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Review: Vitamin D and polycystic ovary syndrome

Posted on: May 28, 2012   by  John Cannell, MD

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The principal symptoms of polycystic ovary syndrome (PCOS) are infrequent ovulation resulting in irregular or a complete lack of periods. Infertility is also common in the disorder as are high levels of male hormones, which causes acne and hirsutism (excessive hair growth). The disease is often associated with obesity, high blood pressure, diabetes, and high cholesterol. Some women have few symptoms and others have them all. PCOS is the most common endocrine problem in women of reproductive ages in the world and produces symptoms in at least 12% of young women.

Dr. Rebecca Thompson and colleagues of the University of South Australia recently reviewed the role vitamin D deficiency plays in the disorder. They report that up to 85% of women with PCOS have vitamin D levels less than 20 ng/ml.

Thomson RL, Spedding S, Buckley JD. Vitamin D in the etiology and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2012 May 10.

Two observational studies have found infertile women with PCOS have lower levels of vitamin D than do fertile women with PCOS. In one study, higher levels of vitamin D inside the follicle (follicles are the basic cellular units of female reproduction and each follicle contains an egg) was associated with increased success at in vitro fertilization. Each single ng/ml increase in vitamin D levels in follicular fluid increased the likelihood for achieving pregnancy by 7%.

Another small open study showed that treating severely vitamin D deficient women suffering from PCOS with enough vitamin D to obtain 25(OH)D levels above 30 ng/ml resulted in normal menstrual cycles in 7 of the 9 women with menstrual irregularities. A larger open study of 46 women with PCOS showed 20,000 IU/week of vitamin D regulated periods in 50% of the women with menstrual irregularities.

In terms of acne and hirsutism (hairiness), most studies show that women suffering from PCOS with these problems have lower vitamin D levels than do PCOS women without acne and hirsutism. One very small open study showed vitamin D improved acne but not hirsutism in women with PCOS, but we await controlled trials using adequate doses of vitamin D.

As mentioned above, women with PCOS are at a high risk for cardiovascular disease as they often have diabetes, high cholesterol, insulin resistance, and obesity. A cross sectional study found low levels of vitamin D in women with PCOS were associated with cardiovascular risk factors, such as elevated cholesterol, blood pressure, blood sugar, CRP and triglycerides.

Finally, the authors lamented that there are no studies on depression and vitamin D in women suffering with PCOS, as mood disorders are common in the disease. However, the authors report that studies suggest that vitamin D may be a good antidepressant and again they advise the academic community to study vitamin D and mood in women with PCOS.

The overall tenor of the paper is that we need more studies, but the authors did think, “There may be a place for vitamin D supplementation in the management of PCOS . . .”

We think there is no place for vitamin D deficiency in women suffering from PCOS.

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