Palmitoylethanolamide in Gynaecological Pain: A Narrative Review of Mechanisms and Clinical Evidence in Dysmenorrhoea and Endometriosis-Associated Pelvic Pain

Background

Dysmenorrhoea and endometriosis-associated pelvic pain are among the most common causes of pain in women of reproductive age. Non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies are the standard of care, but both have limits on tolerability, contraindications and compatibility with fertility goals. Palmitoylethanolamide (PEA) is an endogenous fatty-acid amide that modulates inflammation and pain. It acts mainly through peroxisome proliferator-activated receptor-α (PPAR-α) and by down-regulating mast cells and glia.