Human Reproduction Update Advance Access originally published online on June 16, 2007
Human Reproduction Update 2007 13(5):487-499; doi:10.1093/humupd/dmm015
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Evolution of medical treatment for endometriosis: back to the roots?
1 Division of Gynecological Endocrinology and Reproductive Medicine, University of Vienna, 1090 Vienna, Austria 2 Department of Gynecology and Obstetrics, Emory University School of Medicine, Woodruff Memorial Building, 1639 Pierce Drive, Room 4217, Atlanta, GA 30322, USA 3 UCSF Institute for Health and Aging, San Francisco, CA, USA 4 Health Concerns, Oakland, CA, USA 5 Department of Obstetrics and Gynecology, UCSF, San Francisco, CA, USA
6 Correspondence address. Tel: +1-404-727-9823; Fax: +1-404-727-8609; E-mail: fwieser{at}emory.edu
Experimental evidence is accumulating to suggest that medicinal botanicals have anti-inflammatory and pain-alleviating properties and hold promise for treatment of endometriosis. Herein, we present a systematic review of clinical and experimental data on the use of medicinal herbs in the treatment of endometriosis. Although there is a general lack of evidence from clinical studies on the potential efficacy of medicinal herbs for the treatment of endometriosis-associated symptoms, our review highlights the anti-inflammatory and pain-alleviating mechanisms of action of herbal remedies. Medicinal herbs and their active components exhibit cytokine-suppressive, COX-2-inhibiting, antioxidant, sedative and pain-alleviating properties. Each of these mechanisms of action would be predicted to have salutary effects in endometriosis. Better understanding of the mechanisms of action, toxicity and herb–herb and herb–drug interactions permits the optimization of design and execution of complementary alternative medicine trials for endometriosis-associated pain. A potential benefit of herbal therapy is the likelihood of synergistic interactions within individual or combinations of plants. In this sense, phytotherapies may be analogous to nutraceuticals or whole food nutrition. We encourage the development of herbal analogues and establishment of special, simplified registration procedures for certain medicinal products, particularly herbal derivates with a long tradition of safe use.
Key words: endometriosis / herbs / botanicals / inflammation / CAM
Received on January 19, 2007; revised April 11, 2007; accepted on May 4, 2007
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