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    Homeopathy for endometriosis pain?

    Potentized estrogen is an effective treatment for reducing endometriosis-associated pelvic pain (EAPP) that has been refractory to conventional hormone therapy, according to the results of a randomized, double-blind, placebo-controlled study reported by researchers from Brazil.1

    Potentized estrogen is an oral preparation of 17-beta estradiol in the 12cH, 24cH and 18cH potencies formulated in an alcohol solution.2 The homeopathic treatment was investigated in a trial that included 50 women who were randomized into 2 groups to receive 3 drops twice daily of potentized estrogen or placebo alcohol solution.

    To be eligible for participation, women had to be between18 and 45 years old and diagnosed with deeply infiltrating endometriosis confirmed by magnetic resonance imaging, transvaginal ultrasound after bowel preparation, or laparoscopy. In addition, they needed to have chronic pelvic pain refractory to conventional hormone treatment and a score ≥5 on an 11-point (range 0 to 10) visual analogue scale of EAPP.

    Changes from baseline to week 24 in the EAPP global score and in each of its 5 components (dysmenorrhea, dyspareunia, noncyclic pelvic pain, cyclic bowel pain, and cyclic urinary pain) were analyzed as the primary efficacy endpoint. The results showed women treated with potentized estrogen had statistically significant reductions in the global EAPP and in the component scores for dysmenorrhea, noncyclic pelvic pain, and cyclic bowel pain. In the control group, neither the EAPP global score nor any of the component scores were significantly changed from baseline at week 24.

    Changes in the 36-Item Short-Form Health Survey (SF-36), depression symptoms assessed with the Beckman Depression Inventory, and anxiety symptoms measured using the Beck Anxiety Inventory were analyzed as secondary endpoints. Statistically significant improvements occurred only among women in the potentized estrogen group and were seen in three of eight SF-36 domains (bodily pain, vitality, and mental health) and in the Beckman Depression Inventory.

    In undertaking their study, the investigators noted that pelvic pain associated with endometriosis presents a treatment challenge, and so many women resort to complementary and alternative medicine options, including homeopathic treatment.2 Noting that there is controversy about the effectiveness of homeopathic treatment for chronic pelvic pain of endometriosis because of a lack of published evidence, they aimed to conduct a randomized trial.

    As explained on the New Homeopathic Medicines website (http://newhomeopathicmedicines.com), homeopathy is based on the principle of similitude—the idea that treatment with substances that cause symptoms in healthy persons similar to those of the disease can cure the same symptoms in persons who are sick. The treatment acts by stimulating the body to react against the illness, but uses dilutions of the treatment to reduce its potential for worsening symptoms. 

    The “modern drug” 17-beta estradiol was chosen as a homeopathic treatment for EAPP because the signs and symptoms it causes (ie, depression, anxiety, insomnia, migraine, rhinosinusitis, endometrial proliferation, dysmenorrhea, dyspareunia, etc) are similar to those of “endometriosis syndrome.”3

    References

    1. Teixeira MZ, Podgaec S, Baracat EC. Potentized estrogen in homeopathic treatment of endometriosis-associated pelvic pain: A 24-week, randomized, double-blind, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol. 2017;211:48-55 [Epub ahead of print]

    2. Clinical Trials.gov. Homeopathic treatment of chronic pelvic pain in women with endometriosis. https://clinicaltrials.gov/show/NCT02427386.

    3. Teixeira MZ, Podgaec S, Baracat EC. Protocol of randomized controlled trial of potentized estrogen in homeopathic treatment of chronic pelvic pain associated with endometriosis. Homeopathy. 2016;105(3):240-249.

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