Omega-3 Fatty acids
Place in Therapy
Place in Therapy
Polyunsaturated fatty acids containing the Omega-3 fatty acids EPA and DHA may be used as an adjunct to conventional therapy to reduce the symptoms of dysmenorrhea. Randomized placebo control trials, cohort trials, and an open-label trial demonstrate that various dosage and combinations of EPA and DHA may relieve patient reported symptoms of pelvic pain, abdominal pain, or low back pain. The patients studied are young females with diagnosis of primary dysmenorrhea. The use of Omega-3 fatty acids was has also been shown to reduce the number and frequency and analgesics (ibuprofen or acetaminophen) used to reduce the severity of symptoms. There is some evidence to suggest that the addition of vitamins B12, or a combination of vitamins A, C, and E may increase the efficacy of Omega-3 fatty acids, but more studies are needed to support this hypothesis.
There are no direct comparisons between Omega-3 fatty acids and NSAIDs or other analgesics, suggesting that Omega-3 fatty acids should only be used as an adjunct to conventional therapy and not as monotherapy. For primary dysmenorrhea, Omega 3 fatty acids should be considered if a partial response is obtained from NSAIDs after 3 cycles, contraindications to NSAIDs are present or if the patient wishes to try a natural health product.
The evidence is limited by trials with small sample size, and confounding factors such as differing intakes of polyunsaturated fatty acids and use of oral contraceptives. A large, placebo controlled randomized control trial directly comparing the efficacy of the Omega-3 fatty acids to placebo and/or NSAIDs would strengthen the evidence that Omega-3 fatty acids can be used an a conventional therapy.
References:
1. Deutch B, Jorgensen EB, Hansen JC. Menstrual discomfort in danish women reduced by dietary supplements of omega-3 PUFA and B12 (fish oil or seal oil capsules). Nutr Res. 2000;20(5):621-631.
2. Rahbar N, Asgharzadeh N, Ghorbani R. Effect of omega-3 fatty acids on intensity of primary dysmenorrhea. International Journal of Gynecology and Obstetrics. 2012;117(1):45-47.
3. Sampalis F, Bunea R, Pelland MF, Kowalski O, Duguet N, Dupuis S. Evaluation of the effects of neptune krill oil on the management of premenstrual syndrome and dysmenorrhea. Alternative Medicine Review. 2003;8(2):171-179.
4. Gungor T, Demirturk F, Akbayrak T, Munire AE. Relief of primary dysmenorrhea by supplementation with omega-3 fatty acids. Pain Clinic. 2002;14(1):81-84.
5. Moghadamnia AA, Mirhosseini N, Abadi MH, Omranirad A, Omidvar S. Effect of clupeonella grimmi (anchovy/kilka) fish oil on dysmenorrhoea. Eastern Mediterranean Health Journal. 2010;16(4):408-413.
6. Lefebvre G, Pinsonneault O,Antao V, Black A, Burnett M, Feldman K, Lea R, Robert R, SOGC. Primary dysmenorrhea consensus guideline. J Obstet Gynaecol Can 2005; 27(12):1117-46
7. Smith RP, Kaunitz, AM.Treatment of Primary Dysmenorrhea in adult women. In: UpToDate, Rose, BD (Ed), UpToDate, Waltham, MA, 2005.
8. Omega 3 fatty acids, fish oil, alpha-linolenic acid Natural Standard. Cambridge, MA. http://www.naturalstandard.com. Accessed Jul 6, 2013
Polyunsaturated fatty acids containing the Omega-3 fatty acids EPA and DHA may be used as an adjunct to conventional therapy to reduce the symptoms of dysmenorrhea. Randomized placebo control trials, cohort trials, and an open-label trial demonstrate that various dosage and combinations of EPA and DHA may relieve patient reported symptoms of pelvic pain, abdominal pain, or low back pain. The patients studied are young females with diagnosis of primary dysmenorrhea. The use of Omega-3 fatty acids was has also been shown to reduce the number and frequency and analgesics (ibuprofen or acetaminophen) used to reduce the severity of symptoms. There is some evidence to suggest that the addition of vitamins B12, or a combination of vitamins A, C, and E may increase the efficacy of Omega-3 fatty acids, but more studies are needed to support this hypothesis.
There are no direct comparisons between Omega-3 fatty acids and NSAIDs or other analgesics, suggesting that Omega-3 fatty acids should only be used as an adjunct to conventional therapy and not as monotherapy. For primary dysmenorrhea, Omega 3 fatty acids should be considered if a partial response is obtained from NSAIDs after 3 cycles, contraindications to NSAIDs are present or if the patient wishes to try a natural health product.
The evidence is limited by trials with small sample size, and confounding factors such as differing intakes of polyunsaturated fatty acids and use of oral contraceptives. A large, placebo controlled randomized control trial directly comparing the efficacy of the Omega-3 fatty acids to placebo and/or NSAIDs would strengthen the evidence that Omega-3 fatty acids can be used an a conventional therapy.
References:
1. Deutch B, Jorgensen EB, Hansen JC. Menstrual discomfort in danish women reduced by dietary supplements of omega-3 PUFA and B12 (fish oil or seal oil capsules). Nutr Res. 2000;20(5):621-631.
2. Rahbar N, Asgharzadeh N, Ghorbani R. Effect of omega-3 fatty acids on intensity of primary dysmenorrhea. International Journal of Gynecology and Obstetrics. 2012;117(1):45-47.
3. Sampalis F, Bunea R, Pelland MF, Kowalski O, Duguet N, Dupuis S. Evaluation of the effects of neptune krill oil on the management of premenstrual syndrome and dysmenorrhea. Alternative Medicine Review. 2003;8(2):171-179.
4. Gungor T, Demirturk F, Akbayrak T, Munire AE. Relief of primary dysmenorrhea by supplementation with omega-3 fatty acids. Pain Clinic. 2002;14(1):81-84.
5. Moghadamnia AA, Mirhosseini N, Abadi MH, Omranirad A, Omidvar S. Effect of clupeonella grimmi (anchovy/kilka) fish oil on dysmenorrhoea. Eastern Mediterranean Health Journal. 2010;16(4):408-413.
6. Lefebvre G, Pinsonneault O,Antao V, Black A, Burnett M, Feldman K, Lea R, Robert R, SOGC. Primary dysmenorrhea consensus guideline. J Obstet Gynaecol Can 2005; 27(12):1117-46
7. Smith RP, Kaunitz, AM.Treatment of Primary Dysmenorrhea in adult women. In: UpToDate, Rose, BD (Ed), UpToDate, Waltham, MA, 2005.
8. Omega 3 fatty acids, fish oil, alpha-linolenic acid Natural Standard. Cambridge, MA. http://www.naturalstandard.com. Accessed Jul 6, 2013