The key role of Omega-3 in the management of PCOS

1. What is the nature of omega-3s?

Omega-3s are part of the lipids , a family of fatty compounds essential for the proper functioning of the body . Among lipids, we find steroids, phospholipids, carotenoids, triglycerides, and fatty acids, which play various structural, hormonal, or energy-producing roles.

A. The different types of omega-3: ALA, EPA, DHA

Omega-3s are fatty acids, a category itself divided according to their chemical structure: saturated fatty acids (without double bonds), monounsaturated fatty acids (one double bond) and polyunsaturated fatty acids (several double bonds), the latter being recognized for their beneficial effects on health.

Omega-3s are polyunsaturated fatty acids, characterized by their first double bond located on the third carbon atom of their chain. In comparison, this bond appears on the sixth atom for omega-6s and on the ninth for omega-9s.

There are three main forms of omega-3 fatty acids : alpha-linolenic acid (ALA) , which is essential because it is not synthesized by the body, and its derivatives eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) . ALA can be converted in the body into EPA and then into DHA through a series of complex reactions. This conversion is therefore low (less than 2%) and varies from person to person.

B. Dietary sources of omega-3

Omega-3 fatty acids are present in food at varying concentrations . Plant-based sources, such as walnuts or rapeseed and flaxseed oils, primarily provide ALA. In contrast, oily fish , such as salmon, mackerel, herring, sardines, or anchovies, directly provide EPA and DHA.

Our omega-3 intake is low. According to ANSES (the French Agency for Food, Environmental and Occupational Health & Safety), between 50 and 75% of women have insufficient DHA intake , and more than 75% have insufficient ALA and EPA intake. Supplementation may therefore be beneficial, given the fundamental role of these fatty acids for the proper functioning of the body.

2. What is the role of omega-3 in the body?

Omega-3 fatty acids fulfill several essential functions in the body. First, in terms of energy , 1 gram provides 9 kcal, making it a very concentrated source of energy. They also play a major structural role by being part of the composition of cell membranes, whose fluidity they improve, thus promoting exchanges between cells .

Furthermore, omega-3s play a functional role as precursors of anti-inflammatory mediators. Omega-3 fatty acids are essential for proper brain and vision function : after adipose tissue, the brain is the organ richest in lipids. DHA, also called cervonic acid, makes up 20% of the fatty acids in the brain and 60% of those present in visual cells.

3. The impact of omega-3 on hormonal parameters related to PCOS

Omega-3 fatty acids also play an important role in hormonal regulation, particularly in women with PCOS .

A. Effects on hormone levels: Testosterone, LH, FSH

Several scientific studies have demonstrated the beneficial effects of omega-3 fatty acids on various hormonal markers. A decrease in LH levels , often too high in PCOS, has been observed, which can promote more regular ovulation. In parallel, an improvement in the FSH/LH ratio appears to contribute to better regulation of the menstrual cycle.

Omega-3 fatty acids also play a role in reducing circulating testosterone , a key factor in alleviating certain PCOS symptoms such as acne, hair loss, and hirsutism. They also promote an increase in SHBG , a transport protein that limits the action of free sex hormones.

B. Role in fertility and ovulation

The regulatory effects of omega-3 fatty acids on hormonal balance can have a positive impact on fertility . By supporting better regulation of key hormones involved in ovulation, these essential fatty acids contribute to more regular menstrual cycles. This can be particularly beneficial in cases of PCOS, the leading cause of infertility in young women, where hormonal imbalances often disrupt ovarian function.

4. The impact of omega-3 on metabolic parameters related to PCOS

In addition, omega-3s contribute to the regulation of metabolic disorders frequently associated with this syndrome, which in turn contribute to maintaining hormonal imbalances in a vicious cycle.

A. Improvement of the lipid profile

Omega-3 fatty acids improve lipid metabolism by lowering LDL (the "bad" cholesterol ) levels while increasing HDL (the "good" cholesterol) levels. They also limit lipogenesis , the formation of new fats from sugars, and reduce cholesterol absorption in the intestines.

Furthermore, omega-3 fatty acids promote an increase in plasma concentrations of adiponectin , a hormone secreted by adipose tissue that is essential for regulating lipid and glucose metabolism . Adiponectin levels are often lower in overweight, obese, diabetic, or PCOS individuals, which reinforces the benefit of omega-3s in this context.

B. Improvement of glycemic profile and impact on anthropometric parameters: BMI, waist circumference

Finally, omega-3 fatty acids play a crucial role in improving insulin sensitivity . On average, 50 to 70% of women with PCOS have insulin resistance, causing disruptions in carbohydrate metabolism and increasing the risk of type 2 diabetes.

Clinical studies demonstrate that omega-3 intake leads to a significant reduction in fasting insulin concentrations and an improvement in the HOMA-IR index , a recognized marker of insulin resistance. By promoting more efficient glucose utilization by the body, omega-3s contribute to restoring a favorable metabolic balance, thus limiting complications associated with PCOS. This action is reflected in particular by a reduction in waist circumference and body mass index (BMI). This nutritional approach is therefore a valuable complement to the overall management of the syndrome, with benefits for glucose metabolism and cardiovascular health.

This article is for informational purposes only and does not replace a consultation or advice from your doctor.