Nutrition Notes

Clinical Studies Investigate the Role of Micronutrients to Support Menstrual Comfort

Dysmenorrhea is the most common gynecologic problem and involves recurrent lower abdominal cramping and pain associated with menstruation. Increased production of prostaglandins occurs during endometrial sloughing and can cause myometrial contraction and the stimulation of pain fibers associated with pelvic pain. Evidence suggests that nutritional status may influence certain aspects of menstrual comfort, ovarian function, and reproductive health. For instance, severe dysmenorrhea has been linked to low fish intake, among other risk factors. 

Trace minerals such as zinc have been studied for their potential to help support the inflammatory response and other aspects of menstrual health. Biochemically, zinc helps support antioxidative status and helps downregulate certain inflammatory cytokines. It also helps regulate cyclooxygenase, an enzyme that controls the biosynthesis of many prostaglandins, including those associated with dysmenorrhea. 

A recently published double-blind randomized control trial by Obiagwu and colleagues explored the potential supportive role of zinc in the presence of dysmenorrhea. The study involved 103 students aged 13 to 21 years with primary dysmenorrhea. The treatment group received 40 mg zinc sulfate daily for three menstrual cycles. Statistically significant improvements in mean pain scores were observed after two and three menstrual cycles in the treatment group as compared to placebo. 

A review by Alesi and colleagues explored the potential for vitamins, minerals, and other micronutrients to support health in the presence of polycystic ovarian syndrome (PCOS). PCOS is an endocrine disorder associated with ovarian dysfunction. Certain nutritional deficiencies or insufficiencies have been associated with PCOS, including calcium and vitamin D. A clinical trial involving a combination of calcium and vitamin D supplementation in individuals with both PCOS and vitamin D deficiency reported improvements in parameters related to inflammation, blood glucose metabolism, and antioxidative status.

Several randomized controlled trials involving almost 500 individuals with PCOS assessed the efficacy of a combination product that included calcium and vitamin D reported improvements in menstrual regularity, hirsutism, hormone balance, and other parameters related to metabolic health. However, due to the combination of agents assessed in the treatment group, the efficacy of one or more agents is unclear. More research is needed before clinical conclusions can be made. 

Selenium, magnesium, and chromium picolinate have also been studied for their potential to support menstrual comfort and ovarian health. In a randomized clinical trial involving 64 women with PCOS, magnesium supplementation for 10 weeks helped improve parameters related to quality of life, general health, physical functioning, emotional wellness, and energy/fatigue. A systematic review and meta-analysis involving over 400 individuals with PCOS reported improvements in blood glucose and lipid metabolism and antioxidative status in the presence of selenium supplementation.

While more clinical research is needed, evidence suggests that trace minerals such as zinc, calcium, and selenium, as well as vitamin D, may play a role in menstrual comfort and reproductive health. Zinc and selenium may also help promote antioxidative status. Dietary sources of zinc include meat, fish, seafood, and eggs. 

By Dr. C. Ambrose, ND, MAT