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The pain-relieving aspect appears secondary to tissue repair rather than direct analgesic action

In the normal myometrium, homeostasis is achieved with the assistance of matrix metalloproteinases (MMP), which are involved in remodeling and degrading certain constituents of the extracellular matrices, such as collagen, which contributes to the stiffness of ECM (Korompelis et al., 2015)

Without standardized formulations and defined perioperative protocols, clinical trials will remain vulnerable to confounding and irreproducibility

Recommended treatment protocol: 1000-2000 mcg of B12 given through injections or under the skin, at first daily or weekly

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