Ronald Steriti, ND, PhD
Adenomyosis is a condition where endometrial tissue, which normally lines the uterus, grows into the muscular wall of the uterus. This causes an enlarged uterus and painful, heavy periods.
Presenting signs and symptoms vary, but most commonly are painful menses and/or heavy menstrual bleeding.1
PALM-COEIN Acronym for Abnormal Uterine Bleeding
Adenomyosis is part of the American College of Obstetricians and Gynecologists (ACOG) PALM-COEIN acronym for the evaluation of abnormal uterine bleeding in reproductive-aged patients2: “Polyp; Adenomyosis; Leiomyoma; Malignancy hyperplasia; Coagulopathy; Ovulatory dysfunction; Endometrial; Iatrogenic; and Not yet classified.”
Andrographolide is an active ingredient extracted from andrographis (Andrographis paniculata), a medicinal herb used in traditional Chinese medicine for the alleviation of inflammatory disorders for thousands of years.3
Symptomatic Adenomyosis
A study evaluated the efficacy of andrographolide in treating adenomyosis. The Shanghai Obstetrics and Gynecology Hospital, Fudan University Shanghai Medical College (Shanghai, China) conducted the study. The study was published in Gynecology and Minimally Invasive Therapy.4
The study tested the hypothesis that its efficacy may depend on the nuclear factor-kappa-light-chain enhancer of activated B cells (NF-kB) activation status in eutopic endometrium, which may be a proxy for the status in adenomyotic foci.
Twenty-four patients with transvaginal ultrasound-confirmed adenomyosis (excluding ovarian endometriomas) were recruited for this study after informed consent. All patients had dysmenorrhea and/or heavy menstrual bleeding.
All patients received Andro dripping pill (Tansly Pharmaceutics, Tianjin, China) orally starting at the 5th day of the menstrual cycle, for 3 months, when no serious adverse effect was reported. Andro 600 mg contains 150-mg pure andrographolide.
The patients stopped taking the pill when they had menstruation but resumed at the 5th day of the menstrual cycle. For these patients, the treatment was terminated at the end of the 3rd month after taking the drug. The patients were then followed up for an additional 3 months. During treatment, clinical signs and symptoms were monitored.
The primary outcome measures included the severity of dysmenorrhea, as measured by the visual analog scale (VAS), and menstrual characteristics, such as the amount of menses, all measured before and 3 and 6 months after the drug treatment.
In addition, the patients completed Clinical Global Impression rating scales at the end of the 6th month. Immunostaining of the phosphorylated NF-kB p65 (p-p65) subunit was also performed for eutopic endometrium.
Andrographolide treatment appeared to be well tolerated by the patients.
Six months after taking andrographolide, the average dysmenorrhea VAS score was decreased from the baseline level of 5.3 to 3.5.
Twelve patients (50.0%) reported “marked” or “much” improvement, seven (29.2%) reported “minimal improvement” and five (20.8%) reported “unchanged or worse.”
The eutopic endometrial p-p65 staining levels were closely correlated with the satisfaction rating.
Andrographolide is effective in some patients with symptomatic adenomyosis, who have a higher endometrial expression of the activated form of the NF-kB p65 subunit.4
References
- Gunther, R and C Walker (2024), ‘Adenomyosis’, StatPearls PubMed: 30969690
- Schrager, S, et al. (2022), ‘Adenomyosis: Diagnosis and Management.’, Am Fam Physician, 105 (1), 33-38. PubMed: 35029928
- Li, X, et al. (2022), ‘Andrographolide, a natural anti-inflammatory agent: An Update.’, Front Pharmacol, 13 920435. PubMed: 36238575
- Liu, X, S Yu, and Sun-Wei Guo (2014), ‘A pilot study on the use of andrographolide to treat symptomatic adenomyosis’, Gynecology and Minimally Invasive Therapy, 3 (4), 119-26.
Published June 15, 2024
About the Author
Dr. Ronald Steriti is a graduate of Southwest College of Naturopathic Medicine and currently is researcher for Jonathan V. Wright at the Tahoma Clinic and Meridian Valley Lab.
Dr. Steriti has published several books on natural health research. NaturDoctor.com