Effect of omega-3 polyunsaturated fatty acid on endometriosis

Objective This study aimed to evaluate the effect of Omega-3 Fatty Acids (omega-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 omega-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 omega-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, omega-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, omega-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