Menstrual pain: Omega-3 supplementation could replace the use of nonsteroidal anti-inflammatory drugs

 
 
 

Dysmenorrhea (the medical term for menstrual pain) is characterized by abdominal pain occurring just before and/or during menstruation, and defined as primary if it occurs in the absence of endometriosis, uterine fibroids, or pelvic inflammatory diseases.

Primary dysmenorrhea is one of the most common complaints of women, and the most common gynecologic problem in menstruating women. Up to 90% of women of reproductive age experience menstrual pain (which typically starts during adolescence), usually accompanied by gastrointestinal symptoms; women described their symptoms in many ways, with type and severity of symptoms changing from day to day, from one menstrual cycle to another or over the years (increasing, decreasing, fluctuating, or becoming stable in relation to pregnancy, aging, and/or menopause). Dysmenorrhea negatively affects women’s quality of life and is a common cause of absenteeism from school and work among women in the reproductive age. Despite this, dysmenorrhea is not always seen as a legitimate health issue on the part of health professionals, employers, and society in general.

The cause of primary dysmenorrhea is not completely understood, but most symptoms can be explained by the action of uterine prostaglandins (prostaglandins are involved in the contraction of smooth muscle, the control of inflammation and body temperature, among other physiological functions). Women with primary dysmenorrhea have increased production of endometrial prostaglandins, which causes stronger and more frequent uterine contractions.

Nonsteroidal anti-inflammatory drugs (which acts inhibiting prostaglandin actions) are the main treatment, with the addition of oral contraceptive pills when necessary, but about 10% of affected women do not respond to these measures; besides, some women cannot or prefer not to take medication (because of side effects).

Numerous studies have shown a regulatory role of omega-3 fatty acids against inflammatory pain associated with rheumatoid arthritis, dysmenorrhea, and inflammatory bowel disease. Omega-3 fatty acids decrease the production of inflammatory substances, and this anti-inflammatory action is believed to result in pain reduction. Recently, it has once again been demonstrated that supplementation with omega-3 fatty acids (and even more with vitamin E) significantly relieves menstrual pain, to the extent that it can replace the use of nonsteroidal anti-inflammatory drugs.

Omega-3 fatty acids could be an effective, affordable, and accessible option of treatment to all women.

Bibliography: 

Sadeghi N, Paknezhad F, Rashidi Nooshabadi M, et al. Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: a double-blind, randomized clinical trial. Gynecol Endocrinol. 2018; 15:1-5.

Tokuyama S, Nakamoto K. Unsaturated fatty acids and pain. Biol Pharm Bull. 2011;34(8):1174-78.

Chen CX, Draucker CB, Carpenter JS. What women say about their dysmenorrhea: a qualitative thematic analysis. BMC Womens Health. 2018;18(1):47.

Coco AS. Primary Dysmenorrhea. Am Fam Physician. 1999;60(2):489-96.

 

 
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