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Endometriosis, menstruation pains and treatment with palmitoylethanolamide

Seven out of 10 menstruating women suffer from abdominal and menstruation pain. The medical term for abdominal pain during menstruation is dysmenorrhea. The so-called primary abdominal pain arises due to the ovulation, which is called primary dysmenorrhea.

One of the most common causes of secondary dysmenorrhea is endometriosis. Over 1 out of 10 women suffers from endometriosis. Endometriosis is a difficult to treat condition where the tissue that normally grows inside of the uterus starts to grow outside of the uterus. Women who have endometriosis can suffer from severe pains during menstruation, but also during intercourse and during bowel movements and urination.  The supplement palmitoylethanolamide (supplement PeaPure) can offer relief. PeaPure is pure palmitoylethanolamide.

On this women’s help website you will find more information on the natural treatment of specific women’s pain complaints.


Menstruation pain, endometriosis and neuropathic pain

Neuropathic pain presumably also plays a role in endometriosis. The pain in the pelvis and endometriosis is challenging to treat. In many cases endometriosis comes back after treatment.

Current research points out that neuropathic pain mechanisms also play a role in chronic pelvis pain and endometriosis. [1] Neuropathic pain means pain due to nerve stimuli. The tissue of the uterus stimulates all the little nerves in the pelvis, causing abdominal pain.

Endometriosis can also cause sciatic nerve neuropathy (large nerve through the leg) by putting pressure on the nerve. [2] This is rare, but important to keep in mind due to the irreversible damage to the sciatic nerve due to endometriosis. [3][4][5]

Especially when the neuropathic pain in the leg returns or amplifies monthly, possibly in combination with numbness and decrease of strength, neuropathic pain of the sciatic nerve due to endometriosis should be considered. [6]

If endometriosis is present in the abdomen or pelvic cavity, where a lot of nerves can be found, endometriosis can damage the nerves and cause neuropathic pain. [7] Nerves can also grow in to the endometriosis spots and start to cause neuropathic pain. The types of neuropathic pain that can occur with endometriosis are increased sensitivity to pain (hyperalgesia) and pain due to stimuli that aren’t normally painful (allodynia).


Endometriosis pain and inflammatory cells

The identification of neuropathic pain is important in order for an optimal treatment to be offered. [8] On a number of patients, endometriosis turned out to be treatable with the natural pain relieving substance palmitoylethanolamide (PEA), the supplement PeaPure.

A higher concentration of mast cells is present in the endometriosis spots, which can cause an inflammatory response and make the nerves more sensitive. [9] [10] This could develop in to neuropathic pain. [11] PEA has an inhibiting effect on the activated mast cells. [12] This way PEA has both an anti-inflammatory as well as a pain relieving effect on neuropathic pain. [13] PEA inhibits important inflammatory mediators, like TNF-Alpha and IL1 as well as COX-2, making it a potentially important substance in the treatment of a variety of conditions besides endometriosis. [14]

The nerve fibers that neuropathic pain causes are presumable the thin C fibers and autonomic nerve fibers. The neuropathic pain questionnaire, like the DN-4, can help to distinguish if the endometriosis pain is of neuropathic nature or not. The body’s own substance palmitoylethanolamide shows to bring relief for endometriosis pain. [15]


Endometriosis pain and treatment with palmitoylethanolamide

Patients with a pain score of over 5 (on a scale of 0-10 with 10 being the most pain imaginable) were given a combination preparation of 400mg palmitoylethanolamide and 40mg polydatin twice a day for 90 days.

Pain relief appeared after only one month. As the pelvic pain and pain during intercourse averagely scored the highest among women (around 8), these turned out to be the pains that showed the most effect (to a score of 2 after 90 days). On top of that the women needed to take less painkillers. Ultra-sound scans showed a small decrease of endometriosis spots.

Meanwhile thousands of patients with severe pain have been treated with this substance, often with impressive results. PEA shows to be effective for severe back and hernia pain, shingles pain, pain due to pinched nerves like with the carpal tunnel syndrome, chronic jaw pain and diabetes pain, to name a few difficult to treat types of pain. The substance can be taken with other pain killers without any problems, if necessary and has no knows negative effects on the effectiveness of other medicine. [16] [17] [18] [19][20][15][22] [23][24][25][26][27][28]

Because of this, palmitoylethanolamide can safely be used for menstruation pains due to endometriosis.


Explanation Francais Palmitoylethanolamide, een PEA-houdend product ou PeaPure, treatment du Douleurs neuropathique

Syndrome douloureux:douleur abdominale et pelvienne : douleur abdominale basse sous forme de coup decouteau, coup de poing dorsal, irradiation aine douleur constante avec exacerbation 

Les récepteurs à cannabinoïdes et leurs ligands identifiés chez l’homme: récepteurs CB1 et CB2Distribution non homogène SNC et périphérieZone de densité +++: Cortex cérébral,hippocampe, noyaux gris centraux, cervelet – cœur, adipocytes, système digestif, génito-urinaire. 

CB1: action centrale et périphérique – effet analgésique, antiinflammatoire (modèle douleur aiguë, neuropathique), action antitumorale (colon) 

CB2: action périphérique – centrale ? exprimés par les cellules du système immunitaire: lymphocytes, mastocytes, macrophages. 

Production par l’organisme et action sur récepteurs à cannabinoïdesEffet similaire au THC, mais moins puissant 

Les cannabinoïdes …Connaître les ligandsAnandamide 2-arachidonylglycerol, palmitoylethanolamide 

MÉCANISME D’ACTION CANNABINOÏDES – ANALGÉSIEsystème différent des opiacés mais analogie parallèle; action via complexe protéine G inhibitrice: ↓ AMPc; ↓ activation canaux calcique type N et P/Q; ouverture canaux K+ → ↓ libération neurotransmetteur; ouverture canaux K+ → hyperpolarisation afférence primaire; ↓ libération CGRP(calcitonin-gene-related-peptide);↓ expression C-Fos lamina V et V1; ↓ production facteur de nécrose tumorale; blocage non compétitif des récepteurs NMDA; activation α2 adrénergique centrale; action sur les récepteurs 5-HT3 

Source: https://www.aqsp.org/images/CONGRES2007/Conferences/B_4_Cannabinoides.pdf 


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