Effect of omega-3 polyunsaturated fatty acid on endometriosis

Abstract

Objective: This study aimed to evaluate the effect of Omega-3 Fatty Acids (ω-3 PUFAs) on endometriosis. Design: The authors conducted a comprehensive search of the PubMed, Embase, Cochrane Library and Web of Science databases, focusing exclusively on Randomised Controlled Trials (RCTs) to study the impact of ω-3 PUFAs on endometriosis. The included studies were assessed for methodological quality using the Cochrane bias risk assessment tool and analyzed using data analysis software. Results: The search yielded five RCTs conducted between the database’s inception and July 2023, with a total sample size of 424 patients with endometriosis. The meta-analysis results showed no statistically significant effects of ω-3 Polyunsaturated Fatty Acids (PUFAs) on pain (Mean Difference [MD = -0.387], 95 % Confidence Interval [95% CI -1.742–0.967], I 2 = 93.3%, z = 0.56, p = 0.575), sexual activity (MD = 0.143, 95% CI -0.210–0.497, I 2 = 0%, z = 0.79, p = 0.427), pain intervention (MD = -0.216, 95% CI -0.717–0.285, I 2 = 0.0%, z = 0.84, p = 0.399), catastrophic thinking (MD = 0.158, 95% CI -0.315–0.632, I 2 = 0.0%, z = 0.66, p = 0.512) and the 12-item short form health survey (MD = 0.001, 95% CI -0.053–0.503, I 2 = 0.0%, z = 0.00, p = 1.000), which were all statistically insignificant. However, ω-3 PUFAs appeared to reduce the inflammatory response in patients with endometriosis (MD = -5.20, 95% CI -6.21–-4.20, I 2 = 0%, z = 10.13, p < 0.001). Conclusion: Based on the available evidence, ω-3 PUFAs may reduce the inflammatory response in patients with endometriosis, specifically by decreasing levels of pro-inflammatory cytokines, such as TNF-alpha, IL-6 and IL-1, indicating potential anti-inflammatory properties that warrant further investigation. Trial registration: PROSPERO: CRD42023441699.