecologist. Jul 2023;62(1):42-60. doi: 10.1002/uog.26117. Epub, June 1, 2023. PMID: 36370446.
Holly A., Skovazzi U., Londero A.P., Evangelisti G., Cavalli E., Schiaffino M.G., Vacca I., Oppedisano F., Ferraro M.F., Sirito G., Molinari F. ., Cagnacci A. Uterine flexion angle and adenomyosis. J. Clean Med. June 4, 2022; 11 (11): 3214. doi: 10.3390/jcm11113214. PMID: 35683601; PMCID: PMC9181559.
Raimondo D., Lazzeri L., Raffone A., Giorgi M., Orsini B., Verrelli L., Lenzi J., Travaglino A., De Meis L., Mollo A., Zupi E., Seracchioli R. , Casadio P. Sonographic assessment of uterine biometry for diagnosis. Diffuse adenomyosis in a tertiary clinic. J Pers Med. 2022, September 23; 12(10): 1572. doi: 10.3390/jpm12101572. PMID: 36294711; PMCID: PMC9604640.
Brunelli A.S., Brito LGO, Moro FAS, Jayles R.M., Yela D.A., Benetti-Pinto KL. Ultrasound elastography for the diagnosis of endometriosis and adenomyosis: a systematic review with meta-analysis. Ultrasound Med Biol. March 2023;49(3):699-709. doi: 10.1016/j.ultrasmedbio.2022.11.006. Epub, December 15, 2022. PMID: 36528440.
Lazaridis A, Grammatis AL, Spencer S, Hirsch M. Non-surgical treatment of adenomyosis: a review of current evidence. Curr Opin Obstet Gynecol. October 1, 2022; 34(5): 315–323. doi: 10.1097/GCO.0000000000000810. Epub, July 27, 2022. PMID: 35895912.
Ratinam K.K., Abraham J.J., S.H.P., S.A.S., Sen M., George M., A.P. Evaluation of pharmacological interventions in the treatment of adenomyosis: a systematic review. Eur J Clean Pharmacol. April 2022, 78(4):531-545. doi: 10.1007/s00228-021-03256-0. Epub, January 17, 2022. PMID: 35037089.