Beneficial Effects of Oral Lactobacillus on Pain Severity in Women Suffering from Endometriosis: A Pilot Placebo-Controlled Randomized Clinical Trial

To assess the effects of lactobacillus-based medication on pain intensity scores in women with endometriosis. A randomized pilot placebo-controlled trial was done on eligible women who surgically and pathologically were diagnosed with endometriosis. Thirty-seven enrolled participants who have not received hormonal treatment in the last three months, randomized between lactobacillus and placebo groups. Lactobacillus capsules or placebo administrated orally at a daily dose for 8 weeks. Patients assessed for pain severity using Visual Analogue Scale (VAS) scores for dysmenorrhea, dyspareunia and chronic pelvic pain at baseline and after 8 and 12 weeks post intervention. Mean age of participants and mean BMI for the Lactobacillus and control group were comparable. All patients had stage 3 and 4 of disease based on revised American fertility society (AFS) classification of endometriosis. Mean initial pain scores for dysmenorrhea, dyspareunia and chronic pelvic pain were 6.53 ± 2.88, 4.82 ± 3.76 and 4.19 ± 3.53 respectively in the Lactobacillus group. The corresponding initial scores for the control group were 5.60 ± 2.06, 3.67 ± 2.64 and 2.88 ± 2.80 respectively that were comparable for both groups. The amount of pain score decrease for dysmenorrhea and the overall pain after 8 weeks were significantly higher for lactobacillus group compared to the control group. The scores for dysmenorrhea were 6.53 ± 2.88 and 5.60 ± 2.06 in the Lactobacillus and control groups, respectively, before intervention that changed to 3.07 ± 2.49 and 4.47 ± 2.13 (p = 0.018) after 8 weeks. The changes in overall pain score for the Lactobacillus and control group during this period were 7.33 ± 7.00 and 4.11 ± 1.68 respectively (p = 0.017). This study showed some beneficial effects of Lactobacillus administration on the endometriosis related pain.