Omega-3 Benefits for Perimenopause: What the Evidence Shows
Omega-3 fatty acids support heart health, mood, joints, and hot flashes in perimenopause. Learn what to take, how much, and why it matters now.
What Omega-3 Fatty Acids Do in the Body
Omega-3 fatty acids are a type of polyunsaturated fat that the body cannot make in sufficient amounts on its own. The three main forms are ALA (alpha-linolenic acid), found in plant foods, EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid), both found primarily in marine sources. EPA and DHA are the forms most associated with health benefits, particularly for reducing inflammation, supporting cardiovascular function, and promoting brain health. ALA from plants can be converted to EPA and DHA, but the conversion rate in the body is low, making direct marine sources or algae-based supplements more reliable.
Omega-3 and Cardiovascular Risk in Perimenopause
Heart disease risk rises significantly after menopause, and perimenopause is the window when cardiovascular changes begin to accumulate. Oestrogen has a protective effect on the blood vessels and cholesterol profile, and as levels drop, LDL cholesterol often rises while HDL may fall. Omega-3 fatty acids, particularly EPA and DHA, help reduce triglyceride levels, lower blood pressure slightly, and reduce inflammation in the arterial walls. Several large studies have found that regular omega-3 consumption, whether from fish or supplements, is associated with lower rates of cardiovascular events. Addressing cardiovascular risk factors in perimenopause, rather than after menopause, is the more effective strategy.
Omega-3 and Mood During Perimenopause
The brain is approximately 60 percent fat, and DHA is one of its most abundant structural components. Omega-3s influence the production and signalling of neurotransmitters including serotonin and dopamine, which regulate mood. Research into omega-3 supplementation for depression has produced mixed but generally positive results, particularly for EPA, which appears to have the stronger antidepressant effect of the two marine fatty acids. For women in perimenopause who experience mood dips, low mood, or irritability, ensuring adequate omega-3 intake is a low-risk step that may provide meaningful support alongside other approaches.
Omega-3 and Joint Pain
Joint pain and stiffness are frequently reported during perimenopause, and inflammation is often a contributing factor. Omega-3 fatty acids have well-established anti-inflammatory properties, working in part by competing with omega-6 fatty acids for the same enzymes, which shifts the body toward producing fewer pro-inflammatory compounds. Several clinical trials in people with rheumatoid arthritis have found that fish oil supplementation reduces joint tenderness and morning stiffness. While perimenopause-related joint pain has different origins, the underlying inflammatory mechanisms overlap enough that omega-3s are worth including in a joint health strategy alongside movement and other dietary changes.
Omega-3 and Hot Flashes
Some research suggests that omega-3 supplementation may help reduce the frequency and intensity of hot flashes, though the evidence is not as strong as for other benefits. One proposed mechanism is that omega-3s influence serotonin pathways involved in temperature regulation in the hypothalamus, the part of the brain that triggers hot flashes. A clinical trial published in Menopause journal found that EPA supplementation reduced hot flash frequency significantly compared to placebo. Results vary between individuals, and omega-3s are unlikely to eliminate hot flashes entirely, but for women looking for non-hormonal support, they are a reasonable option to include.
Best Food Sources and Supplement Options
Fatty fish are the richest dietary source of EPA and DHA. Salmon, mackerel, sardines, herring, and anchovies all contain significant amounts and are worth eating two to three times per week. For those who do not eat fish, algae-based omega-3 supplements provide EPA and DHA directly, making them the most effective plant-based option. Flaxseed, chia seeds, and walnuts provide ALA, which offers some benefits but is a less efficient source than marine options. When choosing a fish oil supplement, look for one that has been tested for heavy metals and contaminants, as quality varies considerably between brands. A combined EPA and DHA dose of around 1,000 to 2,000 mg daily covers most evidence-based targets.
How to Fit Omega-3 Into Your Routine
Omega-3 supplements are best taken with a meal that contains some fat to improve absorption. They can cause a mild fishy aftertaste for some people, which is reduced by taking them mid-meal rather than before or after. Enteric-coated capsules also help with this. If you are taking blood-thinning medication, check with your GP before taking high-dose fish oil, as very large amounts may have a mild blood-thinning effect. Starting with a standard dose and being consistent for at least eight to twelve weeks gives the body enough time for omega-3 levels in cell membranes to build up, which is when most of the benefits become apparent.
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