Endometriosis is defined as a chronic, multi-mechanistic and estrogen-dependent, inflammatory disease, that is often debilitating to many women worldwide. This condition occurs when tissue similar to the lining of the uterus grows outside the womb, leading to pain, inflammation, and the formation of cysts.
Conventional treatments include surgery, pain medication, and hormonal therapies, however, emerging research suggests that N-acetylcysteine (NAC) might offer additional benefits. NAC, known for its antioxidant and anti-proliferative effects on tissue, has been shown in previous studies to alleviate pelvic pain and reduce the size of endometriomas (cysts on the ovaries due to endometriosis). Emerging research is also theorizing that NAC may also reduce Cancer Antigen 125 (Ca125) production and help improve fertility.
The focus of this study was to confirm the effectiveness of NAC in reducing endometriosis related pain, improve fertility, and reduce Ca125 serum levels. Patients were given 600mg of oral NAC, 3 tablets/day for 3 consecutive days of the week for 3 months.
After 3 months, the intensity of menstrual cramps, pain with vaginal penetration during sex and chronic pelvic pain were evaluated along with evaluation of endometrioma size via transvaginal ultrasound. Serum Ca125 levels were determined as well as fertility outcomes.
120 patients ages between 18 and 45 years old with clinical/ instrumental or surgical/ histological diagnosis of endometriosis were recruited for this study. Exclusion criteria included 1) pre-menarche and menopausal 2) known hypersensitivity to NAC 3) current hormone treatment, cancer diagnosis, or pregnancy.
Results showed significant improvement in the intensity of dysmenorrhea, dyspareunia, and chronic pelvic pain, decrease in serum Ca125 levels, and decrease in the size of endometriomas among the patients. Out of a total of 52 patients with reproductive desires, 39 successfully achieved pregnancy within 6 months of starting NAC treatment.
Overall, NAC is a promising natural therapy to help patients struggling with endometriosis manage their pain, improve quality of life, and enhance fertility outcomes.
NAC is usually used in combination with other natural therapies that target additional mechanisms involved in endometriosis. These include resveratrol, melatonin, pine bark extract, green tea, and curcumin. Individual treatment plans are based on the specific pelvic symptoms, health history and other medical conditions that the patient is experiencing.
Article by Danielle Melvin, N.D.
Source: Anastasi E, Scaramuzzino S, Viscardi MF, Viggiani V, Piccioni MG, Cacciamani L, Merlino L,
Angeloni A, Muzii L, Porpora MG. Efficacy of N-Acetylcysteine on Endometriosis-Related
Pain, Size Reduction of Ovarian Endometriomas, and Fertility Outcomes. Int J Environ Res
Public Health. 2023 Mar 7;20(6):4686. doi: 10.3390/ijerph20064686. PMID: 36981595;
PMCID: PMC10048621.
