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REVIEW ARTICLE
Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 19-22

Role of iron in the oxidative stress in the pathophysiology of endometriosis: A new concept to know the potential therapeutic benefit


Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India

Correspondence Address:
Dr. Pratap Kumar
Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2394-4285.146702

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Endometriosis is a multifactorial disease characterized by inflammatory changes in the pelvic cavity and symptoms of pain, infertility, and menstrual irregularities. Several theories have been proposed since Samson's theory of retrograde menstrual flow. Iron has been found to be one of the major factors involved in the above-mentioned theory. Abundant retrograde flow of blood into the pelvic peritoneum, followed by the destruction and consumption of the free red cells by the macrophages results in an iron overload both intra-and extracellular. Being a strong catalyst to the formation of free radicals, iron contributes significantly to the rise in the levels of reactive oxygen species, which cause the oxidative stress (OS). Besides stimulating the formation of free radicals and contributing to OS, increased iron in the macrophages also activates a sustained and overstimulated inflammatory response that is responsible for much of the symptoms seen in endometriosis; in particular infertility, due to extensive intraperitoneal adhesions. While genetic factors play a role in determining a woman's response to OS, lifestyle also plays an important part. Dietary deficiency of vitamin C, vitamin E, and micronutrients such as selenium and manganese results in an acquired deficiency of antioxidants and an exaggerated response to the OS. Consumption of fresh fruits, green vegetables, etc. that are rich in antioxidants has been shown to be beneficial in alleviating the symptoms of endometriosis as well as in improving pregnancy rates. Theoretical advantages seem to be present in localized iron chelation as a method of medical management of endometriosis; however, further studies need to be conducted to confirm that the benefits outweigh the risks.


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