Evaluation of Cyclooxygenase-2 and Prostaglandin E2 Expression in Endometrial Tissue Following 8 Weeks of Swimming Exercise and Omega-3 Intake

Background and objectives: Endometriosis is a chronic disease that affects approximately 10% of women of reproductive age. The purpose of this study was to evaluate the effects of 8 weeks of swimming exercise and omega-3 supplementation on the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) genes and serum levels of reproductive hormones in the endometrial tissue of a rat model of endometriosis. Methods: In this experimental study, 30 adult Wistar rats were randomly divided into 5 groups of healthy-control, patient-control, patient+exercise, patient+omega-3, and patient+omega-3+exercise groups. After the induction of endometriosis, the rats were subjected to 8 weeks of swimming exercise, 5 days a week as well as 2 ml/kg/body weight of omega-3. Data were analyzed using one-way analysis of variance and Tukey post hoc test at the significance level of 0.05. Results: The expression of COX-2 and PGE2 as well as serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol levels were significantly higher in the patient group compared with the healthy-control group (p≤0.0001). Exercise and omega-3 supplementation either separately or combined could significantly reduce the expression of both genes and serum levels of LH, FSH, and estradiol (p<0.05). This effect was more profound in the patient+exercise+omega-3 group. Conclusion: The results of the present study indicate that regulating the expression of COX-2 and PGE2 genes as well as serum levels of reproductive hormones through swimming exercise and omega-3 supplementation can improve endometriosis.