Supplementation with Anti-inflammatory Nutraceutical Products in the Management of Chronic Pelvic Pain: A Narrative Review

Abstract

Chronic pelvic pain is a chronic syndrome that affects patients’ life quality and expectancy as far as bladder, bowel and sexual functioning are compromised. So far treatment options are limited since pharmaceutical research has not provided any specific drug therapy to manage chronic pelvic pain. Nutraceutical products represent useful tools to supply this lack of medications. The aim of this narrative review is to provide some insight from a neuroscience perspective on the nutraceuticals’ use as adjuvant therapy in chronic pelvic pain. A review of the literature, between 2001 and 2019 on PMC and PubMed was performed in order to identify studies proving safety and efficacy of nutraceuticals in chronic pelvic pain. Inclusion criteria were nutraceutical compounds, namely curcumin, quercetin, bromelain, and diseases known for causing chronic pelvic pain. Nineteen studies were selected. Quercetin demonstrates to inhibit mast-cells, pro-inflammatory cytokines and regulate cell proliferation; curcumin suppresses inflammatory cytokines expression, inhibits invasion, angiogenesis of endometrial lesions. Bromelain resulted in a reduction of painkiller rescue doses required in endometriosis. Pre-clinical studies show promising effects of nutraceutical supplementation with selected enzymes and antioxidant compounds in patients suffering from chronic pelvic pain. Positive weak evidence suggests efficacy of these products in use as antiinflammatory and analgesic medications for chronic pelvic pain treatment.