title: Effect of palmitoylethanolamide-polydatin combination on chronic pelvic pain associated with endometriosis: preliminary observations.
abstract: OBJECTIVE
  Endometriosis is a chronic oestrogen-dependent gynaecological disorder, the most common symptom of which is pain. Inflammation can be considered one of the major causes of pain in endometriosis. In particular, degranulating mast cells have been found in significantly greater quantities in endometriotic lesions than in unaffected tissues. The increase in activated and degranulating mast cells is closely associated with nerve structures in painful endometriotic lesions. These observations indicate that inflammation due to mast cells may contribute to the development of pain and hyperalgesia in endometriosis. Controlling mast-cell activation may therefore relieve the pain associated with endometriotic lesions.
  
  
  METHODS
  Four patients presenting an endometriosis-related pain intensity >or=5 (visual analogue scale for pain, or VAS) were enrolled and monitored during 3 months of the following treatment: oral palmitoylethanolamide 400mg and polydatin 40mg, twice daily for 90 days. Deep dyspareunia, dyschezia, dysuria, dysmenorrhoea and analgesic drug use during the 3-month follow-up period were also monitored, with the aim of demonstrating a reliable reduction in chronic pelvic pain.
  
  
  RESULTS
  The preliminary results indicate that all patients enrolled experienced pain relief as early as 1 month after starting treatment. Furthermore, a reduction in the analgesic drugs usually employed for pain control was observed in all subjects treated. Additionally, some improvements in endometriotic lesions seemed to be demonstrated by imaging.
  
  
  CONCLUSIONS
  The palmitoylethanolamide-polydatin combination seems to be very useful in controlling chronic pelvic pain associated with endometriosis. As a result of these findings we have initiated a multi-centre pilot study to verify the effectiveness of this treatment in controlling the chronic pelvic pain associated with endometriosis.
authors.affiliation: Department of Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia. Via Pinto, 71100 Foggia, Italy. ugo.indraccolo@libero.it
authors.forename: Ugo
authors.initials: U
authors.lastname: Indraccolo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Barbieri
mesh_terms: D000328:Adult; D000577:Amides; D004338:Drug Combinations; D004414:Dyspareunia / Q000188:drug therapy; D063388:Endocannabinoids; D004715:Endometriosis / Q000150:complications* / Q000473:pathology; D004983:Ethanolamines; D005260:Female; D005960:Glucosides / Q000008:administration & dosage*; D006801:Humans; D008407:Mast Cells / Q000473:pathology; D008875:Middle Aged; D010169:Palmitic Acids / Q000008:administration & dosage*; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D013267:Stilbenes / Q000008:administration & dosage*
chemical_list: D000577:Amides; D004338:Drug Combinations; D063388:Endocannabinoids; D004983:Ethanolamines; D005960:Glucosides; D010169:Palmitic Acids; D013267:Stilbenes; C550607:pelvilen; C005958:palmidrol; C058229:polydatin