Omega 3, allies against premenstrual syndrome and period pain

Omega-3, allies against premenstrual syndrome and menstrual pain

The pain associated with the menstrual cycle is a bitter reality for many women. Fighting it is fundamental to improving quality of life, but are painkillers the only solution? Fortunately not: Omega-3 are also valuable allies against menstrual pain, and not only that: those who face premenstrual syndrome every month can also feel better by taking supplements based on these naturally derived fats.

A disabling problem

The situation is obvious, so much so that it has been the center of parliamentary debates: in Italy, dysmenorrhea (the technical term for menstrual pain) affects between 60% and 90% of women, with impactful consequences on both work and school attendance. It is estimated that from 13% to 51% of school absences and from 5% to 15% of work absences are due precisely to menstrual pain. 

In the case of secondary dysmenorrhea, disorders are associated with even serious health problems, such as endometriosis or uterine fibroids. The pain can start before menstruation, continue even after bleeding ends, and worsen over time.

Most women, however, deal with primary dysmenorrhea, i.e., not associated with any pathology. In this case, the uterus produces a very high amount of prostaglandins, molecules that cause contraction of its muscles leading to painful cramps.

Primary dysmenorrhea can appear one or two days before the onset of menstrual bleeding. Typically, the pain lasts a few days, but for some women it is decidedly worse: for them, the discomfort is strong and persistent.

How to fight dysmenorrhea

There are no specific remedies or drugs for primary dysmenorrhea. Often, hot compresses on the lower abdomen or hot baths are used to relieve it. Some women find relief through relaxation techniques such as yoga and meditation, or physical activity. Finally, resting and avoiding smoking and alcohol can also help.

Among medications, the most used against menstrual pain are non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen. These active ingredients oppose the pro-inflammatory action of prostaglandins, which increase in inflamed tissues causing typical signs like pain. NSAIDs alleviate their effects and reduce their production by the uterus.

Omega-3 against inflammation

Precisely because inflammation is involved, Omega-3 have long been considered potential allies against menstrual pain. Indeed, these fats are characterized by marked anti-inflammatory properties:

- they are precursors of several molecules involved in inflammation that, compared to those derived from other fats in food (especially Omega 6, abundant in modern Western diets), tend to have a lower inflammatory potential;

- they are also progenitors of molecules that help end inflammatory processes (maresins, resolvins, and protectins);

- they activate anti-inflammatory genes and inhibit pro-inflammatory genes;

- they control the activity of immune system cells, counteracting inflammation.

Just like NSAIDs, Omega-3 also regulate prostaglandin production. In short, there are plenty of reasons to think they can be useful even when inflammation and pain depend on the menstrual cycle.

Omega-3 against dysmenorrhea

According to an analysis of randomized controlled trials (high-quality clinical studies) that evaluated the efficacy of Omega-3 intake against primary dysmenorrhea, conducted by Iranian researchers and published in the European Journal of Clinical Pharmacology, «polyunsaturated Omega-3 fatty acids may have a mild effect on the severity of primary dysmenorrhea».

The severity of menstrual pain has been associated with the amount of Omega-3 consumed per day. Omega-3 appear more useful to younger women and, surprisingly, when taken at low doses.

Not only dysmenorrhea

But there is more, because several studies suggest that Omega-3 may also reduce the severity of premenstrual syndrome, that condition that can appear one to two weeks before menstruation and triggers many symptoms other than pain, such as bloating, irritability, fatigue, and weight gain.

In this case, Omega-3 intake appears to be more effective the longer it is continued.

How to take Omega-3 against menstrual discomfort?

Omega-3 are naturally present in various foods of plant origin (such as walnuts, flaxseeds, and their oil) and animal origin (fatty fish and derived oils). However, not all dietary Omega-3 are equivalent.

The biologically active ones are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), i.e., marine-origin Omega-3, present in fish, fish oil, krill oil, and algal oil. Unfortunately, the human body is not an efficient producer of these molecules, so it is advisable to take adequate amounts through food or, if particularly high doses are needed or fish consumption is insufficient, through dietary supplements.

Women who want to try their effectiveness against menstrual disorders can take them in two different ways:

- at low doses, if the problem is primary dysmenorrhea;

- for prolonged periods, if they want to counteract symptoms of premenstrual syndrome.

Bibliographic references:

Brenna JT. Efficiency of conversion of alpha-linolenic acid to long chain n-3 fatty acids in man. Curr Opin Clin Nutr Metab Care. 2002 Mar;5(2):127-32. doi: 10.1097/00075197-200203000-00002

Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans. 2017 Oct 15;45(5):1105-1115. doi: 10.1042/BST20160474

Camera dei Deputati. https://bit.ly/3tHwd6O

Mohammadi MM et al. Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2022 Jun;48(6):1293-1305. doi: 10.1111/jog.15217

Mohammadi MM et al. The impact of omega-3 polyunsaturated fatty acids on primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Pharmacol. 2022 May;78(5):721-731. doi: 10.1007/s00228-021-03263-1

MedlinePlus. Period Pain. https://bit.ly/406cVnV. Last viewed 20/10/23