EP.337/ Being low in this fatty acid could worsen your period (and endo) pain
Today we’re continuing with our discussion on low nutrient levels and their association with period pain. Menstruation is often (though not always) one of the most painful parts of the menstrual cycle, for people with endometriosis - and a connection we see between both dysmenorrhea (which is the medical term for period pain) and endometriosis, is low omega 3 fatty acids.
Omega 3 fatty acids are the precursors to anti-inflammatory prostaglandins; which basically means omega 3 makes our anti-inflammatory prostaglandins. In contrast, omega 6 makes our inflammatory prostaglandins, namely prostaglandin E2. And for those of who don’t know, prostaglandins, in the simplest of terms, are immune chemicals.
Prostaglandin E2 is elevated in people with endometriosis and people with dysmenorrhea, and it’s these inflammatory prostaglandins that are the key cause of our pain with endometriosis and menstruation.
The good news is, what we eat can literally modulate the amount of inflammatory prostaglandins we make and counteract the effects of our inflammatory prostaglandins - and we can do this with omega 3.
Several reviews, research articles and studies have demonstrated the ability to reduce inflammation and pain with endometriosis through lowering inflammatory prostaglandins and raising our anti-inflammatory prostaglandins, by incorporating omega 3 fatty acids in the diet and/or in supplement form. Additionally, research has also demonstrated that omega 3 fatty acids can reduce endo lesions size and suppress growth due to their ability to inhibit the inflammatory chemicals and processes that further endo growth and development, such as prostaglandins and cytokines. So much so, that dietary intervention is now being considered as a treatment for endo.
Additionally, studies have shown a link with low omega 3 and endometriosis risk, and higher levels of omega 3 intake with a reduced risk of endo.
In terms of dysmenorrhea (a.k.a. period pain), there have been numerous studies demonstrating that omega 3 fatty acids can reduce the severity of dysmenorrhea. For example, a review of 11 trials concluded that fish oil intake was associated with lower levels of dysmenorrhea and a recent meta-analysis showed that supplementation of 300 –1800 mg of omega-3 fatty acids over 2–3 months reduced pain and pain killer use in people with dysmenorrhoea. Additionally, research has also associated a low intake of omega 3 and a low omega 3 to 6 ratio with dysmenorrhea.
So, how do we increase our intake of omega 3 fats?
Sources of omega 3 fatty acids include:
Pasture raised eggs
Walnuts
Chia seeds
Flax seeds
Fatty fish like salmon, sardines, mackerel, herring, tuna steak (not tinned tuna) and anchovies
Hemp seeds
It’s worth remembering you need a mix of omega 3 fats; EPA, DHA and ALA. ALA comes from plant foods and is the non-active form of omega 3 and needs to be converted by the body into EPA and DHA, which are the active forms (meaning usable). The body doesn’t do a great job of this and so consuming active forms from foods like fatty fish and algae (if vegan/avoid fish), can provide our body with a broader range of omega 3.
If you do eat fish, two portions of fatty fish per week will provide you with sufficient DHA and EPA to meet your daily requirements and will also be a safe amount to eat considering the mercury levels found in fish, but two portions a week may not be enough to provide a therapeutic dose (basically means effective) of omega 3 to help manage endo and period pain, especially if you eat a diet high in processed foods or rich in omega 6. I like to encourage my clients to also enjoy daily intakes of ALA, such as chia, walnuts, flax, hemp, etc. - especially as these foods also include other nutrients that help us manage pain and endo, such as magnesium, zinc and calcium. And in terms of what’s a portion of fatty fish, the NHS states 140g cooked, which is about 175g-190g raw, is a serving of fatty fish.
In terms of supplementation, in my training with the IWHI, we use between 1000mg to 3000mg per day for endometriosis, but as you can see from the research, 300 –1800 mg per day was shown to be effective for dysmenorrhea in general, so you could start there and build up if you feel that you’re not seeing improvements. In the show notes, I have linked the two brands that I use based on the quality of their fish oil and the doses, as it’s quite hard to find high doses of omega 3. However, these are not affiliate links and I get no commission from these recommendations! I’ve also linked to a vegan source, though unfortunately it’s very hard to find good doses with vegan omega 3 supplements, I’m hoping we get better options in time.
Okay, so that’s it for this week. I really hope you’ve found this episode helpful and enlightening, and I hope that you’re inspired to enjoy some of these wonderful and nutrient dense foods.
Show notes
Omega 3 and inflammation
https://www.tandfonline.com/doi/full/10.3109/09513590.2011.588753
https://pmc.ncbi.nlm.nih.gov/articles/PMC7068519/
https://pubmed.ncbi.nlm.nih.gov/6790261/
Dietary modulation of prostaglandin E2
https://www.pnas.org/doi/10.1073/pnas.0334211100
https://www.mdpi.com/2072-6643/2/3/355figureth?id=figure1
https://onlinelibrary.wiley.com/doi/full/10.1155/2017/5987082
https://www.clinsurggroup.us/articles/JGRO-10-226.pdf
Omega 3 fatty acids and endometriosis pain reduction/treatment
https://www.clinsurggroup.us/articles/JGRO-10-226.pdf
https://www.mdpi.com/1422-0067/24/19/14601
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227695
https://onlinelibrary.wiley.com/doi/10.1002/jcp.26401
https://www.mdpi.com/2075-1729/13/3/654
https://pmc.ncbi.nlm.nih.gov/articles/PMC8677647/
https://www.fertstert.org/article/S0015-0282(07)00202-6/fulltext
Endometriosis risk and omega 3 fatty acids
https://pubmed.ncbi.nlm.nih.gov/20332166/
https://www.ejog.org/article/S0301-2115(13)00173-5/abstract
https://pmc.ncbi.nlm.nih.gov/articles/PMC9983692/
https://theiopn.com/reel-in-the-relief-can-omega-3s-reduce-menstrual-pain/
Omega 3 fatty acids and dysmenorrhea
https://onlinelibrary.wiley.com/doi/10.1111/1747-0080.12835
https://pubmed.ncbi.nlm.nih.gov/22261128/
https://pubmed.ncbi.nlm.nih.gov/8701537/
https://www.ejog.org/article/S0301-2115(13)00173-5/abstract
Omega 3 fat sources
https://www.nhs.uk/live-well/eat-well/food-types/fish-and-shellfish-nutrition/
https://www.efsa.europa.eu/en/efsajournal/pub/2815
Brands
Bare Biology
Rosita Foods
Wiley’s Finest Catch Free (vegan)
Need more help or want to learn how to work with me?
Free resources:
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Ways to work with me:
This EndoLife, It Starts with Breakfast digital cookbook
Masterclasses in endo nutrition, surgery prep and recovery and pain relief
Live and Thrive with Endo: The Foundations DIY course
One to one coaching info and application
This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works
Produced by Chris Robson