Role of vitamin D levels on the ovarian function and androgen profile in adolescents with polycystic ovarian syndrome

Abstract

Background: The presence of the vitamin D receptor (VDR) has been found on the granulosa and theca cells of the ovary but its role in menstruation is not well understood. A few clinical studies in adults have shown that Vitamin D supplementation can lower androgen levels, lower anti-Mullerian hormone (AMH) levels, normalize the metabolic profile and regularize periods in women with polycystic ovarian syndrome (PCOS) whereas others have failed to show any effect on these parameters. Moreover, only a handful of studes have looked at adolescents. In this study, we hypothesized that vitamin D supplementation in adolescents with PCOS and vitamin D deficiency will regularize the periods and have a positive effect on the androgen profile. Methods: We conducted a retrospective chart review of obese adolescent females 12–17 years of age with vitamin D deficiency and irregular menstruation or PCOS (n=17). Patients with obesity and vitamin D deficiency with regular menstruation were included as controls (n=7). Follow up data of at least 3 months after the initiation of vitamin D and when available, data every 3 months till a maximum of 30 months from the first visit was recorded. Results: Thirteen/17 study subjects had regular periods at the end of the study. Of these 13 patients, 84.6% were treated with oral contraceptive pills (OCPs) with or without metformin, 7.6% with vitamin D alone and 7.6% with Metformin alone. Four/17 patients continued having irregular periods; 3 of these 4 were on Metformin and one was on vitamin D alone. Improvement in the vitamin D level occurred in 11/17 subjects during the study period. Among them, 82% of these had regular periods and all of them were on OCPs. The Free testosterone decreased significantly; but total testosterone, LH and LH/FSH ratio did not show any statistically significant improvement. Conclusions: Our study did not support the role of vitamin D in regularizing menstruation or improving the androgen profile in adolescents with PCOS. However, a larger prospective study is needed to confirm these findings.