Omega-3 Fish Oil For PCOS: Benefits, Risks & Practical Tips

Written by Martina S. in Nutrition

The consumption of omega-3 rich fish oil has been shown to have some powerful benefits for a number of health conditions but what about PCOS (Polycystic Ovary Syndrome)? Are there any benefits to taking fish oil for the management of this complex endocrine condition, too? And why?

That’s what you’ll find out in this evidence-based article discussing the effects of omega-3 fatty acids and fish oil on PCOS. I’ll also share my personal experience with this particular nutrient as well as some practical tips on how to best choose and use omega-3 supplements to get the most benefits.

If you’d like to know more about other natural ways to successfully reverse PCOS, make sure to check out my previous article ‘How To Treat PCOS Naturally (Science-Based Guidelines)‘

What is fish oil?

Fish oil is typically derived from the fats of coldwater fish (such as salmon, mackerel, sardines, anchovies) due to their high concentration of omega-3 fatty acids. Omega-3 is an essential fatty acid (your body can’t make it) that is a vital part of cell membranes and hormone structures in your body.

For this reason, sufficient omega-3 intake from your diet is extremely important for a number of bodily functions and processes (including, hormone regulation, brain function, blood clotting and inflammation).

Omega-3 fatty acids

There are, however, different types of omega-3 fats: 

  • ALA (alpha-linolenic acid) – found in plant sources (flaxseed, walnuts, chia seeds, hemp seeds)
  • EPA (eicosapentaenoic acid) – found in marine sources (oily fish, shellfish, algae)
  • DHA (docosahexaenoic acid) – found in marine sources (oily fish, shellfish, algae)

Because EPA and DHA are the ones that your body actually uses for most functions (cell membrane and hormone building) it also converts ALA into those two types of fatty acids so they can be used. 

However, your body is able to convert only a small percentage of ALA into DHA (0.05-5%) and EPA (5-10%) and this process may be even compromised by several health conditions and lifestyle habits (insulin resistance, hormone imbalances, alcohol consumption).

For this reason, the consumption of foods containing ALA alone is not considered a sufficient way of obtaining optimal amounts of EFAs (essential fatty acids) from our diet. Foods and dietary supplements containing omega-3 fats in the form of EPA and DHA (such as fish oil) are therefore a much better option.

The good news is that omega-3 and fish oil are some of the most studied supplements with a large amount of evidence supporting their beneficial effects on health. Many existing studies also focused on the effects of omega-3 on PCOS and here’s what the results suggest.

Benefits of omega-3 fish oil for PCOS:

  • Improved insulin resistance
  • Decreased androgens
  • Cardiovascular health support
  • Improved mental health
  • Weight loss
  • Anti-inflammatory effects
  • Improved fertility
  • Eye health support

✓ Improved insulin resistance

Insulin resistance is now recognized as the main driver of PCOS in most women with this condition as it can lead to serious hormone disturbances in your body. I’ve described this process in my previous article ‘PCOS Insulin Resistance Explained & How To Reverse It’ where you can find more details.

Because high levels of insulin in the blood (caused by insulin resistance) can make your ovaries overproduce androgens (the ‘male’ hormones) and trigger your body to store more fat (especially visceral fat), it is a huge risk factor for most PCOS-related symptoms.

The good news is that with appropriate dietary and lifestyle strategies focused on blood sugar management, you can drastically improve your body’s sensitivity to insulin and even successfully reverse insulin resistance. This will also mean major improvements in your PCOS.

As a part of those effective dietary strategies, you may also want to include omega-3 rich foods or supplements such as fish oil. That’s because the consumption of omega-3 fatty acids has been shown to improve insulin resistance in multiple studies involving patients with metabolic dysfunctions, including women with PCOS.

✓ Decreased androgens

In a few studies, omega-3 supplementations have also been shown to reduce the levels of androgens (including testosterone) in women with PCOS. This effect is particularly important as hyperandrogenism (increased levels of androgens) is responsible for most PCOS symptoms such as hirsutism, acne, hair loss and irregular periods.

Interestingly, the beneficial effects of omega-3 on hormone regulation did lead to improvements in menstrual cycle, skin condition, hair quality and hirsutism in several studies. 

Additionally, omega-3 also appears to be effective in reducing menstrual pain and PMS symptoms, other common side effects of PCOS-induced erratic fluctuations in hormones.

✓ Cardiovascular health support

One of the most powerful properties of fish oil and omega-3 fatty acids is their ability to support cardiovascular health and prevent heart disease. There is solid evidence repeatedly showing the ability of omega-3s to lower blood triglycerides, cholesterol and blood pressure, all major risk factors of CVD.

Since women with PCOS are already at increased risk of developing heart disease due to their metabolic and hormonal dysfunctions, they are highly encouraged to focus on supporting their cardiovascular health in several ways.

Increasing the intake of omega-3 and supplementing with fish oil appears to be an effective strategy of doing so (amongst other dietary and lifestyle changes) as it’s been shown to improve blood lipid profile and metabolic markers of women with PCOS in multiple studies.

✓ Improved mental health

You may already know that foods rich in omega-3s are sometimes referred to as ‘brain foods’ and that lots of fish oil supplements also claim to support your brain health. The truth is that omega-3s are indeed essential for your brain function and optimal mental health.

That’s because your brain consists of about 60% fat and most of it is made up of those omega-3 fatty acids. Your omega-3 intake can therefore have a huge impact on your brain activity and mental state as it’s been demonstrated in large amounts of studies.

Insufficient omega-3 levels have been linked to increased risk of multiple mental disorders (including dementia, depression, ADHD) and supplementing with fish oil has been shown to improve the symptoms of those mental diseases. Increased omega-3 intake has been also shown to improve attention, focus and sleep in several studies.

Those effects are extremely important for women with PCOS as a large proportion of them suffer from anxiety, depression and sleep disturbances, according to the latest data. Supplementing with fish oil could therefore be a great way of supporting their mental health, improving sleep and managing stress. All leading to a better hormonal balance.

✓ Weight loss

Many studies have also focused on the effects of fish oil supplements on weight reduction and body composition change. While the results are quite inconsistent there appear to be a few patterns in which increased omega-3 intake may help support weight loss and improve body composition.

Some studies suggest that the consumption of omega-3 supplements helps reduce appetite and keeps you fuller for longer (you can find more tips here: ‘PCOS Cravings: How To Reduce Appetite & Excessive Hunger‘). Other studies have also linked the intake of omega-3 supplements to increased metabolic rate.

However, most studies suggest that omega-3 fatty acids are effective in reducing body fat percentage and building muscle mass. This effect doesn’t always translate into overall weight loss but it does result in improved body compositions, particularly in a reduced waist-to-hip ratio. 

That’s perhaps even more significant for women with PCOS as an increased waist-to-hip ratio is the main indicator of excessive visceral fat (belly fat) which is considered harmful as it drives inflammation and contributes to insulin resistance. 

I’ve explained this in more detail in my previous article ‘PCOS Belly Fat Explained & How To Reduce It’ where you can find a complete guide with practical tips on how to get rid of belly fat for good.

✓ Anti-inflammatory effects

Chronic inflammation is now recognized as the main contributor to a variety of chronic conditions (including diabetes, cancer, CVD) and it’s also closely linked to the development and progress of PCOS. It’s been shown that women with PCOS suffer from elevated inflammation markers in the body such as CRP (C-reactive protein).

The good news is that omega-3 fatty acids are natural anti-inflammatory agents with strong inflammation-lowering effects. This has been demonstrated in numerous studies where supplementing with fish oil was effective in lowering CRP levels and reducing the production of cytokines and eicosanoids (both strong inflammatory molecules).

The powerful anti-inflammatory and anti-oxidant properties of omega-3s are also believed to be responsible for their beneficial effects on liver health. Several studies have shown significant improvements in NAFD (non-alcoholic fatty liver disease) after supplementing with omega-3 fatty acids.

Because PCOS is a major risk factor for developing NAFD, fish oil supplements and increased omega-3 intake could be an effective strategy for reducing the risk of fatty liver in women with this condition.

✓ Improved fertility

PCOS is currently considered to be the leading cause of female infertility due to the hormone imbalances (causing anovulation and irregular periods) associated with this condition. However, most women with PCOS are able to experience a healthy pregnancy in response to lifestyle changes and other effective treatment strategies.

Interestingly, multiple studies suggest that increased omega-3 intake may also improve fertility in females and support a healthy pregnancy. The research shows that omega-3 may help regulate menstrual cycle and improve ovulatory function, therefore increasing the chances of getting pregnant.

Additionally, sufficient omega-3 intake during pregnancy and breastfeeding is crucial for early fetal growth and development (especially brain and vision). This is why pregnant and breastfeeding women are commonly recommended to supplement with high-quality fish oil.

✓ Eye health support

According to the latest research, there is a close link between PCOS and the development of dry eye syndrome typically associated with redness, itching, light sensitivity, discomfort and vision problems. Women with PCOS are more likely to experience this condition due to their erratic hormone imbalances.

That’s because sex hormones appear to be in control of the eye structure, directly affecting the function of tear glands and eye lipid layers. Increased androgen levels (a typical feature of PCOS) have been linked to structural changes in the eye, contributing to the symptoms of dry eye syndrome.

There is also evidence that a diet low in omega-3s is another major risk factor for developing eye disease and AMD (age-related macular degeneration). That’s because omega-3 fatty acids are essential structural components of your eyes (especially DHA) and their insufficient intake may lead to vision problems.

However, you may be able to support your eye health, improve vision and prevent eye disease by increasing your dietary intake of omega-3 or supplementing with omega-3 rich supplements, such as fish oil. 

Disadvantages of omega-3 fish oil for PCOS:

  • Quality
  • Taste
  • Sustainability

✕ Quality

Omega-3 is one of the most common dietary supplements in the world and this powerful nutrient also comes in many different forms, most commonly as fish oil. However, there tend to be huge differences in terms of the quality and purity of those products between individual brands.

Since dietary supplements are overall very poorly regulated, it can become quite challenging to find a high-quality fish oil supplement that will provide all of the potential health benefits. It is, therefore, best to look for products that are third-party tested by certified organizations such as GOED (Global Organization for EPA and DHA).

✕ Taste

Even if you enjoy eating fish on a regular basis, the idea of drinking fish oil is probably not very appealing. Fish oil capsules are a great way to avoid this problem, however, some supplements still have a strong fishy taste that can leave you with an unpleasant feeling (some people even experience fish burps).

Luckily, not all supplements are the same and there are a few that won’t leave you with a fishy aftertaste (I share some of my favorite brands later in this post). However, keep in mind that fish oil supplements can also go easily rancid if they’re not stored properly or if they’re out of date. Such supplements (with a rancid smell) should not be consumed at all.

✕ Sustainability

It is no secret that fishing has a huge environmental impact and that overfishing has become a serious problem in recent years. The production of fish oil is therefore associated with a lot of ethical and environmental problems. 

To minimize this problem, it’s important to look for brands with a legitimate sustainability certification such as (MSC) Marine Stewardship Council or the Environment Defence Fund. Fish oil derived from smaller fish (such as anchovies, sardines) is also considered more sustainable than from larger fish sources.

You can also find vegan omega-3 supplements (derived from algae) that are probably the most sustainable option, although they’re definitely less accessible and more expensive.

Best types of fish oil & omega-3 for PCOS:

  • Cod liver oil
  • Krill oil
  • Algae oil
  • Fish oil with antioxidants
  • Fish oil and vitamin D

When choosing an omega-3 supplement for PCOS, there are a few things you should focus on if you want to get a high-quality product and gain the most health benefits. Always consider the source, quality, DHA/EPA concentration, sustainability and the type of the supplement.

• Source

Cod liver oil is one of the best sources of fish oil supplements as it’s also naturally rich in vitamin A and vitamin D (unlike other fish oil sources). Krill oil is another great source of EPA and DHA fatty acids as it’s generally more absorbable for the body (you need less). 

Other great sources include smaller fish (sardines, anchovies) from the bottom of the food chain as they’re less likely to accumulate high levels of heavy metals (such as mercury). Algae is the best vegan omega-3 source and it’s in fact the primary source of all omega-3s derived from fish (all fish get their omega-3s from eating algae).

• Quality

Fortunately, most fish oil supplements are purified so they don’t contain mercury that could be harmful to our health. However, the content of those supplements is still very poorly regulated and it usually contains lots of fillers and artificial ingredients.

Always check the list of ingredients and look for products that are third-party tested by an independent organization (such as GOED, IFOS, USP, NFS, TGA). 

Never consume a fish oil supplement that is out of date or with a rancid smell. Store it in a dark cool place (or refrigerator) to maximize its freshness. You can also find many fish oil supplements combined with antioxidant compounds (such as vitamin E) as it helps keep their freshness and avoid oxidation.

• Concentration

Another important thing to look for is the concentration of DHA/EPA per serving. Regardless of the overall dosage (it’s usually 1000mg) always check that there is at least 500mg of EPA/DHA. Most fish oil supplements contain only 300mg of DHA/EPA per 1000mg capsules which is relatively low.

Omega-3 supplements containing only ALA fatty acids are also not considered very efficient as only small amounts will convert into DHA/EPA. 

• Sustainability

Algae is the most sustainable source of high-quality omega-3 fatty acids (EPA/DHA) and it’s 100% vegan. In terms of fish oil supplements, smaller fish are considered more sustainable sources in comparison to larger fish.

Fish oil supplements certified by recognized sustainability organizations should also guarantee using only sustainable fishing practices. 

• Type

There are many different forms in which you can find fish oil and omega-3 supplements, including liquids, capsules or gummies. This choice will be mostly dependent on your preferences as it won’t impact the supplements’ overall effects on health. 

However, fish oil capsules and softgels are usually preferred by most people as they have the lowest fishy taste (unlike fish oil liquids) and they’re not filled with additional sweeteners and other flavoring agents (unlike fish oil gummies).

Is fish oil good for PCOS?

Fish oil is generally considered good for PCOS as it’s rich in omega-3 fatty acids associated with strong anti-inflammatory properties and hormone-balancing effects. The consumption of fish oil may help support cardiovascular health, improve fertility, promote weight loss and support mental health. 

Cod liver oil vs fish oil for PCOS

Cod liver oil and fish oil are both good sources of essential omega-3 fatty acids that appear to have positive effects on PCOS. However, since cod liver oil is also rich in vitamin A and vitamin D, it may provide more health benefits to some women with PCOS in comparison to regular fish oil.

Fish oil and vitamin D for PCOS

Fish oil and vitamin D are amongst the most recommended dietary supplements for PCOS due to their beneficial effects on this condition. According to research, co-administration of those two nutrients may be particularly effective in improving multiple aspects of health in women with PCOS.

Best fish oil & omega-3 supplements for PCOS:

These are some of my favorite fish oil and omega-3 products that are in accordance with the quality criteria I’ve discussed above. I personally take fish oil supplements daily as it’s an easy way to balance my dietary intake of omega-3 to omega-6 ratio. I’ve also found some major improvements in my skin and hair quality after increasing my omega-3 intake.

How to use fish oil for PCOS:

Fish oil can be easily incorporated into a diet in many different ways and forms. Depending on the type and brand of fish oil and omega-3 products, the effects on PCOS may vary. However, there are some general recommendations based on the research findings that may be followed to maximize the positive effects.

How much fish oil should I take for PCOS?

As a general rule, women with PCOS should consume between 1-4 g of fish oil per day to achieve the most health benefits. However, the optimal dosage of fish oil for PCOS may differ between individuals depending on their personal circumstances and the type of omega-3 supplement used.

When is the best time to take fish oil for PCOS?

The best time to take fish oil supplements for PCOS appears to be with meals since other types of fats may help increase the absorption of omega-3 fatty acids. However, fish oil can be consumed at any time of the day depending on personal preferences and lifestyle arrangements.

Pro tips:

  • Create a routine – consistency is key for taking supplements so creating a solid daily routine can make it easy for you to stick to your plan and get better results, try to take it at the same time of the day (eg. with lunch, breakfast or dinner) every day
  • Use a supplement container – if you take multiple supplements a day I highly suggest using one of those practical containers where you can pre-arrange your tablets for each day, it makes taking supplements way more effortless
  • Keep it in the fridge – omega-3 fatty acids are very sensitive to heat and light so the best way to store fish oil is in a dark cool place, I like to keep it in the fridge to prevent oxidation and keep its freshness
  • Eat omega-3 rich foods – don’t forget that omega-3 supplements are not a replacement for omega-3 rich foods and you should still include a variety of different omega-3 sources in you everyday diet to gain the most benefits (it’s an essential nutrient!)
  • Drink a lot of water – make sure you drink a lot of fluids with your supplements so it’s easier for your body to digest and absorb those nutrients
  • Be patient – don’t expect any overnight results, keep in mind that your body is a complex system that doesn’t like rapid changes – it usually takes several weeks before you start seeing results
  • Track your progress – get tested and keep a track of your progress, with enough data you’re more likely to see what strategies and supplements work for you best and it also helps you stay motivated, you can find some useful tools here ‘TOP 5 Smart Devices To Monitor & Manage PCOS‘

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