Vitamin C and the Menstrual Cycle

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Vitamin C and the Menstrual Cycle

The menstrual cycle is a monthly process in which the lining of the uterus is shed, also known as “menstruation,” “the menstrual period,” or simply “the period.” During this time, blood and tissue from the uterine lining flow out of the body through the cervix and exit via the vagina.

On average, a menstrual period lasts around 2 to 7 days, and periods extending beyond 7 days are considered irregular. The flow can range from light to heavy, with heavy bleeding defined as needing to change a sanitary pad or tampon every 1 to 2 hours.

Menstrual flow can be influenced by factors such as stress, diet, and underlying medical conditions. A period is termed late if it is 7 days past the expected date, and if it does not occur within 6 weeks, it is categorised as a missed period. Irregularities in the menstrual cycle can be a sign of health issues or nutrient deficiencies that may require medical attention.

Vitamin C (also known as ascorbic acid) is an essential water-soluble vitamin and potent antioxidant found in fruits and vegetables. Vitamin C strengthens the immune system, protects cells against the negative effects of free radicals, and aids the growth and repair of tissues in the body such as blood vessels, cartilage, muscle and collagen. Vitamin C is not naturally produced or stored in the body, so a diet containing foods rich in vitamin C is important.

Blood serum levels of vitamin C can be affected by numerous factors, including diet, supplements, geography, body weight, pregnancy, genetic variants, smoking, cardiovascular disease and cancer.1

In fact, it has been found that smokers are three times more likely to be vitamin C deficient compared to non-smokers.2

Vitamin C deficiency (also known as scurvy) is relatively rare in developed countries, but still affects up to 1 in 20 people in the United Kingdom.3 On the contrary, in low income countries such as India, more than 1 in 10 people have a deficiency in vitamin C.4

Common signs of vitamin C deficiency can include:

  • Bruising
  • Gum and dental problems
  • Dry hair and skin
  • Anaemia
  • Slow-healing wounds

Research has found that obesity (and adiposity) is associated with lower levels of vitamin C compared to individuals of normal weight, even after supplementation at the same dose.5,6 Therefore, experts often recommend individuals with a higher BMI to take vitamin C supplements.7

Vitamin C and the Menstrual Cycle

Studies show that vitamin C levels are associated with the menstrual cycle.8 For example, increased vitamin C levels have been linked to increased oestrogen and progesterone levels throughout the menstrual cycle. Increased levels of vitamin C have also been associated with decreased concentrations of follicle-stimulating hormone (FSH). This suggests that higher levels of vitamin C may support the regulation of key hormones involved in reproduction and the menstrual cycle.

Research also shows that more vitamin C is excreted in the urine just before ovulation, suggesting an increased demand for vitamin C by the ovary to aid optimal ovulation and ovarian function.9,10 Such research highlights the role of vitamin C in ovulation, in addition to the regulation of hormones.

Overall these studies suggests that adequate vitamin C levels could play a supportive role in maintaining hormonal balance during the menstrual cycle, and potentially improve menstrual cycle regularity and reproductive health.

In fact, vitamin C supplementation has been found to improve fertility in women with specific reproductive conditions. For example, supplementation of vitamin C at 750mg per day significantly improved the pregnancy rate in women with luteal phase defects, and is sometimes recommended for these patients as it is low cost and has no side effects.11

When studied in animals, low vitamin C levels was found to reduce fertility, increased time to pregnancy and resulted in altered offspring characteristics.12 Such research highlights the importance of vitamin C both pre-and post-ovulation when trying to conceive.

Vitamin C effect on Menstruation

Vitamin C levels are significantly lower during menstruation. As such, there is currently no scientific evidence that taking vitamin C can delay a woman’s period. Instead a study found that taking vitamin C supplements (750mg per day) for three weeks significantly improved progesterone levels in 53% of women.11 As raised progesterone levels supports menstruation, this may explain why some women report vitamin C supplementation to cause their period to come early or end faster.

Likewise, there is evidence to suggest that vitamin C can also indirectly help reduce the severity of period cramps by recycling vitamin E, and can also aid iron absorption into the body from foods, which is important as a significant amount of red blood cells can be lost during menstruation.13,14,15 The effect of this appears to depend on baseline levels of vitamin C (i.e. adequate, suboptimal, deficient).

Adults aged 19 to 64 are recommended to have at least 40mg of vitamin C a day, which is usually obtainable from a healthy diet. The highest safe daily limit for vitamin C is around 2000mg per day, but large amounts of vitamin C (over 1000mg) can cause stomach pain, diarrhoea, flatulence or even be harmful.16,17

In short, although vitamin C supplementation may help with menstrual cycle regularity, it is recommended to always speak to a healthcare professional, especially if your period does not return to normal.

A Final Tip from Fertility SCIENCE

Vitamin C is crucial for overall health and can also influence the menstrual cycle. Adequate levels of vitamin C supports the regulation of key reproductive hormones such as oestrogen, progesterone, and follicle-stimulating hormone, which may contribute to maintaining hormonal balance and improving menstrual regularity.

Vitamin C also plays a role in ovulation and uterine function, with studies indicating that supplementation can enhance pregnancy rates in women with specific reproductive conditions, such as luteal phase defects.

However, the evidence is less clear in other cases of infertility. Vitamin C supplementation in the luteal phase during IVF treatment doesn’t significantly improve implantation or pregnancy rates.18 While vitamin C supplementation fails to decrease oxidative stress in women with endometriosis during IVF.19

Nevertheless, some women do benefit from taking vitamin C during infertility treatment according to Crha et al.20 However, larger studies are still required to better understand whom and when vitamin C supplements are helpful. In the meantime, please consult a healthcare professional you are experiencing irregularities in the menstrual cycle and your diet hasn’t changed.

fertilPEDIA

Treatment of Irregular Periods

Treatment of Irregular Periods

Treatment of irregular periods varies according to which WHO Group you fall into and the exact cause. Fortunately, almost all cases of irregular periods…. Read more

References

  1. Carr A C and Rowe S, (2020). Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400679 ↩︎
  2. Schleicher R L, et al. (2009). Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES). https://www.sciencedirect.com/science/article/pii/S0002916523266290 ↩︎
  3. Henderson L, et al. (2003). The National Diet and Nutrition Survey: adults aged 19 to 64 years. https://faunalytics.org/wp-content/uploads/2015/05/Citation291.pdf ↩︎
  4. Chiplonkar S A, et al. (2002). Are lifestyle factors good predictors of retinol and vitamin C deficiency in apparently healthy adults? https://www.nature.com/articles/1601291 ↩︎
  5. Dexter C, et al. (2005). Plasma ascorbic acid concentrations and fat distribution in 19 068 British men and women in the European Prospective Investigation into Cancer and Nutrition Norfolk cohort study. https://www.sciencedirect.com/science/article/pii/S0002916523297208 ↩︎
  6. Block G, et al. (1999). Body Weight and Prior Depletion Affect Plasma Ascorbate Levels Attained on Identical Vitamin C Intake: A Controlled-Diet Study. https://www.tandfonline.com/doi/abs/10.1080/07315724.1999.10718898 ↩︎
  7. Carr A C, et al. (2022). Estimation of Vitamin C Intake Requirements Based on Body Weight: Implications for Obesity. https://www.mdpi.com/2072-6643/14/7/1460 ↩︎
  8. Mumford S L, et al. (2016). Serum Antioxidants Are Associated with Serum Reproductive Hormones and Ovulation among Healthy Women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700980/ ↩︎
  9. Luck M R, et al. (1995). Ascorbic acid and fertility. https://academic.oup.com/biolreprod/article/52/2/262/2761466 ↩︎
  10. Loh H S and Wilson C W, (1971). RELATIONSHIP OF HUMAN ASCORBIC-ACID METABOLISM TO OVULATION. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(71)90843-9/fulltext ↩︎
  11. Henmi H, et al. (2003). Effects of ascorbic acid supplementation on serum progesterone levels in patients with a luteal phase defect. https://www.fertstert.org/article/S0015-0282(03)00657-5/fulltext ↩︎
  12. Coker S J, et al. (2023). Effects of Low Vitamin C Intake on Fertility Parameters and Pregnancy Outcomes in Guinea Pigs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10574174/ ↩︎
  13. Li N, et al. (2020). The Efficacy and Safety of Vitamin C for Iron Supplementation in Adult Patients With Iron Deficiency Anemia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7607440/ ↩︎
  14. Rao S V, et al. (2011). Oxidative stress and antioxidant status in primary dysmenorrhea. https://jcdr.net/article_abstract.asp?issn=0973-709x&year=2011&volume=5&issue=3&page=509&issn=0973-709x&id=1308 ↩︎
  15. Traber M G and Stevens J F, (2011). Vitamins C and E: Beneficial effects from a mechanistic perspective. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156342/ ↩︎
  16. Carr A C and Lykkesfeldtb J, (2020). Discrepancies in global vitamin C recommendations: a review of RDA criteria and underlying health perspectives. https://www.tandfonline.com/doi/full/10.1080/10408398.2020.1744513 ↩︎
  17. Jacob R A and Sotoudeh G, (2002). Vitamin C Function and Status in Chronic Disease. https://onlinelibrary.wiley.com/doi/full/10.1046/j.1523-5408.2002.00005.x ↩︎
  18. Griesinger G, et al. (2002). Ascorbic acid supplement during luteal phase in IVF. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455656/ ↩︎
  19. Lu X, et al. (2018). Effects of vitamin C on the outcome of in vitro fertilization-embryo transfer in endometriosis: A randomized controlled study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259375/ ↩︎
  20. Crha I, et al. (2003). Ascorbic acid and infertility treatment. https://pubmed.ncbi.nlm.nih.gov/12884545/ ↩︎

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