EP.339/ Low vitamin C, endo and period pain: What you need to know
Today we’re continuing with our series on endo and period pain and their associations with low nutrient levels. Today, we’re talking about vitamin C.
Vitamin C is an anti-inflammatory antioxidant, which means it can help lower inflammation and also prevent oxidative stress - a process that triggers inflammatory reactions in the body and is involved in endo pain and progression. It also has antiangiogenic effects, which means it prevents the formation of new blood vessels, which endo relies on to grow.
As far as I can see, there isn’t a huge amount on low levels of vitamin C and period pain, except one small-ish study which showed reduced levels of antioxidants including vitamin C, in patients with primary dysmenorrhea. In terms of endo, and low levels of vitamin C, there are a number of studies showing an association with an increased risk of endometriosis.
So if it’s found to be low in people with endo and dysmenorrhea, can this powerful antioxidant vitamin help us with menstrual pain? According to the research - yes. In fact, a recent meta-analysis reviewed four controlled studies with over 500 endo patients and concluded that both vitamin C and E significantly reduced period pain (as well as pain with sex and daily pelvic pain) with endo. The catch is, these supplements were combined, so vitamin C was always alongside vitamin E, because vitamin C improves the antioxidant capabilities of vitamin E.
And though this isn’t today’s topic, I did want to bring your attention to some other studies on vitamin C and its effects on endo. In research on rats, one study showed vitamin C supplementation significantly reduced the size of endometriosis cysts, whilst another showed that vitamin C treatment suppressed endo lesion development and progress, and inhibited implantation of new lesions. Another study on humans with endo showed that vitamin C supplementation for six months reduced oxidative stress markers in women with endo, which as we explored earlier, is a process linked to endo growth, pain and progression.
But what about period pain in general? There aren’t many studies on vitamin C treatment for menstrual pain yet, and whilst researchers do theorise that vitamin C could help with menstrual pain due to it’s antioxidant properties and there is some research linking to low levels of vit C and dysmenorrhea, most of the literature pointed to the studies we have for endometriosis in terms of symptom improvement.
Now, all of studies for endo-related pelvic pain used 1000mg of vitamin C per day and thankfully, the NHS advises that taking 1000mg or less is unlikely to cause any side effects. However, it’s worth noting that too much vitamin C or too much in one go can cause diarrhoea and gut symptoms. Many of the studies on endo used 500mg of vitamin C twice a day, which improves absorption and prevents these side effects, so you may find you respond better to taking vitamin C in divided doses.
As to combining with vitamin E, the choice is yours. You could try vitamin C alone for a few cycles to see if you notice improvements, and if not, you could add vitamin E, which I covered last week, including the doses.
Again, just like all the other nutrients we’ve been discussing, it’s important we also get vitamin C from food. In fact, research has shown that people with endo have a 30% reduced intake of vitamin C in comparison to those without, and that a high antioxidant diet which included adequate intake of vitamin C over three months, significantly improved vitamin C levels and antioxidants levels, and reduced markers of inflammatory oxidative stress.
Sources of vitamin C include:
Strawberries
Blackcurrants
Oranges
Peppers
Broccoli
Sprouts
Baobab
Carrots
Guava
Kiwis
Papaya
Melon
Leafy greens
Incorporating a couple of these into your daily diet is a fantastic way to raise your vitamin C levels and actually fight the inflammatory processes that cause endo pain and growth.
Okay, that’s it! I’ll see you next week for the next episode in this series.
Show notes
Endo, period pain and prostaglandins
https://pubmed.ncbi.nlm.nih.gov/6790261/
https://pmc.ncbi.nlm.nih.gov/articles/PMC7068519/
https://www.tandfonline.com/doi/full/10.3109/09513590.2011.588753
https://pmc.ncbi.nlm.nih.gov/articles/PMC4512562
Vit C antioxidant properties
https://pubmed.ncbi.nlm.nih.gov/27521769/
https://pubmed.ncbi.nlm.nih.gov/27125410/
Vit C and endo or dysmenorrhea risk
https://pmc.ncbi.nlm.nih.gov/articles/PMC3484190/
https://jcdr.net/articles/PDF/1308/2311-final.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC10227355
https://link.springer.com/content/pdf/10.1186/s12978-024-01895-x.pdf
Vit C supplementation for Endo
https://onlinelibrary.wiley.com/doi/10.1155/2021/5529741
https://pmc.ncbi.nlm.nih.gov/articles/PMC3484190/
https://pubmed.ncbi.nlm.nih.gov/27125410/
https://obgyn.onlinelibrary.wiley.com/doi/10.1111/jog.12050
https://www.sciencedirect.com/science/article/abs/pii/S0020729207005772
https://pmc.ncbi.nlm.nih.gov/articles/PMC3484190/
https://rbej.biomedcentral.com/articles/10.1186/s12958-023-01126-1
Vit C supplementation for dysmenorrhea
https://www.mdpi.com/2075-1729/13/6/1308
High antioxidant diet and endo
https://www.mdpi.com/2072-6643/15/12/2773
https://link.springer.com/article/10.1186/1477-7827-7-54
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