BACKGROUND: Primary dysmenorrhea, prevalent among women of reproductive age, manifests as menstrual pain and discomfort localized in the lower abdomen. This study aimed to observe the effect of exercise, omega-3 fatty acids, and the clubbing of exercise and omega-3 supplements on primary dysmenorrhea. METHODS: A randomized controlled trial was conducted involving young female patients. We assessed a cohort of 72 female patients, aged 18 to 25 years, to determine the effects of exercise and omega-3 fatty acids on primary dysmenorrhea. Parameters such as visual analog scale (VAS) scores, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and complete blood count (CBC) parameters were evaluated before and after the intervention. RESULTS: At baseline, no statistically significant differences were detected among the four groups (control, exercise, omega-3, and combined exercise plus omega-3) regarding VAS scores (p = 0.605), CRP levels (p = 0.164), hemoglobin levels (p = 0.104), or platelet counts (p = 0.949). Nevertheless, significant differences were identified in ESR (p = 0.002) and total leukocyte count (TLC) (p < 0.001). The omega-3 group exhibited elevated levels of ESR and TLC, particularly in conjunction with the combined exercise and omega-3 intervention. Following 12 weeks of intervention, notable enhancements were recorded across various parameters. The VAS scores demonstrated a statistically significant reduction across all groups (p = 0.023), with the most pronounced alleviation observed in the cohort receiving both exercise and omega-3 supplementation, thereby suggesting an enhanced efficacy in pain relief. Additionally, CRP levels revealed significant intergroup variances (p = 0.016), with the exercise group exhibiting the lowest recorded levels. The TLC remained significantly different between the groups (p < 0.001), with consistently elevated levels in the omega-3 group and diminished levels in the combined intervention group. Conversely, no statistically significant alterations were detected in ESR (p = 0.086), hemoglobin (p = 0.077), or platelet counts (p = 0.871) at the conclusion of the 12-week evaluation. CONCLUSION: A notable reduction in the intensity of menstrual pain, as quantified by the VAS, an indicator of systemic inflammation, was observed with omega-3 supplementation and exercise. Moreover, the reduction in the ESR and CRP levels also implied that the implemented interventions may have facilitated an anti-inflammatory response.

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