Omega-3 fatty acid supplements and women’s health

By Rafat Abbasi, MD – Partner, Columbia Fertility Associates. Washington DC.
Clinical Assistant Professor, Department of Family Medicine, Georgetown University Hospital Washington DC.

Omega-3 fatty acids cannot be produced by the human body. They must be provided by the diet and by adding supplements.

The most common essential fatty acids are Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA) and Alpha linolenic acid (ALA) which is converted to EPA and DHA.

Omega-3 fatty acids in menopausal women.

A. Heart Disease.

As women age, their incidence of cardiovascular disease increases.  In some studies, it has been shown to be equal to that of men in the same age group. This is due to the absence of the cardioprotective effect of estrogen.

There are well documented studies confirming the benefits of Omega-3 fatty acids on the cardiovascular system. These include lowering of triglycerides, blood pressure, and plaque formation.

Omega-3 fatty acids also prevent platelets from clumping together, thus decreasing the risk of strokes.

B. Hot flashes.

One of the most common and troublesome effects of decreased estrogen production in menopause are hot flashes. In 2005, Italian scientists demonstrated a significant decrease in hot flashes and night sweats in patients who had been prescribed high doses of Omega-3 supplements. This is a result of the effect on the nerve cell membranes and the anti-inflammatory properties of the Omega-3 fatty acids.  

C. Osteoporosis.

Omega-3 fatty acids are known to improve bone strength and increase bone formation in older women.

D. Mood and age-related memory decline.

Declining memory and cognitive function are some of the side effects of aging, but these are compounded by the estrogen deficient state in menopause. Omega-3 fatty acids have been shown to decrease this age-related decline as well as improve mood and depression. Higher intake of these supplements, in controlled studies, have been associated with positive moods.

Omega 3 fatty acids in pre-menopausal women.

A. Menstrual pain.

Proinflammatory factors produced during menstruation cause increased menstrual cramps. High levels of Omega-3 supplements have been shown to be successful in alleviating menstrual pain.

B. Pre-menstrual Syndrome. (PMS)

This is a monthly occurrence in some women that can be incapacitating. It affects about 40% of women, the combination of mood changes and pain has been shown to affect the quality of life in about 10% of  women who suffer with PMS. A randomized, double blinded controlled trial published in 2012 (Sohrabi, N. et al). This showed the significant impact of high doses(2g) daily of omega-3 supplements within 45 days of starting the pills. Both the psychiatric and somatic symptoms were improved.

C. Polycystic ovary syndrome and Metabolic syndrome.

Polycystic ovarian syndrome (PCOS) is associated with increased weight gain, increased androgen production and insulin resistance. Type II diabetes is found in about 25% of patients with PCOS.  Haiianfar H et al in 2013, published a study showing the positive effect of Omega-3 supplements in decreasing insulin resistance and increasing the antioxidant capacity.

Omega-3 fatty Acids in Reproductive aged women.

A. Improved egg and sperm quality.

Omega-3 fatty acids can lower inflammation by reducing the production of inflammatory molecules such as eicosanoids and cytokines. Increased Omegs-3 intake preconception can improve egg quality, by reducing leptin levels. Sperm parameters are improved by reducing sperm DNA damage and increasing anti-oxidant levels.

B. Reduced risk of miscarriage.

During pregnancy the maternal immune system coverts to a low inflammatory state. This allows a tolerogenic response allowing implantation to occur. Increased blood flow, improved vascular endothelial development and deceased inflammation have all been shown to occur with high doses of Omega-3 fatty acids. 

C. Reduction in preterm birth.

During pregnancy, omega-3 supplementation was associated with a significant reduction in early preterm birth (<34 weeks) and preterm birth. (<37 weeks). A Cochrane review of 70 controlled trials documented that fish oil supplementation reduced the risk for low birth infants and the risk of perinatal deaths.

EPA and DHA play important roles in preventing pregnancy complications.