The impact of omega-3 fatty acid intake on reducing irritability and anxiety in women with premenstrual syndrome: biochemical mechanisms and nutritional strategies

Abstract

Introduction: Premenstrual Syndrome (PMS) is a functional disorder characterized by emotional and physical symptoms that negatively affect women's quality of life. Evidence suggests that omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can modulate inflammatory and neuromolecular processes associated with irritability and anxiety, prevalent symptoms in PMS. Objective: To analyze, through a narrative literature review, the effects of EPA and DHA supplementation on the emotional symptoms of PMS, focusing on the reduction of irritability and anxiety. Methods: Narrative literature review that analyzed 14 studies published between 2015 and 2025, selected from PubMed, SciELO, ScienceDirect, Cochrane Library, and Google Scholar databases, emphasizing the relationship between omega-3 supplementation and PMS. The analysis considered study design, doses, intervention duration, participant characteristics, and main findings. Results: Omega-3 supplementation showed positive effects in reducing irritability and anxiety, attributed to modulation of systemic inflammation and serotonergic and dopaminergic neurotransmission. Doses above 1000 mg/day, for at least three menstrual cycles, showed greater efficacy. However, methodological heterogeneity limits the generalization of the results and reinforces the need for more robust studies. Conclusion: EPA and DHA supplementation is a safe and potentially effective nutritional alternative for attenuating the emotional symptoms of PMS, especially irritability and anxiety. However, clinical application should consider individual factors such as dietary patterns, body composition, and contraceptive use. Further longitudinal studies with greater methodological rigor are necessary to consolidate clinical guidelines.