Experience with nutraceutical supplements in the treatment of pelvic pain in gynaecology: case reports

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Three women with diverse gynaecological medical histories (one with endometriosis, one having had an episiotomy and obstetric anal sphincter injury during a recent delivery, and one having had a recent cystectomy of the left Bartholin gland) developed acute episodes of gynaecological pelvic pain. In each case, clinical investigations (including objective tools for assessing the source, nature and severity of the pain) were conducted early on, and a multimodal approach to therapy was introduced to control the pain and avoid central sensitization or chronicity. The multimodal approach included hormone therapy, antineuropathic medications, and corticosteroid or botulinum neurotoxin infiltrations in some of the patients according to their medical conditions but consistently included behavioural adjustments, physical interventions and a nutraceutical supplement (alpha-lipoic acid, palmitoylethanolamide and myrrh). In each case, the pelvic pain and associated dyspareunia (Marinoff scale 2 or 3) were largely resolved. These clinical cases support the results of clinical trials showing the benefits of alpha-lipoic acid + palmitoylethanolamide + myrrh for the management of gynaecological pelvic pain, enabling the reduction or withdrawal of other analgesic, anti-inflammatory and antineuropathic medications.

Keywords: alpha-lipoic acid, chronic pain, endometriosis, myrrh, neuropathic pain, nutraceutical supplement, palmitoylethanolamide, pelvic pain.

Citation: Nohales Alfonso F. Experience with nutraceutical supplements in the treatment of pelvic pain in gynaecology: case reports. Drugs Context. 2022;11:2021-10-8. https://doi.org/10.7573/dic.2021-10-8

Contributions: The author meets the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, takes responsibility for the integrity of the work as a whole, and has given approval for this version to be published.

Disclosure and potential conflicts of interest: The author declares that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/11/dic.2021-10-8-COI.pdf

Acknowledgements: Medical writing assistance was provided by Content Ed Net (Madrid, Spain), with funding from Uriach.

Funding declaration: There was no funding associated with this article other than for medical writing assistance.

Copyright: Copyright © 2022 Nohales Alfonso F. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2022 Nohales Alfonso F. https://doi.org/10.7573/dic.2021-10-8. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/experience-with-nutraceutical-supplements-in-the-treatment-of-pelvic-pain-in-gynaecology-case-reports

Correspondence: Francisco Nohales Alfonso, Gynecology Section, Clinical Area of Women´s Diseases, La Fe University Hospital, Valencia, Spain. Email: fnohalesa@gmail.com

Provenance: Submitted; externally peer reviewed.

Submitted: 29 October 2021; Accepted: 26 November 2021; Publication date: 12 January 2022.

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