Menopause and Essential Fatty Acids

Omega 3 fatty acids are an essential nutrient, meaning that they are necessary for cell function but the human body does not produce them. Oil from cold-water fish is the richest natural source of Omega 3 fatty acids, but they can also be found in flax seed, borage oil, evening primrose oil, and fruits and vegetables, especially sea vegetables.

Read more about nutritional supplements during and after menopause.

A 2009 study measured hot flash frequency, intensity, and duration and quality of life in women ages 40-55. At the baseline measurement, the average number of hot flashes per day was 3.8. After 8 weeks of supplementation three times a day, hot flash frequency was reduced to about 2 a day. No difference was recorded in quality of life surveys. ¹

Depression and mood swings are common aspects of menopause, and women who experience hot flashes are also more likely to experience depression during menopause. A 2011 preliminary trial on omega 3s was done on 20 women experiencing major depressive disorder (MDD). Number of hot flashes went down significantly based on the Hot Flash Related Daily Interference Scale (HFRDIS) and diaries kept by participants. Depression was measured using Montgomery-Asberg Depression Rating Scale (MADRS), which runs from 0-60. Mean MADRS scores decreased from 22.4 to 10.7.

Those participants whose self-reported depressive symptoms responded to the omega 3 treatment had significantly lower pretreatment DHA plasma levels compared with those who did not respond.

Only minor adverse effects were recorded (slight bloating, gas, and puffiness in the face), and were not confirmed to have been caused by the treatment. ²

Safety Issues

Fish oil appears to be generally safe. The most common problem is fishy burps. However, there are some safety concerns to consider.

For example, it has been suggested that some fish oil products contain excessive levels of toxic substances such as organochlorines and PCBs. ¹ If possible, try to purchase fish oil products certified not to contain significant levels of these contaminants. Note:Various types of fish contain mercury, but this has not been a problem with fish oil supplements, according to reports on Consumerlab.com.

Fish oil has a mild blood-thinning effect; ² in one case report, it increased the effect of the blood-thinning medication warfarin (Coumadin). ³ Fish oil does not seem to cause bleeding problems when it is taken by itself ⁴ or with aspirin. ⁵ Nonetheless, people who are at risk of bleeding complications for any reason should consult a physician before taking fish oil.

Fish oil does not appear to raise blood sugar levels in people with diabetes. ⁶ Nonetheless, if you have diabetes, you should not take any supplement except on the advice of a physician.

Fish oil may modestly increase weight and lower total cholesterol and HDL (“good”) cholesterol levels. ⁷ It may also raise the level of LDL ("bad") cholesterol; however, this effect may be short-lived. ⁸ If you decide to use cod liver oil as your fish oil supplement, make sure you do not exceed the safe maximum intake of vitamin A and vitamin D . These vitamins are fat soluble, which means that excess amounts tend to build up in your body, possibly reaching toxic levels. The official maximum daily intake of vitamin A is 3,000 mcg for pregnant women as well as other adults. Look at the bottle label to determine how much vitamin A you are receiving. (It is less likely that you will get enough vitamin D to produce toxic effects.)

Interactions You Should Know About

If you are taking warfarin (Coumadin) or heparin , do not take fish oil except on the advice of a physician.

1. Jacobs MN, Santillo D, Johnston PA, Wyatt CL, French MC. Organochlorine residues in fish oil dietary supplements: comparison with industrial grade oils. Chemosphere. 37(9-12):1709-21.
2. Emsley R, Niehaus DJ, Oosthuizen PP, Koen L, Ascott-Evans B, Chiliza B, van Rensburg SJ, Smit RM. Safety of the omega-3 fatty acid, eicosapentaenoic acid (EPA) in psychiatric patients: results from a randomized, placebo-controlled trial. Psychiatry Res. 161(3):284-91.
3. Buckley MS, Goff AD, Knapp WE. Fish oil interaction with warfarin. Ann Pharmacother. 38(1):50-2.
4. Harris WS. Dietary fish oil and blood lipids. Curr Opin Lipidol. 7(1):3-7.
5. Leaf A, Jorgensen MB, Jacobs AK, Cote G, Schoenfeld DA, Scheer J, Weiner BH, Slack JD, Kellett MA, Raizner AE. Do fish oils prevent restenosis after coronary angioplasty? Circulation. 90(5):2248-57.
6. Harris WS. Dietary fish oil and blood lipids. Curr Opin Lipidol. 7(1):3-7.
7. Emsley R, Niehaus DJ, Oosthuizen PP, Koen L, Ascott-Evans B, Chiliza B, van Rensburg SJ, Smit RM. Safety of the omega-3 fatty acid, eicosapentaenoic acid (EPA) in psychiatric patients: results from a randomized, placebo-controlled trial. Psychiatry Res. 161(3):284-91.
8. Cobiac L, Clifton PM, Abbey M, Belling GB, Nestel PJ. Lipid, lipoprotein, and hemostatic effects of fish vs fish-oil n-3 fatty acids in mildly hyperlipidemic males. Am J Clin Nutr. 53(5):1210-6.

¹Lucas, Michel, PhD, RD et al. “Effects of ethyl-eicosapentaenoic acid omega-3 fatty acid supplementation on hot flashes and quality of life among middle-aged women: a double-blind, placebo-controlled, randomized clinical trial,” Menopause 16, no 2 (2009): 357-366. DOI: 10.1097/gme.0b013e3181865386

²Freeman, Marlene P, MD et al. “Omega-3 fatty acids for major depressive disorder associated with the menopausal transition: a preliminary open trial,” Menopause 18, no 3 (2011) 279-284. doi: 10.1097/gme.0b013e3181f2ea2e