Topic of the Month

Micronutrients and women’s sexual health

February 1, 2013

Sexual health is an essential factor in the quality of a woman’s life. But, depending on a woman’s phase in life, different aspects of sexual health will be more important to her: While women under the age of 20 in industrialized countries are particularly interested in reliable contraception, women between the ages of 20 and 45 shift their focus to reproductive health and maternity issues – i.e., pregnancy, birth and breastfeeding. Fertility slowly diminishes with age. Usually, changes to the female cycle are the first signs of the climacterium – i.e. the phase of hormonal adjustment that ends with menopause. This is fol-lowed by the postmenopausal phase. The normal processes of aging bring changes that can influence sexual health. In every one of these life phases, a balanced, micronutrient-rich diet plays an important role in maintaining sexual health.

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In addition to these natural changes, a woman’s general physical and mental health can affect her sexual health. Hence chronic illness may give rise to sexual dysfunction. Studies into the maintenance of sexual health and the treatment of sexual function disorders – especially during the reproductive and postmenopau-sal phases – have been pursued with great interest in recent years. Often there is an imbalance in the sensitive metabolism of the sexual organs. Well-documented, evidence-based and potentially successful treatment options are limited. For this reason, prevention is of overriding importance with regard to a woman’s sexual health and well-being, and this is where micronutrients play a key role.

Reproductive health

Reproductive health is a condition of perfect physical and mental well-being in all matters relating to the reproductive system, and its functions and processes (1). Reproductive health therefore implies that women (and men) have a satisfying and safe sex life and that they have the capacity to reproduce and the freedom to decide if, when and how often to do so. The central organs of female reproduction include the primary (congenital) sexual characteristics, i.e. sex organs like the ovaries (or the gonads that produce the ova, or eggs, and the primary female sex hormones estrogen and progesterone), the womb (or the uterus – where a baby develops until birth) and the vagina (or the fertilization and birth canal). The secondary physical sexual characteristics, which develop later, include breasts (for the production of milk after pregnancy) and menstruation (the periodically occurring bleeding to allow renewal of the lining of the womb).

Micronutrients can prevent complaints and functional disorders in several areas of the sexual female system. Globally, 90 percent of women of reproductive age regularly suffer from premenstrual syndrome (PMS) (2). Typical symptoms include mood swings and irritability as well as headache, tiredness, sleep disturbances, nausea, edema formation and sensitive breasts. It has long been known that a combination of B vitamins can alleviate or even effectively prevent premenstrual complaints. This has repeatedly been confirmed by recent studies (3). Besides this, it has been established that women who suffer from PMS demonstrate significantly increased oxidative stress, which is viewed as a possible cause of the symptoms of PMS. The negative effects of oxidative stress can in part be prevented by administration of antioxidants (4). More recent studies were able to show an improvement in emotional and physical PMS symptoms after calcium administration (5). The occurrence of PMS is being debated as a possible indicator for the later development of osteoporosis due to calcium deficiency.

During menstruation many women suffer from painful cramps. If these cramps have no pathological cause, such as myomas or endometriosis, vitamin D may be administered as a potentially preventive measure. A randomized controlled study has shown that this treatment may lead to an up to 40% reduction in the need for pain-killers (6).

Oxidative stress, which is exacerbated by an imbalanced diet, among other things, can have a negative influence on the function of the cells and tissues of the body. Increased oxidative stress also appears to be associated with reduced female fertility. Thus the success rate of “artificial” fertilization (in-vitro fertilization or IVF) could be raised by targeted administration of antioxidants (7). Moreover, a more recent study indicated that administration of vitamin D to redress sub-optimal status could increase the success of IVF (8).

Premature birth is a risk that concerns many women during pregnancy. According to one recent study, this risk can be noticeably reduced if women start to take a multivitamin preparation regularly in the periconcep-tional period, i.e., around the time of conception (9). This also could also reduce the risk of having a baby with low birth weight. 

Hormonal contraception and health

Pregnancy and family planning is a central issue in all societies. As a rule, an unplanned or even unwanted pregnancy leads to a situation of conflict. Hormone contraceptives offer the most reliable method of preven-ting pregnancy – and have so far only been successfully used among women. When “the Pill” made its triumphant entrance more than 50 years ago, it was looked on as revolutionary and promised liberation for women’s sex life. However, taking hormones to suppress natural ovulation can be associated with risks and side effects. Using the Pill appears to noticeably increase the burden of oxidative stress on the female organism. In some studies this burden was counteracted by food supplements containing antioxidants (10). Furthermore, it was shown that women who took the Pill exhibited lower blood levels of the antioxidant micronutrients beta-carotene and vitamin E, as well as vitamin B12 (11). This was redressed by targeted administration of these micronutrients.

Health during climacterium and postmenopause 

With the onset of the climacterium, physiological production of estrogen, the primary female hormone, gradually decreases. The falling estrogen levels in the female organism increase the risk of cardiovascular disease and osteoporosis. Replacing the estrogen has a preventive effect, but appears to increase the risk of breast cancer.

Numerous studies have shown that the vitamin D status is particularly poor in postmenopausal women (12). Regular, targeted intake of vitamin D may therefore reduce the risk of osteoporosis (13) and fractures caused by falls due to muscular weakness (14). Further, successful treatment of osteoporosis with vitamin D plus calcium has been described for postmenopausal women (15).

Other investigations indicate that adequate blood levels of vitamin D in older women could be associated with a reduced risk of cardiovascular disease (16) and breast cancer (17). Current research indicates that there is a connection between the metabolism of vitamin D and prostaglandin (a physiological hormone-like substance involved in inflammatory processes, among other things), and that this could influence the inci-dence of both breast and ovarian cancer (18). Ovarian cancer is rare in women younger than 40. Moreover, more recent studies have indicated that a good supply of folate (19) and increased intake of omega-3 fatty acids (20) could reduce the risk of breast cancer.

 

References

  1. WHO-Report Defining Sexual Health, 2002 (http://www.who.int/reproductivehealth/publications/sexual_health/defining_sexual_health.pdf)
  2. Zaka M. et al. Pre-Menstrual Syndrome – a review  J. Pharm. Sci. & Res. 2012; 4(1): 1684-1691.
  3. Chocano-Bedoya P. O. et al. Dietary B vitamin intake and incident premenstrual syndrome. Am J Clin Nutr. 2011; 93(5):1080-1086.
  4. Duvan C. I. et al. Oxidant/antioxidant status in premenstrual syndrome. Arch Gynecol Obstet. 2011;
    283(2):299-304.
  5. Bendich A. Micronutrients in women's health and immune function. Nutrition. 2001; 17(10):858-67.
  6. Lasco A. et al. Improvement of primary dysmenorrhea caused by a single oral dose of vitamin D: results of a randomized, double-blind, placebo-controlled study. Arch Intern Med. 2012; 172(4):366-367.
  7. Agarwal A. et al. The effects of oxidative stress on female reproduction: a review. Reprod Biol Endocrinol. 2012; 10(1):49.
  8. Ozkan S. et al. Replete vitamin D stores predict reproductive success following in vitro fertilization.
    Fertil Steril. 2010; 94(4):1314-1319.
  9. Catov J. M. et al.  Periconceptional multivitamin use and risk of preterm or small-for-gestational-age births in the Danish National Birth Cohort. Am J Clin Nutr. 2011; 94(3):906-912.
  10. Pincemail J. et al. Effect of different contraceptive methods on the oxidative stress status in women aged 40 48 years from the ELAN study in the province of Liege, Belgium. Hum Reprod. 2007; 22(8):2335-2343.
  11. Hronek M. and Poljaková G. Effect of hormonal contraception on levels of vitamins in the body. 2004;
    69(5):397-401.
  12. American Society for Bone and Mineral Research ASBMR. http://www.asbmr.org
  13. Bischoff-Ferrari H. A. Which vitamin D oral supplement is best for postmenopausal women? Current Osteoporosis Reports. Published online September 2012.
  14. Bischoff-Ferrari H. A. Vitamin D and fracture prevention. Rheum Dis Clin North Am. 2012; 38(1):
    107-113.
  15. Reymondier A. et al. MENOPOST - Calcium and vitamin D supplementation in postmenopausal osteoporosis treatment: a descriptive cohort study. Osteoporos Int. Published online May 2012.
  16. Schierbeck L. L. et al. Vitamin D deficiency in postmenopausal, healthy women predicts increased cardiovascular events: a 16-year follow-up study. Eur J Endocrinol. 2012; 167(4):553-560.
  17. Fedirko V. et al. Serum 25-hydroxyvitamin D and risk of breast cancer: results of a large population-based case-control study in Mexican women. Cancer Causes Control. 2012; 23(7):1149-1162.
  18. Cordes T. et al.  Correlation of prostaglandin metabolizing enzymes and serum PGE2 levels with
    vitamin D receptor and serum 25(OH)2D3 levels in breast and ovarian cancer. Anticancer Res. 2012;
    32(1):351-357.
  19. Tavani A. et al. Dietary folates and cancer risk in a network of case-control studies. Ann Oncol. 2012;
    23(10):2737-2742.
  20. Brasky T. M. et al. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) Cohort. Cancer Epidemiol Biomarkers Prev. 2010; 19(7):1696-1708.