Endometriosis is a common chronic inflammation causing major problems including infertility. The role of omega-3 and omega-6 fatty acids as their potential anti-inflammatory effects in endometriosis needs to be further explored. The objective of this study was to compare serum phospholipid fatty acid profile in endometriosis patients with controls, and to explore the correlation of this profile with the severity of the disease. 

Methods:

Sixty-four endometriosis patients and 74 control women, in reproductive age, participated in this study. Among the endometriosis patients, 19 cases were in stage I, 27 cases in stage II, 8 cases in stage III, and 10 cases in stage IV. Each patient underwent laparoscopy. Before surgery, 5 ml of blood was obtained. After extraction of the total lipids, serum total phospholipid fraction was isolated by thin layer chromatography. Fatty acid composition of the phospholipid fraction was determined by gas chromatography and the resulted profile was compared in endometriosis patients and controls. The profile was also compared in the endometriosis group based on the severity of disease. 

Results: 

Stearic acid was significantly lower in the endometriosis group as compared to controls (P= 0.030). No other fatty acid compositions were significantly different between patients and controls. Serum ratio of eicosapentaenoic acid (EPA) to arachidonic acid (AA) was in reasonable correlation with the severity of endometriosis (r = 0.34, P = 0.006). 

Conclusion:

According to these findings, levels of fatty acids in serum total phospholipids seem not to be a marker for endometriosis, but the EPA to AA ratio was a relevant factor indicating severity of illness.

[PMC3614254]

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EPA is hypothesized to reduce disease severity through their anti-inflammatory and immunomodulatory effects [25]. EPA is the most important component of omega-3 and AA, an omega-6 fatty acid and plays an important role in biological systems. AA has a substrate role for production of certain mediators such as PGE2 and leukotriene (LTB4). PGE2 and LTB4 are initiators for endometriosis and pain [24]. On the other hand, EPA plays a role in biosynthesis of LTB5 and PGE3 which have less inflammatory effect compared with PGE2 and LTB4 [24]. EPA is a competitive inhibitor in conversion of AA to LTB4 and PGE2 [26]. Irrespective of study design, our results were in agreement, in part, with the in vitro experiments by Gazvani et al. [20] that showed a high ratio of omega-3 to omega-6 in endometrial cell culture from endometriosis patients induce higher concentrations of IL-8 productions in cell supernatant. IL-8 as a pro-inflammatory and angiogenic cytokine has a significant role in endometriosis [27].

Polycystic ovary syndrome (PCOS) is a complex and common endocrine disorder characterized by hyperandrogenism, which is accompanied by follicle growth arrest at the small antral stage, minimal granulosa cell proliferation, and chronic anovulation.

Polyunsaturated fatty acids (PUFAs) are necessary for the body’s metabolism, growth and development. Although PUFAs play an important role in the regulation of female reproduction, their role in ovarian development in PCOS is still unclear.

The present study was conducted to investigate the effects of different ratios of n-3/n-6 PUFAs (omega-3/omega-6) on ovary development in PCOS rats. Serum levels of reproductive hormones and enzymes related to steroidogenesis were assessed.

The results indicated that PUFAs (n-3/n-6: 1/15) significantly increased ovarian weight and improved the ovarian structure although they had no significant effect on body weight in PCOS rats.

Meanwhile, apoptosis was attenuated accompanied by increased cell proliferation by PUFAs (n-3/n-6: 1/15). Moreover, serum levels of hormones (FSH and E2) were also significantly increased by PUFAs (n-3/n-6: 1/15) accompanied by decreased T levels.

To investigate whether PUFAs regulate the expression of enzymes related to hormone synthesis, western blotting was used to determine the protein levels of CYP51, CYP19, StAR and 3β-HSD.

The results showed that PUFAs significantly increased the protein levels of all of these enzymes. These results indicate that PUFAs enhance the reproductive performance of PCOS by increasing the expression of steroidogenesis enzymes, which are related to hormone secretion and ovarian functions.

These findings provide evidence that a balanced n-3/n-6 PUFA ratio is beneficial for PCOS reproduction.

The therapeutic benefits of omega-3 fatty acids – which are abundant in certain fish oils – have long been known. In the 1950s, upon the discovery that omega-3 improves brain development, cod liver oil was given for free to young children, pregnant women, and nursing mothers. In the 80s, scientists reported that eskimos enjoy better coronary health than their mainland counterparts as a result of their fish rich diets. And in 2009, a study published in the Menopause journal suggested that omega-3 helps reduce the frequency of hot flushes in menopausal women.

 As you can see, the hype that surround omega-3 is warranted, and not something to be shied away from.

 The Truth About Fats

Many women are concerned about fat, and wrongly believe that consuming fat will make them overweight. The truth is, however, that an extremely low-fat diet won’t regulate your weight – and it certainly won’t enhance your health. Fat can be hugely beneficial in the right form, and by consuming fatty acids such as omega-3, you will surely be more healthy.

Research has confirmed that omega-3 fatty acids may have an excellent effect on impacting degenerative diseases, such as heart disease, rheumatoid arthritis, hypertension, Alzheimer’s disease, diabetes, and many more. As for menopause, omega-3 fatty acids contain anti-inflammatory properties shown to have a positive effect on many of the symptoms associated with “the change”.

What can omega-3 help with?

Because of its wonderful properties, omega-3 can greatly help women during menopause. It helps treat a range of menopausal symptoms, such as:

  • Hypertriglyceridemia– Postmenopausal women may have higher triglyceride concentrations than premenopausal women, exposing them to increased risk of coronary heart disease. As  omega-3 offers a triglyceride-lowering effect, many practitioners recommend menopausal women obtain a bare minimum 1g/day as provided by your diet or supplementation.
  • Joint pain/menopause arthritis– Omega-3 fats can reduce inflammation, which may help relieve joint pain and stiffness related to menopause arthritis. Omega-3s work in a similar way as non-steroidal anti-inflammatory drugs (NSAIDs).
  • Menstrual pain â€“ As part of your ovaries’ frustrating grand finale, perimenopausal women often experience strong menstrual pain and cramping. This pain is often caused by substances called prostaglandins, which come in both “good” and “bad” form. Menopause promotes the bad kind, while  omega-3 fatty acids promote the good kind.
  • Depression– Women are twice as likely to suffer depression compared with men, and the risk is even greater following menopause. Irritability and sadness are common emotional symptoms of menopause, but omega-3 may effectively alleviate these symptoms. Omega-3s work to improve mood and restore structural integrity to brain cells that are critical in performing cognitive functions.
  • Osteoporosis– An increased intake of omega-3 acids increases bone mineral content and produces healthier, stronger bones. As menopause can increase a woman’s risk of developing osteoporosis due to a drop in oestrogen levels, omega-3 fatty acids should be an essential part of a menopausal diet.
  • Hot flushes– The frequency of hot flushes in women going through menopause can vary from as little as once a week to every 30 minutes. Some hot flushes last minutes, while others a mere few seconds. Studies have shown that while omega-3 may not affect the intensity of hot flushes, it can halve the frequency of hot flushes with the right dosage.
  • Vaginal dryness– Fatty acids help to lubricate the body in general, therefore helping with dryness of the vagina – a common symptom of menopause.

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