Could Vitamin D Be Key to Managing PCOS Symptoms?

Credit: Adobe Stock/avaye

A study evaluating vitamin D levels in women with polycystic ovary syndrome (PCOS) found that vitamin D deficiency is significantly more common in women with PCOS than in those without, particularly in individuals with insulin resistance or obesity. Lower vitamin D levels in these patients were also associated with higher insulin resistance and body mass index (BMI).

Investigators believe these findings suggest that vitamin D deficiency may play a role in PCOS and that vitamin D supplementation could potentially help in managing the condition, although further research is necessary.

A retrospective, comparative, monocentric study conducted in Morocco included a cohort of 176 women of reproductive age (between 18 and 40 years) who were divided into two groups: those with PCOS (82 women) and those without PCOS (94 women). A vitamin D deficiency was defined as a serum concentration of less than 10 ng/ml. Other information collected included BMI, waist circumference, age, blood pressure and the presence of acanthosis nigricans.

A diagnosis of PCOS was based on the presence of two or more ovulation abnormalities, including anovulation or oligo-ovulation, clinical signs of hyperandrogenism and/or biochemical hyperandrogenism, and the incidence of polycystic ovarian morphology. Diagnosis was confirmed after excluding other diagnoses of hyperandrogenism, such as adrenal tumors, adrenal hyperplasia and androgen-secreting ovarian tumors. Irregular menstrual cycles were defined as having fewer than 8 cycles per year, cycles longer than 35 days, or cycles shorter than 21 days.

The condition, which affects between 10% and 13% of women, has been shown to increase the risk of developing a number of conditions including type 2 diabetes, chronic cardiovascular diseases, sleep apnea, high blood pressure and metabolic syndrome. It has also been linked to a higher prevalence of psychological disorders and can cause complications during pregnancy.

“Recently, growing evidence has proposed that insufficient vitamin D status could be associated with a major risk of the development of PCOS,” wrote the team of Moroccan investigators. “Hence, it could be hypothesized that supplementation of vitamin D may improve PCOS management.”

In the current study, the mean age of patients with PCOS was 25 years and the level of mean 25(OH)D was 13.8 ± 6.7 ng/ml. Vitamin D deficiency was reported in 40.2% of women with PCOS compared with 24% of those without PCOS. Similarly, vitamin D insufficiency was also more prevalent among patients with PCOS compared with those without (56% vs. 50%, respectively).

Levels were lower in women with PCOS, in whom the incidence of deficiency was significantly higher compared with healthy individuals without PCOS.

Among women with PCOS, those with insulin resistance or obesity demonstrated lower vitamin D levels compared with patients without these factors (61.9% vs 38.4%, respectively).

Although the age, fasting glucose level and lipid profile were comparable among patients with either deficient or insufficient vitamin D levels, those with a deficiency were more likely to have significantly higher waist obesity, obesity and homeostatic model assessment for insulin resistance (HOMA-IR). Vitamin D was significantly linked with metabolic syndrome, HOMA-IR, waist obesity and fasting insulinemia.

According to investigators, the study was limited by the small number of patients recruited from a single center. Therefore, they encourage larger studies covering other parts of Morocco to confirm these findings.

“Among PCOS patients, 25(OH)D levels were associated with metabolic syndrome and IR,” investigators concluded. “The effectiveness of vitamin D supplementation essentially on IR remains a debatable issue. It is now primordial to establish an optimal consensus of vitamin D supplementation for [women with PCOS]."