Polycystic Ovarian Syndrome (PCOS) is a condition affecting between 4-8% of females of reproductive age, according to the NIH [1]. PCOS is characterized by symptoms of hyperandrogenism (e.g. acne, hirsutism, and alopecia), anovulation (e.g. irregular, infrequent, or absent menstrual cycles), and the growth of cysts on and around the ovaries [2]. Due to underlying causes of these issues, fertility can also be problematic for women with PCOS.

PCOS and mental health are also closely related. Specifically, rates of depression, anxiety, and perceived stress are all higher in PCOS patients, even after adjusting for factors such as body mass index, infertility, and socio-demographic factors [3]. 

There is no one, singular root cause of this syndrome. However, PCOS is associated with imbalanced hormones and multiple metabolic conditions [2]. Somewhere between 44-70% of patients with PCOS also experience insulin resistance and hyperinsulinemia [2]. They are also at a higher risk of cardiovascular disease due to the high prevalence of dyslipidemia [2]. 

Vitamins for PCOS Support

While a balanced diet and regular exercise are the most common prescription for natural PCOS management, supplements can offer support. Magnesium and vitamin E co-supplementation for 12 weeks has been shown to provide beneficial effects on insulin metabolic parameters, and markers of cardio-metabolic risk in women with PCOS [2]. 

Omega-3 fatty acids and vitamin E co-supplementation for 12 weeks has been shown to significantly improve insulin resistance, and both total and free testosterone levels in women with PCOS [2]. 

Vitamin D is an important vitamin for women experiencing a depressed mood, whether or not they have PCOS. However, PCOS is associated with increased inflammation and low vitamin D levels which are both linked to mood challenges [4]. Consider having your vitamin D levels tested by a doctor and/or adding a vitamin D supplement to your health regimen. This is especially crucial if you are not spending sufficient periods in the sun, uncovered and without sunscreen, daily.

Vitamin E for PCOS fertility

Enigmatic fertility issues can be a source of sadness and frustration that may lead to a depressed mood. If you fall in this camp, addressing both mood and reproductive health with natural support may be advantageous.

Vitamin E alone has been shown to improve the overall hormonal profile by decreasing testosterone and LH levels and increasing progesterone and FSH levels [2]. A healthy hormonal profile will likely contribute to better fertility. 

But how does this work? What is the mechanism behind vitamin E’s actions?

Increased levels of reactive oxygen species (ROS), as a result of oxidative stress, likely play a key role in the pathogenesis of PCOS [5]. PCOS may actually cause its own oxidative stress, creating a vicious cycle [5]. ROS may negatively affect pregnancy rates, by interfering with oocyte maturation, progesterone production, and luteolysis [5]. Luckily, vitamin E supplementation can decrease oxidative stress in cases of PCOS [2].

Ischemia modified albumin (IMA) is a marker of oxidative stress. IMA levels are often found to be elevated in infertile PCOS patients [5]. IMA may impact the quality of oocytes by changing the balance of critical follicular fluid factors. 

A recent fertility study showed that while ongoing pregnancy rates did not change, supplementation of vitamin E for women with PCOS did reduce both the gonadotrophin requirement and risk of ovarian hyperstimulation syndrome (OHSS) [5]. For this reason, and those described above, vitamin E is likely a beneficial choice for PCOS women undergoing ovarian induction.

References:

  1. Woods Jr, James R., Mark A. Plessinger, and Richard K. Miller. “Vitamins C and E: missing links in preventing preterm premature rupture of membranes?.” American journal of obstetrics and gynecology 185.1 (2001): 5-10.
  2. Tefagh, Ghazale, et al. “Effect of vitamin E supplementation on cardiometabolic risk factors, inflammatory and oxidative markers and hormonal functions in PCOS (polycystic ovary syndrome): a systematic review and meta‐analysis.” Scientific reports 12.1 (2022): 1-16.
  3. Damone, Anna L., et al. “Depression, anxiety and perceived stress in women with and without PCOS: a community-based study.” Psychological medicine 49.9 (2019): 1510-1520.
  4. Moran, Lisa Jane, Helena Jane Teede, and Amanda Jane Vincent. “Vitamin D is independently associated with depression in overweight women with and without PCOS.” Gynecological Endocrinology 31.3 (2015): 179-182.
  5. Chen, Jie, et al. “Effect of a short-term vitamin E supplementation on oxidative stress in infertile PCOS women under ovulation induction: a retrospective cohort study.” BMC women’s health 20.1 (2020): 1-9.