PCOS and Bone Density
Bone density isn’t a super sexy thing to talk about. In the context of PCOS, it’s a big deal because progesterone is the hormone that helps to make sure we are making dense enough bones. No ovulation = no progesterone.
In a very critical period of our life (fertile years), we are put on birth control and we don’t make progesterone while on birth control. Those not on birth control do not cycle as regularly as women without PCOS and are exposed to much less progesterone.
So if we have low vitamin D levels and low progesterone(lack of ovulation) we are going to be on shaky ground as we age (figuratively and literally). Our body will not have the exposure needed to two hormones that play a critical role in bone health: vitamin D and progesterone.
This doesn’t need to be the case though. You can supplement with vitamin D and try to recover these levels and you can work on root cause factors to improve ovulation and progesterone production.
Vitamin D Levels Are Linked to Cycle Regularity
Low vitamin D status is related to irregular ovulation and longer cycles. In fact, those with normal vitamin D levels are 13.3 times more likely to ovulate in a cycle. (5)
There are some studies that have been done to assess if the genes that make it more likely to develop PCOS are linked with genes that make it more likely that you are vitamin D deficient. It seems there is some overlap in preliminary research.
Improving vitamin D levels has been associated with improved ovulation, pregnancy rates, and live birth rates.
How is vitamin D linked to fertility?
Did you know that your ovary has vitamin D receptors? How cool is that?! There are also receptors in the uterus and placenta.
It is common for women with PCOS to have high levels of a hormone called antimüllerian hormone (AMH). These high levels are typically associated with longer cycles and poorer egg quality.
When vitamin D levels are low AMH levels can be higher in someone with PCOS. Supplementing vitamin D helps to lower abnormally elevated AMH levels and can improve how follicles develop to be ready for ovulation. (3)
In one study looking at PCOS women in the context of fertility treatment there were three groups:
taking metformin alone
taking metformin + calcium + vitamin D
taking calcium and vitamin D alone
It was found that the group taking vitamin D, calcium, and metformin had the most improvement in dominant follicles and pregnancy rates. (4)
Vitamin D levels are known to improve natural pregnancy, treatments with ovulation-inducing medicines like metformin and clomid, and IVF success.
The goal isn’t getting pregnant for most people, right? We want to stay pregnant and have healthy babies.
Is vitamin D also important during pregnancy?