**5. Conclusion**

Endometriosis is one of the most common benign gynaecological conditions. It affects an estimated 176 million worldwide regardless to their ethnics and social background. And it is estimated that 30-40% of women with endometriosis may not be able to have children. However, there is currently no single etiology that can explain the pathogenesis and pleomorphic manifestations of endometriosis.

Green Tea for Endometriosis 291

Calabrese, L & Fleischer, AB (2000). Thalidomide: current and potential clinical applications,

Camanni, M, Delpiano, EM, Bonino, L & Deltetto, F Laparoscopic conservative management

Camp-Sorrell, D (2003). Antiangiogenesis: the fifth cancer treatment modality?, *Oncol Nurs* 

Carmeliet, P & Jain, RK (2000). Angiogenesis in cancer and other diseases, *Nature* 407(6801):

Choan, E, Segal, R, Jonker, D, Malone, S, Reaume, N, Eapen, L & Gallant, V (2005). A

Chung, HW, Lee, JY, Moon, HS, Hur, SE, Park, MH, Wen, Y & Polan, ML (2002). Matrix

Coutinho, EM (1982). Treatment of endometriosis with gestrinone (R-2323), a synthetic

Cramer, DW & Missmer, SA (2002). The epidemiology of endometriosis, *Ann N Y Acad Sci*

Creus, M, Fabregues, F, Carmona, F, del Pino, M, Manau, D & Balasch, J (2008). Combined

D'Hooghe, TM, Nugent, NP, Cuneo, S, Chai, DC, Deer, F, Debrock, S, Kyama, CM, Mihalyi,

Dabrosin, C, Gyorffy, S, Margetts, P, Ross, C & Gauldie, J (2002). Therapeutic effect of

Davis, CJ & McMillan, L (2003). Pain in endometriosis: effectiveness of medical and surgical

de Mejia, EG, Ramirez-Mares, MV & Puangpraphant, S (2009). Bioactive components of tea: cancer, inflammation and behavior, *Brain Behav Immun* 23(6): 721-31. Donnez, J, Van Langendonckt, A, Casanas-Roux, F, Van Gossum, JP, Pirard, C, Jadoul, P,

Flower, A, Liu, JP, Chen, S, Lewith, G & Little, P (2009). Chinese herbal medicine for

Galle, PC (1989). Clinical presentation and diagnosis of endometriosis, *Obstet Gynecol Clin* 

Gottschalk, C, Malberg, K, Arndt, M, Schmitt, J, Roessner, A, Schultze, D, Kleinstein, J &

Ansorge, S (2000). Matrix metalloproteinases and TACE play a role in the

endometriosis, *Gynecol Obstet Invest* 54 Suppl 1: 52-8; discussion 59-62. Ferrara, N (2002). VEGF and the quest for tumour angiogenesis factors, *Nat Rev Cancer* 2(10):

laparoscopic surgery and pentoxifylline therapy for treatment of endometriosis-

A & Mwenda, JM (2005). Recombinant human TNF binding protein-1 (r-hTBP-1) inhibits the development of endometriosis in baboons; a prospective, randomized,

angiostatin gene transfer in a murine model of endometriosis, *Am J Pathol* 161(3):

Squifflet, J & Smets, M (2002). Current thinking on the pathogenesis of

antiestrogen, antiprogesterone, *Am J Obstet Gynecol* 144(8): 895-8.

associated infertility: a preliminary trial, *Hum Reprod* 23(8): 1910-6.

placebo and drug controlled study., *Biol Reprod* 74(131-6).

management, *Curr Opin Obstet Gynecol* 15(6): 507-12.

endometriosis, *Cochrane Database Syst Rev* (3): CD006568.

pathogenesis of endometriosis, *Adv Exp Med Biol* 477: 483-6.

prospective clinical trial of green tea for hormone refractory prostate cancer: an evaluation of the complementary/alternative therapy approach, *Urol Oncol* 23(2):

metalloproteinase-2, membranous type 1 matrix metalloproteinase, and tissue inhibitor of metalloproteinase-2 expression in ectopic and eutopic endometrium,

of ureteral endometriosis, *Curr Opin Obstet Gynecol* 22(4): 309-14.

*Am J Med* 108(6): 487-95.

*Forum* 30(6): 934-44.

*Fertil Steril* 78(4): 787-95.

955: 11-22; discussion 34-6, 396-406.

249-57.

108-13.

909-18.

795-803.

*North Am* 16(1): 29-42.

Current treatments for endometriosis remain unsatisfactory, owing to their focus on treating the symptoms rather than curing the disease. In addition, each treatment proved to have many side effects (Rice, 2002). Hence, there is a need to derive a new therapy to provide a more efficient and specific therapeutic alternatives to eliminate the lesions, while preventing reoccurrence and retaining fertility.

To provide additional evidence to support the role of green tea in suppressing endometriosis, it would be an important future research goal. Several study areas should be emphasized. These areas include a more detailed molecular and cellular mechanism studies in animals and humans to verify the effects of green tea in humans, compared with those studied in animals. Next, the interactions between the green tea polyphenols and endometriosis have not been extensively investigated. This drawback can cause many important details being vague. Furthermore, the potential interactions of active compounds in green tea with other dietary active components and the roles of polymorphisms on the protective effects of tea need to be examined in future studies. Ultimately, clinical intervention trials should be conducted to verify the mechanisms of action of tea observed in animal studies in which tea does not show any unwanted side effect.
