N-Acetyl-Cysteine (NAC) is an acetylated form of the amino acid L-cysteine. In the biochemical field, it has been studied for its role as a precursor of glutathione, a tripeptide naturally present in the body.

Daily dose: 100 mg

Bibliographic references:
1. Benaglia L, Bermejo A, Somigliana E, et al. Randomized controlled trial on N-acetylcysteine to reduce the size of ovarian endometriomas. Reprod Biomed Online. 2019;39(2):308–314.

2. Porpora MG, Risalvato A, Piazze JJ, et al. A prospective cohort study on the efficacy of N-acetylcysteine in the treatment of endometriomas. Eur J Obstet Gynecol Reprod Biol. 2021;256:350–356.

3. Sanaei M, Kianpour M, Azadbakht M, et al. Impact of N-acetylcysteine on oxidative stress and pain scores in women with endometriosis. J Obstet Gynaecol Res. 2020;46(10):1920–1926.

4. Anastasi E, et al. Efficacy of N-Acetylcysteine in endometriosis-related pain, endometrioma size and fertility outcomes (prospective cohort). Int J Environ Res Public Health. 2023;20(6):4686.

5.  Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022;93(1):e2022159. PMID: 35315418

Alpha-lipoic acid is a naturally occurring compound that acts as an enzymatic cofactor in energy metabolism processes.

Daily dose: 100 mg

Bibliographic references:

1. Lete I, Mendoza N, Piñero-Saavedra M, et al. Effectiveness of an antioxidant preparation with N-acetyl cysteine, alpha lipoic acid and bromelain in the treatment of endometriosis-associated pelvic pain (LEAP Study). Eur J Obstet Gynecol Reprod Biol. 2018;228:120–4.

2.  Zarei S, Jamilian M, Shafiee M, Asemi Z. Effect of alpha-lipoic acid in combination with mefenamic acid on pain severity in girls with primary dysmenorrhea: a randomized, double-blind, placebo-controlled clinical trial. J Obstet Gynaecol Res. 2019;45(4):771–778.

3. Sanaei M, Kianpour M, Azadbakht M, et al. Impact of antioxidant therapy on oxidative stress markers in women with endometriosis. J Obstet Gynaecol Res. 2020;46(10):1920–6.

4. Cavalli G, Biavasco R, Campochiaro C, et al. Antioxidant compounds including alpha-lipoic acid modulate inflammatory signalling in endometrial cells. Antioxidants. 2020;9(6):502.

5. Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022;93(1):e2022159. PMID: 35315418

6. Di Tucci C, Di Feliciantonio M, Vena F, et al. Alpha lipoic acid in obstetrics and gynecology. Gynecol Endocrinol. 2018;34(9):729–733. PMID: 29726290.

The resveratrol used is derived from the root of Polygonum cuspidatum, one of the richest natural sources of this polyphenol. The formula uses resveratrol in its active form, trans-resveratrol, with a purity of 98%.

Daily dose: 60 mg → ~58,8 mg of pure resveratrol.

Bibliographic references:

1. Kianpour M, Khademi N, Pahlavani N, et al. Effects of resveratrol on inflammatory markers and pain in women with endometriosis. Nutrients. 2021;13(4):1200.

2. Mendes da Silva S, Vitale SG, Silveira GD, et al. Clinical evaluation of resveratrol forendometriosis-associated pain. Clin Exp Obstet Gynecol. 2017;44(4):568–572.

3. Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022;93(1):e2022159. PMID: 35315418

4. Novakovic R, Rajkovic J, Gostimirovic M, Gojkovic-Bukarica L, Radunovic N. Resveratrol and reproductive health. Life (Basel). 2022;12(2):294. PMID: 35207581.

5. Arablou T, Hamedi S, Vafa M. Resveratrol treatment reduces the development of experimental endometriosis through modulation of VEGF and inflammatory markers. Biol Reprod. 021;104(3):692–700.

6. Hipólito-Reis M, Neto AC, Neves D, et al. Impact of curcumin, quercetin, or resveratrol on the pathophysiology of endometriosis: a systematic review. Phytother Res. 2022;36(6):2416–2433.PMID: 35583746.

The quercetin used is obtained from a dry extract of Acacia nilotica, a plant source rich in flavonoids. Its standardisation to 95% guarantees consistency and purity.

Daily dose: 400 mg (≈ 380 mg of pure quercetin).

Bibliographic references:

1. Yalçın Bahat P, Ayhan I, Üreyen Özdemir E, İnceboz Ü, Oral E. Dietary supplements for treatment of endometriosis: A review. Acta Biomed. 2022;93(1):e2022159. PMID: 35315418

2. Jian X, Shi C, Luo W, Zhou L, Jiang L, Liu K. Therapeutic effects and molecular mechanisms of quercetin in gynecological disorders. Biomed Pharmacother. 2024;173:116418. PMID: 38461683.

3.  Hipólito-Reis M, Neto AC, Neves D, et al. Impact of curcumin, quercetin, or resveratrol on the pathophysiology of endometriosis: a systematic review. Phytother Res. 2022;36(6):2416–2433. PMID: 35583746.

4. Vitale SG, La Rosa VL, Rapisarda AM, et al. Effectiveness of the integration of quercetin, curcumin and N-acetylcysteine in reducing inflammation and pain associated with endometriosis. Minerva Ginecol. 2020;72(5):285–291. PMID: 32921020.

Bromelain is a proteolytic enzyme derived from the stem of Ananas comosus.

Daily dose: 50 mg

Bibliographic references:

1. Kazemi M, Ghazanfarpour M, Abdolahian S, et al. Oral bromelain supplementation for the management of menstrual pain: a randomized clinical trial. J Complement Integr Med. 2021;18(4):763–770.

2. Pakniyat H, Ghazanfarpour M, Abdolahian S, et al. Bromelain as an adjunctive treatment in women with primary dysmenorrhea: a randomized controlled trial. Complement Ther Med. 2019;45:69–74.

3. Lete I, Mendoza N, de la Viuda E, Carmona F. Effectiveness of an antioxidant preparation with N-acetyl cysteine, alpha lipoic acid and bromelain in the treatment of endometriosis-associated pelvic pain: LEAP study. Eur J Obstet Gynecol Reprod Biol. 2018;228:221–224. PMID: 30007250.

4. Kianbakht S, Ghazanfarpour M, Salari R, et al. Bromelain and curcumin in the treatment of primary dysmenorrhea: a randomized clinical trial. J Altern Complement Med. 2020;26(5):411–417.

SULFODYNE® is a registered trademark of Ingood by Olga and provides a broccoli seed extract (Brassica oleracea) standardised to 5% sulforaphane. This compound is naturally found in cruciferous vegetables and is known for its involvement in physiological processes related to antioxidant response and the activation of cellular pathways widely studied in nutrition and plant biology.

Daily dose: 60 mg → 3 mg of active sulforaphane.

Bibliographic references:
1. Kim TH, Lee HH, Cho JH, et al. Sulforaphane reduces endometriotic lesion size by inhibiting inflammatory and angiogenic pathways in a murine model. Int J Mol Sci. 2019;20(19):4876.

2. Murakami A, Matsumoto H. Sulforaphane and its role in chronic inflammatory conditions: molecular mechanisms and clinical relevance. J Nutr Biochem. 2021;90:108578.

3. Zhao H, Xu J, Zhang Y, et al. Sulforaphane inhibits oxidative stress and inflammatory responses by activating Nrf2 signaling. Antioxidants. 2020;9(5):395.

4. Tamura M, Takahashi M, Nakamura H, et al. Protective effects of glucoraphanin against oxidative stress in endometrial tissue. Oxid Med Cell Longev. 2022;2022:7249034.

5. Yagishita Y, Fahey JW, Dinkova-Kostova AT, et al. Broccoli-derived sulforaphane activates Nrf2 and modulates inflammatory and cytoprotective pathways: implications for chronic inflammatory diseases. Clin Immunol. 2019;203:1–7.

The magnesium used is in the form of bisglycinate, an organic salt formed by binding the mineral to two glycine molecules. It contributes to normal nervous system function, helps reduce tiredness and fatigue, and contributes to normal muscle function, according to Regulation (EU) 432/2012.

Daily dose: 120 mg magnesium (32% NRV).

Bibliographic references:

1. Moslehi M, Kheirkhah M, Salari R, et al. The effect of magnesium supplementation on primary dysmenorrhea: a randomized clinical trial. Obstet Gynecol Sci. 2020;63(5):587–593.

2. Pattanittum P, Kunyanone N, Brown J, Sangkomkamhang US, Barnes J, Seyfoddin V et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev. 2016;(3):CD002124. PMID: 27000311.

3. Naz MS, Ghazanfarpour M, Dastjerdi MS, et al. The effect of micronutrients on dysmenorrhea pain management: a systematic review. J Obstet Gynaecol Res. 2020;[Epub ahead of print]. PMID: 32296659.

4. Gök S, Gök B. Comparison of magnesium citrate and combined oral contraceptive therapy for primary dysmenorrhea: a case-controlled prospective study. Cureus. 2022;14(6):e32028. PMID: 36600872.

5. Parazzini F, Di Martino M, Pellegrino P. Magnesium in the gynecological practice: a literature
review. Magnes Res. 2017;30(1):1-7. PMID: 28392498.

Pyridoxal-5-phosphate is the active, coenzymatic form of vitamin B6. It contributes to the normal functioning of the nervous system and to the regulation of hormonal activity (Regulation (EU) 432/2012).

Daily dose: 2 mg (142,86 % VRN).

Referencias bibliográficas:

1. Yin L, Liang F, Xie B, et al. Vitamin B6 intake and endometriosis risk: evidence from the National Health and Nutrition Examination Survey (NHANES). Front Nutr. 2024;11:140709.

2. Moslehi M, Jahanlou F, Mansouri S, et al. The effect of vitamin B6 supplementation on primary dysmenorrhea: a randomized clinical trial. Obstet Gynecol Sci. 2020;63(5):587–593.

3. Faramarzi M, Salehi-Abargouei A, Kafeshani M, et al. The effect of vitamin B6 supplementation on symptoms of primary dysmenorrhea: a randomized controlled trial. Eur J Obstet Gynecol eprod Biol. 2021;258:284–289.

4. Tabeian F, Najar S, Ozgoli G, et al. Comparison of pyridoxine (vitamin B6) and placebo on the severity of primary dysmenorrhea: a randomized controlled trial. Complement Ther Clin Pract.
2018;31:244–248.

Methylcobalamin is the active form of vitamin B12. It contributes to normal energy metabolism, to the formation of red blood cells, and to the normal functioning of the immune system.

Daily dose: 200 μg

Bibliographic references:

1. Sánchez AM, Vanni VS, Bartiromo L, Papaleo E, Candiani M, Viganò P. The importance of diet in the treatment of endometriosis. Nutrients. 2024;16(3):468.doi:10.3390/nu16030468.

2.  Abdollahpour S, Alimoradi Z, Azizi M, Kheirkhah M, Khodakarami B. Association of serum vitamin B12 levels with menstrual characteristics in reproductive-aged women. BMC Womens Health. 2022;22:440.

3. Nurwanti N, Sari DP, Lestari R, et al. Stress, physical activity, and dietary intake associated with dysmenorrhea: role of vitamin B12 and folic acid. Indones Midwifery Health Sci J. 2024;8(1):12–19.

4. Naraoka Y, Ueno T, Nakamura K, et al. Severity of menstrual pain is associated with nutritional intake and lifestyle factors in young women. Healthcare (Basel). 2023;11(4):555

Folic acid is a synthetic form of vitamin B9, an essential B-group nutrient. It contributes to the normal functioning of the immune system, to normal blood formation, and to the reduction of tiredness and fatigue (Regulation (EU) 432/2012).

Daily dose: 300 μg (150 % VRN)

Bibliographic references:

1. Sánchez AM, Navarro E, Bellver J, et al. Folic acid intake and risk of endometriosis. Reproductive Health. 2024;21:185.

2. Gersekowski GF, Wilkens LR, McClaine RJ, et al. Folate intake and risk of endometriosis. Gynecologic Oncology. 2023;171(2):238–244.

3. Gaskins AJ, Rich-Edwards JW, Hauser R, et al. Dietary folate intake and reproductive hormone concentrations across the menstrual cycle. Journal of Clinical Endocrinology & Metabolism.
2021;106(12):e5030–e5041.

4. Xu T, Zhang Y, Zhang Y, et al. Association between vitamin intake and endometriosis: a
cross-sectional study of NHANES 1999–2006. Reproductive Health. 2024;21.