EP.319/ Pycnogenol for endo, pots, mcas and perimenopause
Recently I shared an episode on pycnogenol and the research behind its use for chronic UTIs and interstitial cystitis - and the evidence is pretty impressive.
I mentioned in the show that pycnogenol is one of my favourite supplements for us endo peeps, and I thought I should elaborate on some of the key benefits, for those of you who are curious.
So let’s start with endometriosis, of course.
Endo
In research, pycnogenol was shown to reduce pain with endo by 33%, which though it may not sound a lot, if you consider endo pain can be and often is about a level 10 on the pain scale, a reduction of 33% would reduce it to about a 6 to 7 on the pain scale, which I think most of us would appreciate. Especially when you consider that managing endo pain and symptoms is about taking a layered approach, using multiple changes to bring levels down overall.
The study was conducted in people with endometriomas and not only did pycnogenol lower pain, but it also lowered levels of CA125. CA125 is an inflammatory marker which can indicate ovarian cancer, but don’t worry - high levels with endo do not mean you have cancer, CA125 is also elevated the more severe your endo. People with endometriosis and more advanced stages, like stage 3 and 4, have the highest levels. A reduction in CA125 indicates the endometriomas and lesions were reducing in severity and size, though frustratingly, they didn’t confirm this with any scans to check the endometriomas size reduction.
The study also compared pycnogenol to hormonal therapy for endo and whilst the pycnogenol was slower to take effect, the results were longer lasting than the hormonal medication group, with a return of symptoms bouncing back after those patients came off the medication.
The dose studied was 30mg twice a day for 48 weeks - and yes, that’s a long time but it takes time to reduce the inflammatory process that aggravate and develop endo, so it’s not something we can change overnight. However, I do recommend to my clients who use pycnogenol, to layer it with something that can reduce pain quicker, such as ginger or to combine it with another supplement that’s also shown reduction in lesions and endometriomas such as NAC. Combining supplements means you can still benefit from the effects of pycnogenol, but feel relief sooner.
Menstrual pain
Okay now let’s talk about dysmenorrhea, otherwise known as menstrual pain. I’ve talked many times before about inflammatory prostaglandins. These are immune chemicals that play various roles in the body, but increase at ovulation and menstruation to enable the shedding of the uterine lining and the eruption of the egg from the ovary. However, in people with endometriosis and dysmenorrhea, numbers are higher than normal, and it’s these high levels that drive the pain and in the case of endo, also help drive its growth. Pycnogenol was shown in the research to significantly inhibit the inflammatory pathways and production of prostaglandins, much like NSAID medications work, but without the side effects. This was also echoed in other studies that showed participants who used pycnogenol required less pain medication on their periods.
Various studies have been conducted in people with dysmenorrhea, one study showed a significant reduction in menstrual pain with 30mg of pycnogenol taken seven days before menstruation. Another study showed a 36% improvement in pain when participants took pycnogenol three weeks before their period, and these improvements increased when they continued to take pycnogenol daily.
Many of these studies used between 30mg once or twice per day, similar to the endometriosis research.
Allergies/histamine
Okay, now let’s talk about allergies and histamine issues. Research shows that people with endometriosis tend to have a higher prevalence of allergies (I’ve linked to an episode on this in the show notes), and additionally, we also tend to have more mast cells, and overactive mast cells at that. Mast cells are the immune cells which release histamine, and they are heavily involved in the development of endo, but can also further drive symptoms of allergies and inflammation.
Pycnogenol is what’s known as a mast cell stabiliser, which means it inhibits the production of histamines when the mast cells are exposed to an irritant, making these mast cells less reactive and sensitive. In fact, it was shown to be just as effective as over the counter antihistamines and was found to reduce mast cell reactivity in a dose dependent manner, meaning the more pycnogenol, the better the effects.
Dysautonomia
Now let’s talk about how pycnogenol could benefit those us with POTS or dysautonomia. These conditions affect the autonomic nervous system and are common in endo patients, especially those with SIBO, IC, MCAS and Ehlers Danlos Syndrome. If you want to learn more about this connection, I’ve linked to a few episodes in the show notes.
Dysautonomia and POTS affect involuntary bodily functions such as heart rate, blood pressure, and circulation. Venous insufficiency is when the veins in your legs struggle to pump blood back up to the heart, and many people with POTS and dysautonomia struggle with this due to their condition. As a result, blood and lymph fluid can pool in the legs, resulting in swelling, pain and discomfort.
Whilst (to my knowledge) no studies have been conducted on POTS or dysautonomia with pycnogenol, many studies have shown a significant improvement in swelling of the legs, circulation and venous insufficiency and the accompanying symptoms such as leg heaviness and pain. Additionally, many people in the POTS and dysautonomia community report improvements when using pycnogenol.
The doses used in these studies were generally higher than those used for endo and menstrual pain, at about 100 - 200 mg a day.
However, I will just say that pycnogenol has been shown to lower blood pressure in people with high blood pressure. There’s not really any research on it for people with low blood pressure, but because POTS and dysautonomia does cause low blood pressure, I would check in with your doctor and be mindful of your blood pressure and how you feel when on it, to ensure it’s right for you. As I said, many people with these conditions report improvements, but it’s always best to be careful.
Menopause and perimenopause
Finally, let’s talk about its benefits for perimenopause and menopause. Unfortunately, many people with endo may experience a medically induced or surgically induced menopause due to either hormonal treatment or a total hysterectomy. Additionally, there is some research suggesting a higher risk of early menopause in some people with endometriosis.
To compound this, perimenopause can often make endometriosis symptoms worse, because oestrogen can actually increase during this time before it starts to drop, whilst progesterone decreases (often first), and therefore, oestrogen excess or dominance can be a factor. As we know, endo can be aggravated by oestrogen, so higher levels or oestrogen dominance can and often does trigger a return of or increasing symptoms. This is something I see a lot with clients going through perimenopause.
The challenge is that a lot of perimenopause and menopause treatments involve oestrogen, which is not always helpful for those of us with endo. Pycnogenol has no effect on oestrogen, but has been shown to alleviate symptoms of perimenopause such as hot flashes, insomnia, menstrual problems, mood, cognitive function, night sweats, sex drive and more. Whilst this isn’t an episode on perimenopause, you can further support these changes with working on oestrogen clearance and supporting progesterone production as much as possible.
Okay, so as you can see, there are so many helpful benefits of pycnogenol for our community. If you try it, I do suggest you stick to the studied doses and time frames, to get the best results. Of course, remember this is general and not tailored information, so you need to consult your healthcare practitioner when considering starting pycnogenol.
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Show Notes
Endo research
https://pubmed.ncbi.nlm.nih.gov/17879831/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4512562/
https://ri.conicet.gov.ar/bitstream/handle/11336/130924/CONICET_Digital_Nro.f5b315e1-bd81-4dcb-83f0-4e4a751927ce_A.pdf?sequence=2&isAllowed=y
https://www.mdpi.com/2227-9059/11/3/978
Mentstrual pain
https://www.pycnogenol.com/fileadmin/pdf/Application_brochures/pycno_menstrual_discomfort_16012016_WEB.pdf
https://pubmed.ncbi.nlm.nih.gov/6790261
Histamine intolerance
https://www.pycnogenol.com/fileadmin/pdf/Application_brochures/pycno_respiratory_health_18012016_WEB.pdf
https://pubmed.ncbi.nlm.nih.gov/22332753/
https://pubmed.ncbi.nlm.nih.gov/31998139/
https://www.emjreviews.com/reproductive-health/article/targeting-mast-cells-as-a-viable-therapeutic-option-in-endometriosis/
Histamine Intolerance 101 Dr. Becky Campbell
https://www.thisendolife.com/this-endolife-podcast-episodes/strategies-for-lowering-histamine-reducing-allergies-endometriosis
https://www.thisendolife.com/this-endolife-podcast-episodes/association-between-endometriosis-allergies
Endometriosis, SIBO, Interstitial Cystitis and Allergies: The Histamine Connection
Dysautonomia
https://www.pycnogenol.com/fileadmin/pdf/Application_brochures/pycno_healthy_veins_18012016_WEB.pdf
https://www.pycnogenol.com/applications/circulatory-heart/
https://www.theendobellycoach.com/podcast/pots-dysautonomia-with-endo
https://drive.google.com/file/d/18q4ZAbC7Ism7OcJu39vw_GwPnl-0_5Lz/view
https://www.theendobellycoach.com/podcast/endo-and-dysautonomia
https://www.theendobellycoach.com/podcast/endometriosis-and-ehlers-danlos-syndrome
https://www.theendobellycoach.com/podcast/endo-ic-sibo
https://www.theendobellycoach.com/podcast/jessica-drummond-endometriosis-mcas-hypermobility-dysautonomia
Perimenopause
https://www.pycnogenol.com/fileadmin/pdf/Application_brochures/Pycnogenol_Menopause_EN_211.pdf
https://www.ncbi.nlm.nih.gov/books/NBK507826/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788287
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Produced by Chris Robson