Omega-3 Benefits: Omega-3 in Menopause

Omega-3 benefits to women during menopause

 

Interest in non-hormonal therapies for the treatment of menopause-related disorders increased after publication of the results from the Women's Health Initiative Study. This study failed to demonstrate some of the preventative benefits associated with hormone treatment and even suggested there were associated risks.(1)

 

Effect of omega-3 on hypertriglyceridemia in menopause

 

In general, postmenopausal women have higher triglyceride concentrations than premenopausal women. It is well known that high triglyceride levels are associated with cardiovascular diseases, especially in women. The powerful effects of long-chain Omega-3 polyunsaturated fatty acids (LC-PUFAs) on triglycerides make them even more important among this group. This is particularly significant in the case of women receiving hormone therapy, as this can increase triglyceride levels.(2,3) A study on the effects of omega-3 DHA supplements on risk factors for cardiovascular disease among postmenopausal women found that treatment with omega-3 DHA was associated with a 20% reduction in triglyceride concentrations, an 8% increase in HDL cholesterol concentrations, a 28% reduction in TG/HDL cholesterol and a 7% decrease in heart rate.

 

Effect of omega-3 on depressive disorders in menopause

 

Women are twice as likely to suffer depression than men, the risk being even greater during and after menopause.(5-7) The causes of depression (disorder involving serotonin receptors and membrane transport in particular) is multifactor in origin and includes genetic, environmental and nutritional factors. The nutritional element is based on studies where an increased correlation was observed between Omega-3 LC-PUFA, omega-3 DHA(8) and/or EPA(9) levels in erythrocytes or adipose tissue and depressive symptoms, (10,11) and also on studies where lower tissue or plasma levels of Omega-3 LC-PUFAs (especially omega-3 DHA) were found in subjects with depression than in non-depressed subjects.(12,3) In studies in which an omega-3 EPA and DHA supplement was administered to patients receiving antidepressant treatment, patients' symptoms improved significantly compared to groups receiving placebo as a supplement.(14-15)

 

Osteoporosis, menopause and omega-3

 

Osteoporosis involves destruction of bone or reduced bone formation. Pharmacological treatment is incapable of restoring good quality bone in a skeleton with osteoporosis, although it does delay bone loss.(16) It is notable that the risk of suffering cardiovascular disease is directly proportional to the severity of osteoporosis in post-menopausal women.(17) In animal studies, ingestion of Omega-3 LC-PUFA reduced the capacity for bone destruction and the loss of bone mass in overiectomized mice.

 

Omega-3 for vasomotor symptoms in menopause

 

Finally, though of no less importance with respect to the quality of life of menopausal women, there are data to suggest that Omega-3 LC-PUFAs are effective in treating the vasomotor symptoms of menopause. Such vasomotor symptoms include hot flushes and sweating occurring during the menopausal transition period and lasting until after the last menstruation. The mechanism by which Omega-3 LC-PUFAs exert this effect is related to serotonin transmission, as is also the case with antidepressants (in particular selective serotonin reuptake inhibitors - SSRIs), which have been shown to reduce vasomotor symptoms.(21,22) Serotonin is involved in the control of body temperature homeostasis. Also, plasma concentrations of omega-3 PUFAs are predictors for levels of 5-hydroindolacetic acid (HIAA), the main serotonin metabolite, in the cerebrospinal fluid (CSF).(21) It is thought that changes in the ingestion or metabolism of omega-3 LC-PUFA could play an important role in the serotonin reuptake rate mediated by their significant presence in neuronal tissue, particular in the neuronal membranes(23) (if the serotonin concentration increases or its reuptake decreases, it remains longer in the synapses and interstitial spaces).

Depression and vasomotor symptoms are usually associated during menopausal transition and women who suffer from hot flushes have a greater risk of developing a major depressive disorder. (24)

 

  

Bibliography on omega-3 and menopause

 

1. Rossouw JE, Anderson GL, Prentice RL et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002;288:321-333. // 2. Dayspring TD. Understanding hypertriglyceridemia in women: clinical impact and management with prescription omega-3-acid ethyl esters. Int J Womens Health 2011;3:87-97. // 3. Saldeen P, Saldeen T. Women and Omega-3 Fatty Acids. Obstet Gynecol Surv 2004;5910:722-730. // 4. Stark KD, Holub BJ. Differential eicosapentaenoic acid elevations and altered cardiovascular disease risk factor responses after supplementation with docosahexaenoic acid in postmenopausal women receiving and not receiving hormone replacement therapy. Am J Clin Nutr 2004;795:765-773. // 5. Bromberger JT, Kravitz HM. Mood and menopause: findings from the Study of Women's Health Across the Nation SWAN over 10 years. Obstet Gynecol Clin North Am 2011;383:609-625. // 6. Cohen LS, Soares CN, Vitonis AF et al. Risk for new onset of depression during the menopausal transition: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry 2006;63:385-390. // 7. Freeman EW, Sammel MD, Lin H et al. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry 2006;63:375-382. // 8. Frasure-Smith N, Lespérance F, Julien P. Major depression is associated with lower omega-3 fatty acid levels in patients with recent acute coronary syndromes. Biol Psychiatry 2004;55(9):891-896. // 9. Adams PB, Lawson S, Sanigorski A et al. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids 1996;31(Suppl):S157-S161. // 10. Freman M, Hibbblen J, Wisner K et al. Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry 2006;67:1954-1967. // 11. Marszalek JR, Lodish HF. Docosahexanoid acid, fatty acid interacting-proteins and neuronal function: breastmilk and fish are good for you. Annu Rev Cell Dev Biol 2005;21:633-657. // 12. Mamalakis G, Tornaritis M, Kafatos A. Depression and adipose essential polyunsaturated fatty acids. Prostaglandins Leukot Essent Fatty Acids 2002;67:311-318. // 13. Tiemeier H, van Tuijl HR, Hofman A et al. Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr 2003;78:40-46. // 14. Su K-P, Huang S-Y, Chiu C-C et al. Omega-3 fatty acids in major depressive disorder: a preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol 2003;134:267-271. // 15. Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry 2002;1593:477-479. // 16. Karlsson MK, Ahlborg HG. Karlsson C. Female reproductive history and the skeleton-a review. BJOG 2005;112(7):851-856. // 17. Tanko LB, Christiansen C, Cox DA et al. Relationship between osteoporosis and cardiovascular disease in postmenopausal women. J Bone Miner Res 2005;2011:1912-1920. // 18. Sun D, Krishnan A, Zaman K et al. Dietary n-3 fatty acids decrease osteoclastogenesis and loss of bone mass in ovariectomized mice. J Bone Miner Res 2003;187:1206-1216. // 19. Sakaguchi K, Morita I, Murota S. Eicosapentaenoic acid inhibits bone loss due to ovariectomy in rats. Prostaglandins Leukot Essent Fatty Acids 1994;50(2):81-84. // 20. Sun L, Tamaki H, Ishimaru T et al. Inhibition of osteoporosis due to restricted food intake by the fish oils DHA and EPA and perilla oil in the rat. Biosci Biotechnol Biochem 2004;68(12):2613-2615. // 21. Hibbeln JR, Linnoila M, Umhau JC et al. Essential fatty acids predict metabolites of serotonin and dopamine in cerebrospinal fluid among healthy control subjects, and early-and late onset alcoholics. Biol Psychiatry 1998;44:235-242. // 22. Chalon S. Omega-3 fatty acids and monoamine neurotransmission. Prostaglandins Leukot Essent Fatty Acids 2006;75:259-269. // 23. Hibbeln JR, Umhau JC, George DT et al. Plasma total cholesterol concentrations do not predict cerebrospinal fluid neurotransmitter metabolites: implications for the biophysical role of highly unsaturated fatty acids. Am J Clin Nutr 2000;71(1 Suppl):331S-338S. // 24. Joffe H, Hall J, Soares C et al. Vasomotor symptoms are associated with depression in perimenopausal women seeking primary care. Menopause 2002;9:392-398