What the Research Shows on PEA for Endometrial Pain

Endometriosis is believed to impact one in 10 women of reproductive age globally. The pain and bleeding that result from endometrial tissue growing outside the uterus can interfere with quality of life, interfere with fertility and cause debilitating bladder, bowel and even gut issues.  

But despite how common this condition is, women often wait between seven and nine years for a confirmed diagnosis, leading to untold physical, emotional and even financial side effects. There is no known cure for endometriosis, and treatments have traditionally included hormonal birth control, surgery and pain medicine.  

However, the endogenous fatty acid amide palmitoylethanolamide (PEA) has shown promise for both chronic pelvic pain and quality of life for individuals living with endometriosis.  

What is PEA? 

PEA is part of a group of biologically active lipids naturally produced by the body to soothe pain and discomfort. According to available research, PEA possesses analgesic actions, without any unwanted effects.   

In the body, the biological properties and mechanisms of PEA impact glial and mast cells, cannabinoid-2 receptors, NF-kB, and the nuclear receptor peroxisome proliferator-activated receptors. PEA also enhances the effects of the fatty acid anandamide (also referred to as the “bliss molecule”) when it binds to CB receptors. 

PEA and Endometriosis 

Here are some of the recent studies on PEA and endometriosis:  

A 2013 study published in the journal Clinical Trial examined the effectiveness of micronized PEA for chronic pelvic pain in women affected by endometriosis. A total of 24 patients experiencing severe pelvic pain received two tablets a day of PEA 400 mg and 40 mg polydatin for 90 days. Researchers found statistically significant results in relation to pelvic pain, dysmenorrhea and dyspareunia compared with the start of the study. However, changes in dysuria and dyschezia were not statistically significant.  

A 2016 rodent model published in Frontiers in Pharmacology explored how a PEA and polydatin (PLD) treatment could impact surgically-induced endometriotic lesions. After four weeks, the treated group showed promising results: smaller cysts, improved fibrosis scores and a decrease in mast cells. Results suggest that PEA may be of use to inhibit development of endometriotic lesions in rats. 

And in 2019, an open-label pilot study published in the International Journal of Women’s Health evaluated the impact of ultra-micronized PEA and co-micronized PEA and PLD on pelvic pain in patients who wanted to become pregnant. Thirty patients received the ultra-micronized PEA for 10 days, then the PEA/PLD combination two times a day for another 80 days. After the three-month treatment, all participants showed significant improvements in chronic pelvic pain, deep dyspareunia, dysmenorrhea and dyschezia. They also reported better quality of life and psychological well-being. 

Choosing a PEA Supplement 

Since PEA is a lipid that has a large particle size in its unprocessed state, that can limit its solubility and bioavailability. However, ultra-micronized PEA has been processed using an air-jet milling technique. Both its particle size and purity are then confirmed. Research shows that, in animal studies, this form of PEA exerts a superior action.  

Avoid synthetic forms, which involve the use of powerful synthetic solvents such as toluene.