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How Do Minerals Affect the Menstrual Cycle?

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Scientists from Johannes Kepler University Linz have revealed how minerals play a role in the complexity of female fertility and the menstrual cycle. Published in Nutrients, the review looks at several minerals and how they impact hormonal regulation, ovarian function and ovulation, endometrial health and oxidative stress.


Iron is crucial for the menstrual cycle, with deficiencies leading to hormonal imbalances and anemia, affecting ovulation regularity and blood flow to the ovaries.

Both deficiency and excess iron can impact fertility. Studies have linked low ferritin levels to unexplained infertility, due to disturbances in the menstrual cycle, and elevated ferritin levels to endometriosis, a chronic condition characterized by the presence of endometrial-like tissue outside the uterus.

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Zinc plays a direct role in influencing sex hormone balance through testosterone synthesis and insulin metabolism. The mineral also affects follicle maturation, libido and estrogen receptor function.

Zinc deficiency can lead to menstrual irregularities, reduced fertility and may contribute to conditions like PCOS and endometriosis.


Lead and corresponding authors Celine Kapper and Dr. Marlene Rezk-Füreder, from Johannes Kepler University Linz, told Technology Networks, “Zinc supplementation has been found to enhance insulin sensitivity, which can help alleviate some PCOS symptoms. Therefore, maintaining balanced levels of these minerals could be crucial for improving reproductive health and fertility in women with PCOS.”

Zinc also regulates endometrial cell proliferation, potentially influencing conditions like endometrial cysts.


Iodine plays an important role in thyroid function and hormone balance, both of which can lead to disruptions in the menstrual cycle if homeostasis is disturbed.

Iodine deficiency is linked to hypothyroidism, disrupting ovulation, and affecting female fertility. Thyroid dysfunction also affects sex hormone-binding globulin levels, altering testosterone and estrogen concentrations. Excessive iodine intake can be toxic and adversely affect pregnancy outcomes, highlighting the need for careful iodine management throughout the reproductive cycle.


Magnesium is a cofactor in over 600 enzymatic reactions, playing a pivotal role in DNA repair and antioxidant function. The mineral supports healthy ovulation and endometrial function throughout the menstrual cycle by mitigating oxidative stress. Its ability to relax smooth muscles may influence the regularity of uterine contractions, potentially affecting menstrual flow and reducing the risk of conditions like endometriosis.


“Both a deficiency and an excess of magnesium can disrupt metabolic balance and negatively affect reproductive health,” said Kapper. Hypomagnesemia can increase oxidative stress and impair reproductive function.


Magnesium's involvement in estrogenic metabolic pathways and glucose regulation also underscores its significance in managing menstrual irregularities, particularly in conditions like PCOS.


Magnesium is vital for insulin metabolism, essential in PCOS management where insulin resistance is a significant concern,” added Kapper.


Selenium protects reproductive tissues from oxidative damage, promoting stable ovulation and preserving ovarian function. Optimal selenium levels are linked to enhanced fertility outcomes by mitigating oxidative stress and supporting the hormonal equilibrium required for ovulation.


Imbalances in selenium levels can disrupt menstrual and ovulatory patterns, highlighting its importance throughout the menstrual cycle, from the follicular phase to menstruation.


Calcium's influence on the menstrual cycle extends from hormonal regulation to reproductive tissue function. It contributes to the secretion of gonadotropin-releasing hormone (GnRH), a pivotal hormone controlling ovulation and the menstrual cycle, as well as other intracellular signaling pathways crucial for follicular development, oocyte maturation and the release of the oocyte during ovulation.


Imbalances in calcium levels can compromise fertility and pregnancy success. During pregnancy, calcium is vital for endometrial tissue health, embryo implantation and gene expression crucial for successful pregnancy initiation.


Copper is a cofactor for superoxide dismutase (Cu,Zn-SOD), which helps protect oocytes from oxidative stress. It also supports endothelial function, essential for optimal blood flow to the uterus and ovaries.


Excessive copper levels can lead to oxidative stress and balancing its intake is crucial for leveraging its antioxidative benefits while mitigating potential adverse effects.


Manganese is also a vital antioxidant in female reproductive health, primarily by acting as a cofactor for manganese superoxide dismutase (Mn-SOD). This enzyme safeguards cellular structures against oxidative stress, which can have detrimental effects on oocyte quality, hormonal balance, and the reproductive cycle.


Similarly to copper, excessive manganese levels can lead to pro-oxidative states, potentially resulting in the degradation of oocyte quality and disturbances in ovarian function.

Guiding dietary recommendations

“The research landscape for minerals in female fertility is less developed compared to male fertility, with numerous studies focusing on men. During our research, we found no comprehensive reviews specifically addressing the impact of minerals on female fertility,” said Rezk-Füreder.

“Our research provides a comprehensive overview of how maintaining optimal levels of various minerals can significantly influence women's reproductive health and fertility,” added Rezk-Füreder. “It offers evidence-based guidelines for improving dietary and clinical interventions aimed at enhancing female reproductive well-being.”

Reference: Kapper C, Oppelt P, Ganhör C, et al. Minerals and the menstrual cycle: impacts on ovulation and endometrial health. Nutrients. 2024;16(7):1008. doi: 10.3390/nu16071008

Celine Kapper and Dr. Marlene Rezk-Füreder were speaking to Rhianna-lily Smith, Editorial Assistant for Technology Networks.

About the interviewees:

Celine Kapper is a laboratory assistant in the Department of Gynecology, Obstetrics, and Gynecological Endocrinology at Johannes Kepler University Linz.


Dr. Marlene Rezk-Füreder is the co-founder of Diamens, a biotechnology research company that targets healthcare innovations and solutions for Endometriosis. Rezk-Füreder completed her PhD in the Department of Gynecology, Obstetrics, and Gynecological Endocrinology at Johannes Kepler University Linz.