Approximately seventy percent of all women experience hot flashes and/or night sweats during the menopause transition (Stearns et al, 2002).  Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes, but today many women are pursuing non-hormonal treatments, including over-the-counter complementary and alternative medicines (CAMs) for the treatment of these symptoms.

Conducted at several sites included in the MsFlash Network, a recent study assessed the efficacy of omega-3 fatty acids for the treatment of vasomotor symptoms (VMS) in perimenopausal and postmenopausal women.  In this 12-week randomized controlled trial, eligible women were randomized to receive either omega-3 fatty acids (n = 177) or placebo (n = 178).  Participants received 1.8 g of omega-3 daily for 12 weeks. Each capsule contained ethyl eicosapentaenoic acid (425 mg), docosahexaenoic acid (100 mg), and other omega-3s (90 mg).

After 12 weeks, the reduction in VMS frequency with omega-3 fatty acids did not differ significantly from that with placebo.  Changes in VMS bother at 12 weeks were also similar between groups.  Omega-3s compared with placebo showed no improvement in self-reported sleep or mood.

Thus it appears that among healthy, peri- and post-menopausal women, 12 weeks of treatment with omega-3 fatty acids did not improve VMS frequency, VMS bother, sleep, or mood as compared to placebo.  In their discussion of the findings, the authors comment that studies assessing the efficacy of omega-3 fatty acids for menopausal symptoms have yielded inconsistent findings and point to a previous randomized controlled study which demonstrated the efficacy of omega-3 acids in 91 women with vasomotor symptoms (Lucas et al, 2009).

In the Lucas study, participants were selected based on the presence of emotional distress; however, in the current study, levels of psychological distress, as measured by depressive and anxiety symptoms in the participants, were relatively low. These differences between the two studies raise questions of whether certain women (e.g., those with emotional distress or depressive symptoms) may experience a more robust response to omega-3 fatty acids than healthy women with only vasomotor symptoms.  While omega-3 fatty acids may have other health benefits, there is currently limited evidence to support the use of these treatments for the treatment of vasomotor symptoms.

Ruta Nonacs, MD PhD

Cohen LS, Joffe H, Guthrie KA, et al. Efficacy of omega-3 for vasomotor symptoms treatment: a randomized controlled trial.  Menopause 2013 Aug 26. [Epub ahead of print]

Lucas 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 trialMenopause 2009; 16(2): 357-66.

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