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Women and Omega-3 Fatty Acids

Saldeen, Pia MD, PhD*; Saldeen, Tom MD, PhD†

Obstetrical & Gynecological Survey: October 2004 - Volume 59 - Issue 10 - pp 722-730
CME Program: CATEGORY 1 CME REVIEW ARTICLES 28, 29, and 30: CME REVIEW ARTICLE 29

Omega-3 fatty acids (omega-3 FA) are constituents of the membranes of all cells in the body and are precursors of locally produced hormones, eicosanoids, which are important in the prevention and treatment of various diseases, especially in women. Omega-3 FA are of interest in some of the most common conditions affecting women. One mechanism underlying dysmenorrhea is a disturbed balance between antiinflammatory, vasodilator eicosanoids derived from omega-3 FA and proinflammatory, vasoconstrictor eicosanoids derived from omega-6 FA. Increased intake of omega-3 FA can reverse the symptoms in this condition by decreasing the amount of omega-6 FA in cell membranes. An increased prostacyclin/thromboxane ratio induced by omega-3 FA can facilitate pregnancy in women with infertility problems by increasing uterine blood flow. Supplementation with omega-3 FA during pregnancy lowers the risk of premature birth and can increase the length of pregnancy and birth weight by altering the balance of eicosanoids involved in labor and promote fetal growth by improving placental blood flow. Intake of omega-3 FA during pregnancy and breast feeding may facilitate the child’s brain development. There is also some evidence that supplementation with omega-3 FA might help to prevent preeclampsia, postpartum depression, menopausal problems, postmenopausal osteoporosis, and breast cancer. Furthermore, because elevated triglyceride levels are associated with cardiovascular disease, especially in women; and because omega-3 FA have powerful effects on triglycerides, women in particular gain from an increased intake of these fatty acids. This is especially important in women receiving hormone therapy, which can increase triglyceride levels. The quality of the omega-3 FA preparation is important. It should have an appropriate antioxidant content not to induce lipid peroxidation, and its content of dioxin and polychlorinated biphenyls (PCBs) should be well below the established safe limit.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to describe the function and actions of omega-3 and omega-6 fatty acids, to outline the potential advantages of omega-3 fatty acid supplementation, and to list the potential sources of omega-3 fatty acids.

*Researcher, Department of Obstetrics and Gynecology, Malmö University Hospital, University of Lund, Sweden; and the †Professor, Department of Surgical Sciences, University of Uppsala, Sweden

Chief Editor’s Note: This article is the 29th of 36 that will be published in 2004 for which a total of up to 36 Catgory 1 CME credits can be earned. Instructions for how credits can be earned appear on the last page of the Table of Contents. This CME activity is supported by an unrestricted educational grant from Procter & Gamble.

Reprint requests to: Professor Tom Saldeen, Department of Surgical Sciences, University of Uppsala, Dag Hammarskjölds väg 17, 75237, Uppsala, Sweden. Email: tom.saldeen@surgsci.uu.se.

Dr. Pia Saldeen has disclosed no significant financial or other relationship with any commercial entity.

Dr. Tom Saldeen has disclosed that he receives grant-research support from MSD and Cardinova.

Editor’s Note: Antioxidants, of which omega-3 fatty acids are prominent examples, have attracted a great deal of attention from the public, clinicians, nutritionists, and investigators. In this review, the authors focus on the role of omega-3 fatty acids in a variety of physiological and pathologic aspects of women’s health. A number of the studies discussed demonstrate a causal relationshipbetween omega-3 fatty acids, particularly those in fish oils, and the disorders discussed. Other studies mentioned demonstrate a strong association between fatty acids and these disorders, and still others point to plausible hypotheses that pave the way for definitive studies.

As the authors note, omega-3 fatty acids are constituents of all of the body’s cell membranes and serve as precursors of eicosanoids, locally produced hormones that are involved in a wide array of preventive and therapeutic modalities. Thus, this thoughtful and informative review warrants our readers’ interest and attention—RBJ.

© 2004 Lippincott Williams & Wilkins, Inc.