Omega-3 vs Evening Primrose Oil for Perimenopause: Comparing Two Popular Supplements

Two Oils, Very Different Jobs

Walk into any health food store and you will find both omega-3 and evening primrose oil marketed for hormonal health. They are both fatty acid supplements. They both come up in conversations about perimenopause. And they are often confused with each other.

But they work through different mechanisms, contain different types of fatty acids, and have different evidence bases for perimenopause-related symptoms.

Understanding the distinction helps you make a more informed decision rather than just reaching for whichever product was most prominently displayed.

What Are Omega-3 Fatty Acids?

Omega-3s are a family of polyunsaturated fatty acids found primarily in fatty fish, flaxseed, chia seeds, and walnuts. The two most researched forms are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), found in fish and algae.

Omega-3s are known primarily for their anti-inflammatory properties and their role in cardiovascular and brain health. Fish oil and algae-based omega-3 supplements are among the most widely studied supplements in the world, with a large and generally positive evidence base.

DHA is particularly important for brain structure and function. EPA has stronger associations with mood regulation and inflammatory processes. Both are relevant to perimenopausal health.

What Is Evening Primrose Oil?

Evening primrose oil is extracted from the seeds of the Oenothera biennis plant. Its key active component is gamma-linolenic acid, or GLA, an omega-6 fatty acid that is converted in the body into anti-inflammatory compounds.

Evening primrose oil has a long history of use in traditional and complementary medicine for hormonal symptoms, including premenstrual symptoms and menopause-related complaints. However, the research evidence is more limited and mixed than for omega-3s.

Important note: evening primrose oil may have mild estrogenic or hormonal activity. If you have or have had a hormone-sensitive condition such as breast cancer, endometriosis, or uterine fibroids, discuss this supplement with your healthcare provider before using it. It may also interact with blood thinners and should not be used before surgery.

How Each Relates to Perimenopause Symptoms

Omega-3 fatty acids have the strongest evidence for cardiovascular health, which becomes increasingly relevant as estrogen levels decline during perimenopause and cardiovascular risk begins to shift. Some research also suggests omega-3s may support mood and reduce depressive symptoms, which aligns with the mood changes many people experience in perimenopause.

For hot flashes specifically, a few studies have examined omega-3s with mixed results. Some suggested modest reductions in hot flash frequency, though this is not a consistent finding across all research.

Omega-3s also appear to support brain health and may help with the cognitive changes some people notice during the hormonal transition.

Evening primrose oil is most often studied for hot flashes and breast tenderness. The hot flash research is mixed. Some small studies suggest it may reduce hot flash severity, but larger or more rigorous trials have not consistently confirmed this. It is more commonly cited anecdotally by women who find it helps with breast discomfort and skin dryness.

The evidence for evening primrose oil in perimenopause is generally considered preliminary and lower quality than the evidence for omega-3s across multiple health areas.

Safety Considerations and Drug Interactions

Omega-3 supplements are generally very well tolerated. The most common side effects are a fishy aftertaste and mild digestive discomfort, both of which can be reduced by choosing enteric-coated capsules or algae-based forms. At very high doses, omega-3s may affect blood clotting, so if you take blood thinners, anticoagulants, or any prescription drugs, check with your provider before significantly increasing your intake.

Evening primrose oil carries more caution flags. It has potential interactions with blood thinners and antiplatelet medications. It should be used with caution in people with seizure disorders. As noted above, its potential hormonal activity means it requires discussion with your provider if you have any hormone-sensitive health history.

Neither supplement should replace prescribed medication or hormone therapy. If you take any prescription drugs, check with your provider before adding either supplement.

Practical Use and Dosing

Studies examining omega-3 benefits for mood and inflammation have generally used doses of 1 to 3 grams of combined EPA and DHA daily. For cardiovascular benefits, current guidelines from major health organizations suggest aiming to get omega-3s primarily from food (two servings of fatty fish per week) with supplementation filling the gap.

Evening primrose oil studies for hot flashes have used various doses. Research has examined doses in the range of 500 mg to several grams daily. Talk to your healthcare provider about the right dose for your situation before starting.

Both supplements are best taken with food to improve absorption and reduce any digestive discomfort.

Can You Take Both?

Many people do take both omega-3 and evening primrose oil, and there is no known direct interaction between them. However, taking multiple supplements that can thin the blood does compound the effect, so it is worth flagging this to your provider if you are considering both.

If you are prioritizing evidence and overall health support, omega-3 has the stronger foundation. If you are specifically interested in experimenting with GLA for hot flashes or breast tenderness and your provider agrees it is safe for you, evening primrose oil can be added.

Always prioritize food sources where possible. Fatty fish, walnuts, flaxseed, and chia seeds provide omega-3s in their natural context. No supplement perfectly replicates whole food nutrition.

Tracking Whether Supplements Are Helping

One of the challenges with supplements is that their effects are often gradual and subtle. Without consistent tracking, it is difficult to know whether anything has actually changed.

If you decide to try either omega-3s or evening primrose oil for perimenopause symptoms, logging your symptoms before you start and consistently throughout gives you a clearer basis for evaluation. PeriPlan lets you log daily check-ins so patterns over weeks become visible rather than relying on memory.

If you notice no change after a reasonable trial period, typically two to three months, that is useful information to bring back to your provider as well.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.