ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Immunology
Omega-3 Polyunsaturated Fatty Acid Intake and Pain, Inflammatory Cytokines, and Quality of Life in Endometriosis
Provisionally accepted
- 1The Ninth Medical Center, Chinese PLA General Hospital, Beijing, China
- 2The first medical center, Chinese PLA General hospital, Beijing, China
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Background: Endometriosis is a chronic inflammatory gynecologic disorder associated with pelvic pain and impaired health-related quality of life (HRQoL). Omega-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory potential and may confer adjunctive benefit when combined with conventional therapy. This study evaluated the association between adjunctive omega-3 PUFA intake and pain, inflammatory biomarkers, and HRQoL in endometriosis. Methods: This retrospective, time-period–based cohort study included patients with confirmed endometriosis treated at a single center between January 2021 and December 2024. Conventional therapy during 2021–2022 served as the control period, whereas conventional therapy plus omega-3 PUFA supplementation during 2023–2024 constituted the exposure period. Outcomes included pain assessed by the visual analogue scale (VAS), inflammatory biomarkers (interleukin-6 [IL-6], tumor necrosis factor alpha [TNF-α], and C-reactive protein [CRP]), and HRQoL measured using the 36-Item Short Form Health Survey (SF-36), including the Physical Component Summary (PCS) and Mental Component Summary (MCS). Multivariable logistic regression and inverse probability of treatment weighting (IPTW) were applied, with prespecified subgroup and sensitivity analyses. Results: Among 302 screened patients, 289 were analyzed (control n = 138; omega-3 n = 151), with comparable baseline characteristics. Median exposure to eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) was 900 mg/day (interquartile range [IQR] 600–1,200) for 12 weeks (IQR 10–12). Compared with controls, the omega-3 group experienced greater reductions in overall pain (VAS Δ 3.0 ± 1.0 vs 1.5 ± 0.9; p < 0.001), larger decreases in IL-6, TNF-α, and CRP (all p < 0.001), and greater improvements in SF-36 PCS (Δ 12.1 ± 5.2 vs 5.3 ± 4.8) and MCS (Δ 10.3 ± 5.0 vs 4.8 ± 4.6) (both p < 0.001). Omega-3 PUFA intake was independently associated with clinically meaningful improvement, including VAS ≥2-point reduction (odds ratio [OR] 3.06, 95% confidence interval [CI] 1.85–5.06), PCS ≥5-point increase (OR 2.74, 95% CI 1.67–4.50), and MCS ≥5-point increase (OR 2.41, 95% CI 1.50–3.88), with consistent findings across subgroup, sensitivity, and IPTW analyses. Conclusions: Adjunctive omega-3 PUFA intake was associated with improved pain, reduced inflammatory biomarkers, and better HRQoL in endometriosis, warranting confirmation in future prospective randomized studies.
Keywords: Endometriosis, inflammatory cytokines, Interleukin-6, Omega-3 polyunsaturated fatty acid supplementation, Pelvic Pain, tumor necrosis factor alpha
Received: 15 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Huang, Zhou, Zhu and Ni. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dong-Dong Ni
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