Area: Women's Health

Women's Health


D-mannose is a simple sugar structurally related to glucose; it is found in several fruits and has an important role inhuman metabolism, especially in the glycosylation of certain proteins. The supposed mechanism of action is inhibiting bacterial adherence to uroepithelial cells. D-mannose binds to the type 1 pili of enteric bacteria blocking their adhesion to uroepithelial cells, and reduction in bacteriuria levels. In a recent study, women with history of recurrent urinary tract infections (UTIs), treated with 2 g of D-mannose powder daily for 6 months, had a significant reduction of the risk of recurrent UTI. Under D-mannose treatment the elapsed time to UTI recurrence was 200 days, while it was 52.7 days following antibiotic treatment. Bladder pain and urinary urgency also decreased after D-mannose treatment.


The proanthocyanidins (PACs) in cranberry, in particular the A-type linkages have been implicated as important inhibitors of primarily P-fimbriated E. coli adhesion to uroepithelial cells. Administration of PAC-standardized cranberry powder may offer a nyctohemeral protection against bacterial adhesion and virulence in the urinary tract. Since bacterial adhesion is the primary step in initiation of UTI, consumption of cranberry may offer an additional means to help prevent infections.

Urinary tract infections

Urinary tract infections (UTIs), normally known as cystitis, are common, and it is estimated that around 11 % of women aged over 18 have an UTI each year. Simple isolated cases of UTIs do not cause severe problems for patients. On the other hand, recurrent UTIs (defined as 2 infections in 6 months or 3 or more infections in 1 year) carry a significant burden for the patient.
Long-term antibiotic prophylaxis is used to prevent ecurrent UTIs. Long-term antibiotic prophylaxis (lasting from 6–12 months) significantly reduced the proportion of women with clinical recurrence during prophylaxis. Also, it has been shown that the rate of infection returns to initial levels when prophylaxis is stopped, with up to 60 % of patients having a recurrence within 3 months. Possible side effects (although rare), costs, and increasing bacterial resistance to antibiotics are also the downfalls of long-term antibiotic prophylaxis, so alternative prophylactic methods such as D-mannose and cranberry juice have been advocated.


Inositol belongs to the vitamin B complex. Epimerization of the six hydroxyl groups of inositol leads to the formation of up to nine stereoisomers, including myo-inositol (MYO). Elevated concentrations of MYO in human follicular fluid play a role in follicular maturity and provide a marker of good-quality oocytes. MYO mechanism of action appears to be mainly based on improving insulin sensitivity of target tissues, resulting in a positive effect on the reproductive axis and hormonal functions through the reduction of insulin plasma levels. Previous studies have demonstrated that MYO is capable of restoring spontaneous ovarian activity, and consequently fertility, in most patients with polycystic ovary syndrome.

Phaseolamin (Phaseolus vulgaris)

Phaseolamin is a glycoprotein in white kidney beans (Phaseolus vulgaris). Phaseolus vulgaris extract has been shown to inhibit the activity of digestive enzyme alpha-amylase present in saliva and pancreatic juice. It may help promote weight loss by interfering with the digestion of complex carbohydrates (oligosaccharides) to simple (monosaccharides), absorbable sugars, potentially reducing carbohydrate-derived calories and glycemia. Also, slowing of the rapid absorption of carbohydrates would favorably influence the insulin system that could, in turn, lead to lesser fat accumulation.
A dietary formula containing Phaseolus vulgaris extract produced significant decreases in body fat while essentially maintaining lean body mass. Phaseolus vulgaris extract appears to be a safe and effective aid to consider in weight loss/maintenance programs.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most common cause of infertility, ovarian dysfunction and menstrual irregularity, affecting 5-10% of women in reproductive age. Several studies have reported that insulin resistance is common in PCOS women, regardless of the body mass index (BMI). Indeed, hyperinsulinaemia due to insulin resistance occurs in approximately 80% of women with PCOS and central obesity, as well as in 30-40% of lean women diagnosed with PCOS. The exact cause of the insulin resistance observed in PCOS women is unknown, although a post-receptor defect, that could affect glucose transport, has been proposed. Insulin resistance is significantly exacerbated by obesity, and it is a key factor in the pathogenesis of anovulation and hyperandrogenism. Further studies have suggested that impairment in the insulin pathway could be due to a defect in the inositolphosphoglycans (IPGs) second messenger. IPGs are known to have a role in activating enzymes that control glucose metabolism. In PCOS women, a defect in tissue availability or altered metabolism of inositol or IPGs mediators may contribute to insulin resistance.

Docosahexaenoic Acid (DHA)

Docosahexaenoic acid (DHA) is an omega-3 fatty acid that falls into the larger category of polyunsaturated fatty acids. Many chronic conditions are associated with excessive intake of dietary saturated fatty acids (including obesity, insulin resistance, coronary heart disease, and some form of cancer). Clinical assessment of dietary supplementation of omega-3 polyunsaturated fatty acids, including DHA, indicate their beneficial impact on human diseases, in which inflammation is suspected as a key component of the pathogenesis. DHA has a positive effect on membrane fluidity and permeability, carrier-mediated transport of nutrients in and out of the cell, enzymatic activities and cell-to-cell communication. Recent studies have revealed that, during the course of acute inflammation, omega-3 polyunsaturated fatty acids-derived mediators, including DHA, with potent anti-inflammatory properties are produced (resolvins).

Alpha lipoic Acid (ALA)

Of all the antioxidant nutrients, α-lipoic acid (ALA) seems to be the strongest for its unique ability to act as an antioxidant in both lipid and aqueous phases of the cell. Dietary sources include red meat, organ meats, spinach, broccoli, potatoes, yams, carrots, beets, and yeast. ALA is well known for its antioxidant properties in cytokine-induced inflammation. In addition, ALA can regenerate endogenous antioxidants, such as vitamin E, vitamin C, and glutathione, and prevent oxidative damage. Endogenous ALA is also a coenzyme involved in carbohydrate metabolism, and in the mitochondrial citric acid cycle which produces adenosine triphosphate.

Formulation DHA + ALA

Some results obtained with a formulation ALA plus DHA demonstrate the inventive property of this combination, since the compounds have different chemical structures and act through different modes of action but which, when acting together, interact at the cellular level to elicit a therapeutically meaningful response almost immediately. In fact, the oral administration of ALA in combination with DHA brought about a greater effect than the sum of either component alone, indicating a synergic interaction in antagonizing the inflammatory effect.

Chronic pelvic pain

Chronic pelvic pain is defined as continuous or intermittent pain located in the hypogastrium (minor pelvis) persisting for more than 6 months. Chronic pelvic pain is a widespread condition affecting about 1 in 6 adult females.  Acute pain is caused by tissue damage and decreases or subsides simultaneously with healing. Since the aetiology of chronic pain is affected by some additional factors, it can persist long after the tissue injury has healed or occur despite its absence. Increased pain deteriorates the quality of life of the subjects affected and call require pharmacological treatment or surgical interventions. In particular, the association of omega-3 with α-lipoic acid has showed interesting results in the treatment of chronic pain.

Menaquinone 7 (Vitamin K2)

Menaquinone 7 is a member of the Vitamin K2 family. Major source of Vitamin K2 are dairy products such as cheese and the traditional Japanese food natto (fermented soybeans). Vitamin K is required for the activation of glutamate into γ-carboxyglutamate (Gla) residues in so-called Gla-proteins, including osteocalcin synthesised in the bone. Active osteocalcin (cOC) is able to attract Calcium ions and incorporate them in hydroxyapatite crystals that form bone matrix. At a systemic level, concentrations of plasma cOC and its inactive form (ucOC) reflect the functional state of this protein in the bone matrix and have been shown to be a valid index to describe bone health: increased levels of ucOC were found in post-menopausal woman with increased bone loss, osteoporosis and increased fracture risk. Menaquinone 7 (MK-7) performs several functions, all related to its recognised effect on activation of certain Gla-proteins. MK-7 intake significantly improved Vitamin K status and decreased the age-related decline in bone mineral density (BMD) at the lumbar spine and femoral neck.
Then, improvement of Vitamin K status as measured by increased activation of OC is readily achievable by dietary supplementation with Vitamin K. Consistently, the European Food Safety Authorities (EFSA) accepted the health claim on Vitamin K’s role in maintenance of normal bone. So, postmenopausal women may benefit from taking MK-7 supplements to prevent the age-related bone loss.


Osteoporosis is a systemic skeletal condition that involves a reduction in bone mass and deterioration of the bone structure, making it more fragile with an increased risk of fractures. Postmenopausal women experience accelerated bone loss, which leads to osteoporosis and increased risk of development of fractures in the spine (vertebral crush fractures), forearm (Colles’ fractures) and hip. Osteoporotic fractures of the spine and forearm are associated with significant morbidity, but the most serious consequences of bone loss arise in patients with hip fracture, which is associated with a significant increase in mortality (15–20%), particularly in the elderly. Nutritional approaches to the prevention of osteoporosis are currently generating considerable interest, in particular regarding the recently found correlation between the severity of osteoporosis and dietary habits. Long-term Vitamin K inadequacy has been indicated as an independent but modifiable risk factor for the development of age-related diseases, including osteoporosis and cardiovascular disease.