Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period and is associated with pelvic pain and infertility. Oxidative stress (OS) occurs when reactive oxygen stress (ROS) and anti-oxidants are in imbalance. OS is a potential factor involved in the pathophysiology of endometriosis. Iron-induced ROS may trigger a chain of events resulting in the development and progression of endometriosis. Endogenous ROS are correlated with increased cellular proliferation and ERK1/2 activation in human endometriotic cells. An oxidative environment leads to stimulation of the ERK and PI3K/AKT/mTOR signaling pathways that facilitate endometriotic lesion progression through adhesion, angiogenesis, and proliferation. OS is also known to be involved in epigenetic mechanisms in endometriosis. We summarize the recent knowledge in our understanding of the role of oxidative stress in the pathogenesis of endometriosis.

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Chronic pelvic pain is a common condition in women of reproductive age and can be described as chronic nociceptive, inflammatory and neuropathic pain characterized by spontaneous pain or a response to various stimuli. Oxidative stress is a component of the inflammatory reaction associated with pain processes. Iron and NF-κB are well-known inducers of oxidative stress, and reactive oxygen species (ROS) are associated with chronic pelvic pain and play an important role in the regulation of genes expressing immunoregulators, cytokines, and other molecules. Chronic pelvic pain treatment is often unsatisfactory and limited to symptom control. However, dietary treatment with antioxidants can improve the function of the immune system and overcome free radical damage. Therefore, dietary supplementation is suggested as a means to treat some chronic medical conditions that respond poorly to medication. In summary, dietary treatment with antioxidants could be considered for new strategy for treatment of chronic pelvic pain and may be better tolerated by patients than current treatments.

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  S.О. Shurpyak, O.B. Solomko
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