Vitamin D Status and the Menstrual Cycle: A Systematic Review
Authors: Subramanian Anita , Gernand Alison D 
Published: November 2023

Estimating vitamin D status is important for nutrition research and public health monitoring and can impact the prevention and treatment of vitamin D deficiency in women of reproductive age. Our objective was to conduct a systematic review of studies that assessed concentrations of 25‐hydroxyvitamin D [25(OH)D, a marker of vitamin D status] or 1,25‐dihydroxyvitamin D [1,25(OH)2D, biologically active vitamin D metabolite] and the menstrual cycle. We aimed to assess if vitamin D biomarkers change at different points in the cycle and if vitamin D status is related to menstrual cycle disorders. We conducted a systematic search in PubMed of literature which reported vitamin D status in women at one or more identified phases among women with regular menstrual cycle, irregular menstrual cycles, or premenstrual syndrome (PMS) or dysphoric disorder (PMDD) across the normal menstrual cycle and among women experiencing irregular cycles and premenstrual syndrome (PMS). Twelve studies published between 1980 and 2016 met the inclusion criteria; 10 were conducted in the US, one in Denmark and one in Jordan. Seven studies measured vitamin D status in women longitudinally and 5 used a cross‐sectional design. Study size ranged from 5 to 1102 subjects (combined total was 4009) with an age range of 18–45 years. The majority of women studied were healthy and had a regular cycle length (26–35 days). There was an increase in the concentration of 1,25(OH)2D from the early follicular phase to the late luteal phase that varied from 13% and 26%. Three studies found increased concentrations within the follicular phase, including a midcycle (day 1 to 15) 1,25(OH)2D rise of 128% (among women not taking oral contraceptives); an 8 % increase in 1,25(OH)2D concentration from day 3 to day 13; and an increase of 56% in 1,25(OH)2D concentration from day 0 to day 12. In contrast, no changes were found in the concentration of 25(OH)D across the menstrual cycle, among the 3 longitudinal studies reporting it. Two cross‐sectional studies found an inverse association between 25(OH)D concentration and odds of irregular and long menstrual cycles. Three studies found no association between concentration of 25(OH)D and PMS or PMDD, whereas one study reported a lower concentration of 25(OH)D among women with PMS than the controls. Limited research has been conducted on vitamin D status and the menstrual cycle. The few existing studies suggest that 1,25(OH)2D changes across the menstrual cycle, but the relationship with PMS or PMDD is unclear. Future studies should examine vitamin D status and its active metabolite across specific points in the menstrual cycle, as changing concentrations could impact estimates of vitamin D deficiency in women of reproductive potential as well as influencing other hormones and reproductive function. Vitamin D deficiency is a worldwide problem and further research in this area can have global implications and help towards improving the health status of women of reproductive age.

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