Volume 30, Issue 172, June 2026

N-acetylcysteine as an Investigational Molecular Modulator in Endometriosis: A Narrative Review

Magdalena Rakuś^1♦, Krzysztof Łukasz ¹, Jakub Marzec ¹, Michał Nowakowski ¹, Aleksandra Musioł ¹, Paweł Gwałt ¹

¹Medical University of Warsaw; ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Magdalena Rakuś, Medical University of Warsaw; ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland

ABSTRACT

Background: Endometriosis is an inflammatory condition featuring persistent oxidative stress. Usual hormonal therapy and surgery can be limited because they introduce contraceptive effects. Aim: This review considers the potential of Nacetylcysteine (NAC) as a candidate non-hormonal molecule that could influence endometriosis, while considering the preliminary and methodological weaknesses of the available data. Materials and Methods: A structured PubMed-MEDLINE search (January 2010 – May 2026) was performed to identify the role of N-acetylcysteine (NAC) in endometriosis. A comparative approach was used to summarize the methodological validity of preclinical animal studies and clinical trials and to assess study quality. Results: Evidence from mechanistic studies and experimental models indicates NAC as a candidate factor associated with molecular changes in tissue and lesion regression in preclinical models. Clinical research reports pain relief and a reduction in endometrioma size; however, the results are affected by small sample sizes, lack of randomization and placebo control, or mixed antioxidant formulations. Conclusions: Current knowledge is insufficient to support NAC as a conventional treatment for endometriosis. Limitations stemming from the heavy reliance on preclinical models and the confounding design of clinical trials hinder understanding of NAC’s role. Further research needs to focus on randomized controlled trials on NAC alone. Showing the disease-modifying potential of NAC requires long-term outcomes.

Keywords: endometriosis, n-acetylcysteine (NAC), redox signaling modulation, proliferation-to-differentiation switch

Medical Science, 2026, 30, e112ms3921

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DOI: https://doi.org/10.54905/disssi.v30i172.e112ms3921

Published: 29 June 2026