12334 Harnessing Protective Diets: Phytoestrogens As A Strategy To Alleviate Estradiol-driven Progression And Symptomatology In Endometriosis

Abstract

Abstract Disclosure: A.D. Strong: None. S. Andrisse: None. D. Antani: None. Endometriosis (EMS) is a prevalent gynecological disorder affecting 10% of reproductive-age women with up to 50% experiencing infertility. It is characterized by the presence of endometrial-like tissue outside the uterus, leading to symptoms such as pelvic pain and infertility. While the exact cause of EMS remains elusive, hormonal dysregulation and the succeeding inflammation play a crucial role in its pathogenesis. Phytoestrogens (PEs) are a diverse group of plant-derived compounds that exhibit structural and functional similarities to endogenous estrogens and have emerged as potential therapeutic agents due to their ability to modulate hormonal signaling and inflammatory pathways. This integrative review aimed to provide a summation of the current evidence on the mechanisms of action and potential therapeutic applications of PEs in the context of EMS. PEs exhibit weak estrogenic activity and can interact with estrogen receptors (ERs), influencing hormonal and molecular pathways relevant to the pathology. These compounds have shown promise in regulating estrogen levels, inhibiting cell proliferation, and modulating insulin-like growth factor 1 signaling, all of which are critical in developing and progressing the disease state. Notably, curcumin and resveratrol have demonstrated anti-proliferative effects on endometrial cells by targeting key pathways involved in cell growth and angiogenesis. Curcumin has been shown to downregulate inflammatory factors like COX-2 and TNF-α while reducing vascular endothelial growth factor expression associated with angiogenesis. Similarly, resveratrol has been found to suppress inflammatory responses in endometrial stromal cells through the sirtuin 1 pathway. Studies indicate PEs can enhance antioxidant defenses and counteract reactive oxygen species levels implicated in endometriotic pain and disease progression. By restoring antioxidant balance and mitigating oxidative damage, PEs may offer therapeutic benefits in managing EMS symptoms. In conclusion, their multifaceted effects on estrogen signaling, inflammation, and oxidative stress highlight their potential as adjunctive or alternative treatments for symptomatic women with active disease. Plausible evidence supports that certain dietary components can reduce or exacerbate inflammation associated with EMS symptoms and progression. Foods that are rich in phytoestrogens include soy, fruits, vegetables, spinach, sprouts, beans, cabbages, and grain. Specifically, curcumin is a primary component in turmeric and resveratrol is found in high amounts in black and red grapes, red wine, berries, and nuts. While more research is still needed to fully understand the relationship between diet and endometriosis, utilizing therapeutic dietary interventions appears to be a promising self-management strategy for improving quality of life and symptom management. Presentation: 6/3/2024