Curcumin-Based Interventions for Endometriosis: A Systematic Review of Clinical Outcomes

Endometriosis is a chronic inflammatory gynecological disorder commonly associated with pelvic pain, infertility, sexual dysfunction, and impaired quality of life. Curcumin has gained interest as a potential complementary therapy because of its anti-inflammatory, antioxidant, and anti-angiogenic properties, although clinical evidence remains limited and inconsistent. This systematic review was conducted according to PRISMA 2020. PubMed/MEDLINE, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov were searched for randomized controlled trials evaluating curcumin-based interventions in women with endometriosis. Outcomes included endometriosis-associated pain, quality of life, sexual function, reproductive and assisted reproductive technology (ART) outcomes, inflammatory and oxidative stress biomarkers, disease-related parameters, and adverse events. Risk of bias was assessed using the Cochrane RoB 2 tool. Three randomized controlled trials involving 204 women were included. Conventional curcumin did not significantly improve pain or quality of life compared with placebo. In contrast, nanomicellar curcumin added to dienogest was associated with greater reductions in several pain domains and improvements in quality of life and sexual function. In women undergoing ART, nanomicelle curcumin improved several oxidative stress and inflammatory markers and intermediate reproductive outcomes, including oocyte retrieval, mature oocytes, fertilization, and cleavage rates, but did not significantly improve pregnancy rates. Evidence regarding endometrioma size and safety remained limited. All studies were judged to have some concerns overall in the RoB 2 assessment. Curcumin-based interventions show promising but heterogeneous effects in endometriosis. Larger multicenter trials with standardized formulations, longer follow-up, and clinically meaningful outcomes are required. Keywords: Curcumin; Endometriosis; Infertility; Nanocurcumin; Pelvic pain