Gynecology & Obstetrics
Open Access

Abstract

The Effect of Oral Contraceptives Combined With Pycnogenol (Pinus Pinaster) On Aromatase and VEGF Expression in the Eutopic Endometrium of Endometriosis Patients

Hugo Maia Jr, Clarice Haddad, Nathaniel Pinheiro and Julio Casoy

Oral contraceptives are effective in curbing down endometrial inflammation and decreasing endometriosisrelated dysmenorrhea. This antiinflammatory action is mediated by the progestin component of the pill and it involves the blockade of the NF-kappa.B inflammatory cascade. One of the genes activated by NF-kappa.B is the one that codes for angiogenic factors such as VEGF. In this respect, oral contraceptives would be expected to block VEGF expression in the endometrium. However, the use of oral contraceptives alone failed to significantly decrease the percentage of endometria testing positive for VEGF. Introducing pycnogenol to the treatment regimen, on the other hand, significantly reduced the percentage of VEGF-positive cases in oral contraceptive users. Since pycnogenol blocks NF-kappa.B gene transcription after its binding to DNA, the combination of oral contraceptives with pycnogenol would be expected to have a synergetic effect on the eutopic endometrium of endometriosis patients. The expression of other inflammatory-induced genes in the endometrium, such as aromatase, is also significantly diminished with the use of oral contraceptives alone. However, this inhibitory effect was significantly enhanced with the concomitant use of pycnogenol. These results suggest that the concomitant use of pycnogenol with oral contraceptives is more effective in reducing VEGF and aromatase expression in the eutopic endometrium of endometriosis patients than the use of oral contraceptives alone.