Overview of the Effect of Complementary Medicine on Treating or Mitigating the Risk of Endometriosis

Mirzaee, Firoozeh; Ahmadi, Atefeh

doi:10.1055/s-0041-1735156

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Revista Brasileira de Ginecologia e Obstetrícia

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Brasil

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Sumário

Original Article, Gynecological Endocrinology • Rev Bras Ginecol Obstet. 43 (12) • Oct 2021 • https://doi.org/10.1055/s-0041-1735156 copy

Overview of the Effect of Complementary Medicine on Treating or Mitigating the Risk of Endometriosis

Visão geral do efeito da medicina complementar no tratamento ou mitigação do risco de endometriose

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Endometriosis is a hormone-dependent chronic inflammatory disease with symptoms such as pelvic pain, which affect the physical, emotional, and social health of women in reproductive age. The current overview article aims to explore the effect of complementary medicine on the treatment or in mitigating the risk of endometriosis.

Methods

This is an overview article done in Iran. Two separate researchers systematically searched 3 databases (Medline, Scopus, and Cochrane Central Register Trials) until September 2020. The methodological quality of each study was assessed using the assessment of multiple systematic reviews (AMSTAR) tool.

Results

The results of two reviews suggested that physical activity, tobacco smoking, diet, coffee and caffeine intake had no effect on mitigating the risk of endometriosis or improving its treatment, but acupuncture successfully reduced pain and related marker (serum CA-125) levels.

Conclusion

As endometriosis is an annoying disease with many complications and is hard to diagnose and treat, related studies in complementary medicine can help patients with endometriosis. Based on the relevant literature review, among the complementary medicine available for the treatment or to mitigate the risk of endometriosis, only acupuncture seems to alleviate the pain of endometriosis.

Keywords
complementary medicine; endometriosis; overview

Authors	Year	Type of review	Age range (years old)	Type of intervention	Sample size	Conclusion
Xu et al.⁶6 Sesti F, Pietropolli A, Capozzolo T, Broccoli P, Pierangeli S, Bollea MR, et al. Hormonal suppression treatment or dietary therapy versus placebo in the control of painful symptoms after conservative surgery for endometriosis stage III-IV. A randomized comparative trial. Fertil Steril. 2007;88(06):1541–1547. Doi: 10.1016/j.fertnstert.2007.01.053 https://doi.org/10.1016/j.fertnstert.200...	2017	Meta- analysis	13–52	Acupuncture, sham acupuncture, Western medicine, traditional chinese medicine	591	Acupuncture reduced pain and had a positive effect on peripheral blood CA-125 levels
Chiaffarino et al.¹⁴14 Chiaffarino F, Bravi F, Cipriani S, Parazzini F, Ricci E, Viganò, et al. Coffee and caffeine intake and risk of endometriosis: a meta-analysis. Eur J Nutr. 2014;53(07):1573–1579. Doi: 10.1007/ s00394-014-0662-7 https://doi.org/10.1007/ s00394-014-0662...	2014	Meta- analysis	15–65	Coffee and caffeine intake	1,407	There was no evidence on the association between coffee/caffeine intake and the risk of endometriosis
Mira et al.⁹9 Mira TAA, Buen MM, Borges MG, Yela DA, Benetti-Pinto CL. Systematic review and meta-analysis of complementary treatments for women with symptomatic endometriosis. Int J Gynaecol Obstet. 2018;143(01):2–9. Doi: 10.1002/ijgo.12576 https://doi.org/10.1002/ijgo.12576...	2018	Meta- analysis	13–50	Acupuncture, exercise, electrotherapy, and yoga	385	All studies were inconclusive in affirming benefits, but demonstrated a positive trend in the treatment of endometriosis symptoms
Hoorsan et al.¹³13 Hoorsan H, Mirmiran P, Chaichian S, Moradi Y, Akhlaghdoust M, Hoorsan R, et al. Diet and risk of endometriosis: a systematic reviewand meta-analysis study. Iran Red Crescent Med J. 2017;19 (09):e41248	2017	Meta- analysis	Reproductive age	Calcium intake, milk, eggs bacon, red meat	72,662	Calcium, milk, eggs, bacon, and red meat intake increase the risk of endometriosis
Ricci et al.	2016	Meta-analysis	Reproductive age	Endometriosis women physical activity	79,55	Physical activity does not reduce the risk of endometriosis
Bravi et al.¹¹11 Bravi F, Parazzini F, Cipriani S, Chiaffarino F, Ricci E, Chiantera V, et al. Tobacco smoking and risk of endometriosis: a systematic review and meta-analysis. BMJ Open. 2014;4(12):e006325. Doi: 10.1136/bmjopen-2014-006325 https://doi.org/10.1136/bmjopen-2014-006...	2014	Meta- analysis	15–56	Tobacco smoking	13,129	No evidence on the association between tobacco smoking and the risk of endometriosis

AMSTAR items
References	Year	*1^ 1: Did the study address a clearly focused question?*	2^† †2: Was a comprehensive literature search conducted using relevant research databases (e.g., ABI/INFORM, Business Source Premier, PsycINFO, Web of Science, etc.)	3^‡ ‡3: Is the search systematic and reproducible (e.g., were searched information sources listed, were search terms provided)?	4^§ §4: Has publication bias been prevented as far as possible (e.g., were attempts made at collecting unpublished data)?	5^\| \|5: Are the inclusion and exclusion criteria clearly defined (e.g., population, outcomes of interest, study design)?	6^¶ ¶6: Was the methodological quality of each study assessed using predetermined quality criteria?	7^ 7: Are the key features (population, sample size, study design, outcome measures, effect sizes, limitations) of the included studies described?	8^†† ††8: Has the meta-analysis been conducted correctly?	9^‡‡ ‡‡9: Were the results similar from study to study?	10^§§ §§10: Is the effect size practically relevant?	11^\|\| \|\|11: How precise is the estimate of the effect? Were confidence intervals given?	12^¶¶ ¶¶12: Can the results be applied to your organization?
Xu et al.⁶6 Sesti F, Pietropolli A, Capozzolo T, Broccoli P, Pierangeli S, Bollea MR, et al. Hormonal suppression treatment or dietary therapy versus placebo in the control of painful symptoms after conservative surgery for endometriosis stage III-IV. A randomized comparative trial. Fertil Steril. 2007;88(06):1541–1547. Doi: 10.1016/j.fertnstert.2007.01.053 https://doi.org/10.1016/j.fertnstert.200...	2017	Yes	Yes	No	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Chiaffarino et al.¹³13 Hoorsan H, Mirmiran P, Chaichian S, Moradi Y, Akhlaghdoust M, Hoorsan R, et al. Diet and risk of endometriosis: a systematic reviewand meta-analysis study. Iran Red Crescent Med J. 2017;19 (09):e41248	2014	Yes	Yes	Yes	No	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes
Mira et al.⁹9 Mira TAA, Buen MM, Borges MG, Yela DA, Benetti-Pinto CL. Systematic review and meta-analysis of complementary treatments for women with symptomatic endometriosis. Int J Gynaecol Obstet. 2018;143(01):2–9. Doi: 10.1002/ijgo.12576 https://doi.org/10.1002/ijgo.12576...	2018	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Hoorsan et al.¹³13 Hoorsan H, Mirmiran P, Chaichian S, Moradi Y, Akhlaghdoust M, Hoorsan R, et al. Diet and risk of endometriosis: a systematic reviewand meta-analysis study. Iran Red Crescent Med J. 2017;19 (09):e41248	2017	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Ricci et al.¹²12 Ricci E, Viganò P, Cipriani S, Chiaffarino F, Bianchi S, Rebonato G, et al. Physical activity and endometriosis risk in women with infertility or pain: systematic review and meta-analysis. Medicine. 2016;95(40)	2016	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
Bravi et al.¹¹11 Bravi F, Parazzini F, Cipriani S, Chiaffarino F, Ricci E, Chiantera V, et al. Tobacco smoking and risk of endometriosis: a systematic review and meta-analysis. BMJ Open. 2014;4(12):e006325. Doi: 10.1136/bmjopen-2014-006325 https://doi.org/10.1136/bmjopen-2014-006...	2014	Yes	Yes	Yes	No	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes

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[1] Address for correspondence Atefeh Ahmadi, M.D, PhD, Assistant prof., 2nd Floor, Building No. 1, Medical University Campus, Haft-Bagh Highway, Kerman, Iran (e-mail: a.ahmadi@kmu.ac.ir).