The Journal of Steroid Biochemistry and Molecular Biology
Dietary vitamin D intake, 25-hydroxyvitamin D3 levels and premenstrual syndrome in a college-aged population☆
Introduction
Moderate-to-severe premenstrual syndrome (PMS) affects up to 20% of reproductive age women and is associated with substantial levels of impairment [1]. The most common symptoms of PMS include irritability, mood swings, anxiety, depression, breast tenderness, bloating, and headaches. While many pharmaceutical treatments for PMS have been evaluated, all have significant limitations and none has a reported efficacy greater than 60–70%. Because of the substantial limitations of available treatments, it is important to identify ways to prevent the initial development of this disorder.
While the etiology of PMS remains largely unclear, evidence from multiple sources suggests that vitamin D may play a role in its development and/or the experience of symptoms. Both diet and sunlight contribute to circulating levels of plasma vitamin D metabolites. Dietary intake of fortified dairy foods and cereals, some types of fish, multivitamins and calcium/vitamin D supplements contribute importantly to vitamin D in elderly populations and those with low ambient sunlight exposure [2]. In populations with ample sun exposure, cutaneous conversion of 7-dehydrocholesterol to previtamin D after exposure to solar UV radiation provides the greater source. Previtamin D from both diet and cutaneous production is hydroxylated in the liver into 25-hydroxyvitamin D3 (25(OH)D3), the metabolite circulating in the greatest concentration. 25(OH)D3 is then further hydroxylated to 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), in the kidney and in target tissues including the brain, breast and endometrium. 1,25(OH)2D3 is the biologically active metabolite that binds to nuclear vitamin D receptors in target tissues.
It has been suggested that women with luteal phase symptoms consistent with PMS may be experiencing vitamin D deficiency, or related conditions of calcium dysregulation and hyperparathyroidism [3] but few studies have addressed this. In a sub-study within the prospective Nurses’ Health Study II (NHSII), high total vitamin D intake was associated with a significant 41% lower risk of PMS, while high vitamin D from food sources only was associated with a significant 31% lower risk [4]. Results from this study are provocative and raise several questions. For example, it is unknown whether vitamin D may be associated with overall severity of menstrual symptoms in a general population, and whether serum 25(OH)D3 levels, which better reflect vitamin D status than dietary intake alone, are associated with PMS. Therefore, we have evaluated these relationships in a pilot study of college-aged women in Massachusetts, USA.
Section snippets
Study population
We conducted a cross-sectional analysis among members of the University of Massachusetts Vitamin D Status Study. Participants were 186 healthy, premenopausal women aged 18–30 living in the Amherst, MA, USA area (latitude = 42.380N), and were enrolled in the study between March 2006 and June 2008. Women were ineligible if they: (1) were pregnant or not currently menstruating; (2) were experiencing untreated depression; (3) reported a history of high blood pressure or elevated cholesterol, kidney
Results
The mean age of our study population was 21.6 (SD = 3.2) years. Mean BMI was 22.8 (2.9) kg/m2 and women averaged 56.8 (49.2) MET-hours per week of physical activity. PMS cases were significantly more likely to have ever smoked cigarettes compared to controls (14.4% vs. 2.2%; P = 0.002). PMS cases and controls did not differ significantly by total calorie intake, total calcium intake, BMI, oral contraceptive use, SSRI use, MET-hours per week of activity or aspects of sun exposure.
Among all study
Discussion
In our pilot study in young women, we observed evidence that vitamin D intake may be inversely associated with prevalent PMS, and perhaps with menstrual symptom severity in general. In contrast, late luteal phase serum 25(OH)D3 levels were not associated with either outcome.
High dietary intake of vitamin D may reduce the risk of PMS perhaps by affecting calcium levels [2], cyclic sex steroid hormone fluctuations [3], and/or neurotransmitter function [11]. Vitamin D has been observed to
Acknowledgements
This work was supported by Public Health Services Grant K01MH076274 from the National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, and by the University of Massachusetts at Amherst, and Proctor and Gamble.
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Association between Vitamin D Status and Premenstrual Symptoms
2019, Journal of the Academy of Nutrition and DieteticsSerum vitamin D concentrations in young Turkish women with primary dysmenorrhea: A randomized controlled study
2018, Taiwanese Journal of Obstetrics and GynecologyCitation Excerpt :Accordingly, Bertone-Johnson et al. has related low dietary intake of vitamin D with the emergence of premenstrual symptoms [38]. In addition, it has been demonstrated that high calcium intake or vitamin D supplementation contributes to the alleviation of premenstrual symptoms [39–43]. However, Obeidat et al. were unable to show a significant difference between vitamin D levels of women with and without premenstrual symptoms.
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Special issue selected article from the 14th Vitamin D Workshop held at Brugge, Belgium on October 4–8, 2009.