Background: Polycystic ovarian syndrome (PCOS) is a common female endocrine disorder with unknown etiology. Many treatments are available to treat the symptoms associated with this condition including obesity, insulin resistance, abnormal glucose metabolism, infertility, menstrual irregularity, hirsutism, and acne vulgaris. More recently, it has been found that women with PCOS, particularly if obese, are more likely to be vitamin D deficient. It is hypothesized that vitamin D and calcium metabolism can also affect symptoms associated with PCOS as it influences many physiologic processes within the body. Does vitamin D and calcium supplementation improve symptoms of PCOS?
Methods: An exhaustive medical literature search was conducted using Medline-OVID, CINAHL, EBMR Multifile, GoogleScholar and Web of Science using keywords: polycystic ovarian syndrome and vitamin D. The search was further narrowed to include articles with English language and humans only. For included articles, bibliographies were screened for relevant articles. Included articles were evaluated using GRADE.
Results: For this review, the final number of relevant, primary articles meeting inclusion criteria was a total of 6 articles. These articles included two randomized- controlled trials, three observational studies, and one case-control study. These studies vary in sample size, measurement of outcomes, population selection, and significance in results. Multiple studies suggest improvement in menstruation regularity, fertility, BMI, insulin resistance, glucose metabolism, and hyperandrogenism; but the studies evaluated have many limitations and yield insignificant observations.
Conclusion: It is possible that vitamin D and calcium supplementation yields a good outcome in a variety of symptoms common in PCOS, but evidence is lacking in quality. A weak recommendation for vitamin D and calcium supplementation can be made as vitamin D is relatively inexpensive and safe. A stronger recommendation is made if PCOS patients are vitamin D deficient. Long-term, randomized clinical studies need to be conducted to determine whether vitamin D and calcium supplementation is necessary in the treatment of PCOS and to demonstrate the benefits of supplementation in relation to the general population with this condition.
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