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Nutrients
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Nutritional Effects on Women’s Reproductive Health and Disease
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Nutritional Effects on Women’s Reproductive Health and Disease

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition in Women".

Deadline for manuscript submissions: closed (31 May 2025) | Viewed by 8417

Special Issue Editors

Prof. Dr. Fabio Parazzini

E-Mail Website
Guest Editor
Department of Clinical Science and Community Medicine, University of Milan, 20122 Milan, Italy
Interests: reproduction; gynecological disease; diet; epidemiology; risk factors
Special Issues, Collections and Topics in MDPI journals
Dr. Giovanna Esposito

E-Mail Website
Guest Editor
Department of Clinical Science and Community Medicine, University of Milan, 20122 Milan, Italy
Interests: reproduction; pregnancy outcomes; perinatal care; epidemiology; risk factors

Special Issue Information

Dear Colleagues,

Balanced nutrition is paramount for a number of health conditions affecting women throughout life, from puberty to menopause, and which can also be related to their reproductive well-being. For example, in polycystic ovary syndrome, reducing refined sugar intake with a low-carbohydrate diet can help improve insulin sensitivity and regulate the menstrual cycle. Similarly, in endometriosis, an anti-inflammatory diet rich in fruit, vegetables and omega-3 fatty acids can help reduce chronic inflammation and relieve symptoms.

Interest in the relationship between diet and fertility has also increased greatly over the past decade, but a full understanding of the role of diet on fertility and pregnancy outcomes is far from complete. Further, dietary factors have been also associated with the outcome of assisted reproductive technologies.

This Special Issue aims to delve deeper into the aspects that link diet with fertility and human reproduction from epidemiological, biological and clinical points of view. Both original data and specific meta-analyses or systematic reviews that may offer new insights into the study of this relationship will be considered.

Prof. Dr. Fabio Parazzini
Dr. Giovanna Esposito
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diet
  • dietary supplements
  • dietary patterns
  • macronutrients
  • micronutrients
  • infertility
  • pregnancy outcomes
  • endometriosis
  • polycystic ovary syndrome
  • reproductive health
  • assisted reproductive technology

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Published Papers (5 papers)

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Research

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17 pages, 679 KiB  
Article
Impact of Hypocaloric Dietary Intervention on Phenotypic Presentations of Polycystic Ovary Syndrome (PCOS)
by Faith E. Carter, Brittany Y. Jarrett, Alexis L. Oldfield, Heidi Vanden Brink, Joy Y. Kim and Marla E. Lujan
Nutrients 2025, 17(13), 2223; https://doi.org/10.3390/nu17132223 - 4 Jul 2025
Viewed by 291
Abstract
Background/Objective: Lifestyle intervention is recommended as first-line treatment for polycystic ovary syndrome (PCOS). This pilot study aimed to determine if a short-term hypocaloric dietary intervention induced changes in the phenotypic presentation of PCOS. Methods: Twenty women with PCOS and overweight/obesity participated in a [...] Read more.
Background/Objective: Lifestyle intervention is recommended as first-line treatment for polycystic ovary syndrome (PCOS). This pilot study aimed to determine if a short-term hypocaloric dietary intervention induced changes in the phenotypic presentation of PCOS. Methods: Twenty women with PCOS and overweight/obesity participated in a 3-month hypocaloric dietary intervention with a 6-month follow-up. At pre-intervention, post-intervention, and follow-up, assessments of menstrual cycle status, hyperandrogenism, and polycystic ovarian morphology were performed, and PCOS phenotype status was determined using the following scale of decreasing severity: Phenotype A (ovulatory dysfunction, hyperandrogenism, and polycystic ovaries), Phenotype B (ovulatory dysfunction and hyperandrogenism), Phenotype C (hyperandrogenism and polycystic ovaries), or Phenotype D (ovulatory dysfunction and polycystic ovaries). Results: The participants lost 8 ± 3% of their initial body weight with the intervention (p < 0.001). Eight (40%) participants experienced a favorable shift in PCOS phenotype, while the remaining 12 (60%) participants had an unfavorable shift or no change. Changes in PCOS phenotype were primarily driven by reductions in menstrual cycle length (p = 0.010) and follicle number per ovary (p = 0.017), albeit no baseline clinical variable predicted a favorable-change PCOS presentation. At the 6-month follow-up (N = 12), weight was increased (p < 0.05), and seven participants (58%) had reverted to a more severe phenotype. Conclusions: Weight loss may provide temporary improvement in the phenotypic presentation of PCOS, yet sustained lifestyle change may be required to maintain these benefits. Full article
(This article belongs to the Special Issue Nutritional Effects on Women’s Reproductive Health and Disease)
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18 pages, 1381 KiB  
Article
Vitamin D Status Determines the Effect of Cabergoline on Sexual Function and Depressive Symptoms in Hyperprolactinemic Women
by Robert Krysiak, Karolina Kowalcze, Johannes Ott, Andrea Deledda and Bogusław Okopień
Nutrients 2025, 17(11), 1813; https://doi.org/10.3390/nu17111813 - 27 May 2025
Viewed by 835
Abstract
Background/Objectives: Although untreated prolactin excess is often associated with female sexual dysfunction, sexual functioning improves after chronic administration of dopamine agonists, including cabergoline. Extra-sexual benefits of cabergoline therapy were found to be less pronounced in young hyperprolactinemic women in the case of [...] Read more.
Background/Objectives: Although untreated prolactin excess is often associated with female sexual dysfunction, sexual functioning improves after chronic administration of dopamine agonists, including cabergoline. Extra-sexual benefits of cabergoline therapy were found to be less pronounced in young hyperprolactinemic women in the case of coexistent hypovitaminosis D. Thus, the present study was aimed at investigating whether vitamin D status also determines cabergoline action on sexual function and depressive symptoms in reproductive-age women. Methods: This prospective cohort study included 75 young women with prolactin excess, who, depending on vitamin D status, were assigned to one of three groups. Females with vitamin D deficiency (group A), vitamin D-insufficient women (group B) and vitamin D-sufficient women (group C) were matched for age, body mass index, blood pressure and prolactin levels. For the following six months, they received cabergoline. Before and after cabergoline treatment, all participants completed questionnaires evaluating female sexual functioning (FSFI) and depressive symptoms (BMI-II). The remaining outcomes of interest included plasma levels of 25-hydroxyvitamin D, prolactin and sex hormones. Results: Before treatment, there were no differences between the study groups in sexual functioning and mood. The study groups differed in post-treatment levels of 25-hydroxyvitamin D, prolactin, testosterone and estradiol. Although cabergoline reduced the total FSFI score and improved functioning in all domains of the FSFI questionnaire, this effect was strongest in group C and weakest in group A. Statistically significant changes in the BDI-II score were observed only in group C. The increase in the total FSFI score and domain scores correlated with the decrease in prolactin levels, 25-hydroxyvitamin D levels, the increase in testosterone and estradiol concentrations, and the reduction in the BDI-II score. Conclusions: Low vitamin D status attenuates the beneficial effects of cabergoline on sexual function and depressive symptoms in reproductive-age women. Full article
(This article belongs to the Special Issue Nutritional Effects on Women’s Reproductive Health and Disease)
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15 pages, 321 KiB  
Communication
The Camden Study—A Pregnancy Cohort Study of Pregnancy Complications and Birth Outcomes in Camden, New Jersey, USA
by Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C. Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez and Emily S. Barrett
Nutrients 2024, 16(24), 4372; https://doi.org/10.3390/nu16244372 - 19 Dec 2024
Viewed by 1551
Abstract
Background: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and [...] Read more.
Background: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women. Methods: From 1985–2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White participants; 98% using Medicaid in pregnancy). Study visits, including questionnaires, dietary assessments, and biospecimen collection, occurred in early and late pregnancy as well as at delivery. Medical records were abstracted, and a subset of mothers and infants participated in a six-week postpartum visit. Results: Findings from the Camden Study have added to the understanding of adolescent and young adult maternal health and perinatal outcomes. These include associations of adolescent linear growth while pregnant with smaller neonatal birth size, low dietary zinc intake in early pregnancy with increased risk of delivery <33 gestational weeks, and higher circulating fatty acid levels with greater insulin resistance. More recent analyses have begun to unpack the biochemical pathways in pregnancy that may be shaped by race as an indicator of systemic racism. Conclusions: The Camden Study data and biorepositories are well-positioned to support future research aimed at better understanding perinatal health in under-represented women and infants. Linkages to subsequent health and administrative records and the potential for recontacting participants over 18–39 years after initial participation may provide key insights into the trajectories of maternal and child health across the life course. Full article
(This article belongs to the Special Issue Nutritional Effects on Women’s Reproductive Health and Disease)

Review

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16 pages, 600 KiB  
Review
Reproductive Health and Assisted Conception in Celiac Disease and Non-Celiac Gluten Sensitivity: A Narrative Review
by Efthalia Moustakli, Panagiotis Christopoulos, Anastasios Potiris, Athanasios Zikopoulos, Eirini Drakaki, Theodoros Karampitsakos, Ismini Anagnostaki, Nikolaos Kathopoulis, Periklis Katopodis, Apostolia Galani, Chrysi Christodoulaki, Athanasios Zachariou, Peter Drakakis and Sofoklis Stavros
Nutrients 2025, 17(13), 2215; https://doi.org/10.3390/nu17132215 - 3 Jul 2025
Viewed by 401
Abstract
The increasing use of assisted reproductive technologies (ARTs) globally, such as intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF), has highlighted the pressing need to determine the modifiable factors affecting the success of implantation and the outcomes of early pregnancy. Scientific interest [...] Read more.
The increasing use of assisted reproductive technologies (ARTs) globally, such as intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF), has highlighted the pressing need to determine the modifiable factors affecting the success of implantation and the outcomes of early pregnancy. Scientific interest in the role of nutrition in fertility is growing, but outside of celiac disease, little is known about gluten, a dietary protein with immunogenic and inflammatory properties. With an emphasis on ART results, this narrative review summarizes the most recent data regarding the possible effects of gluten consumption on reproductive health, focusing primarily on individuals with celiac disease (CD) and non-celiac gluten sensitivity (NCGS). In addition to discussing potential molecular processes connecting gluten-induced inflammation, increased gut permeability, autoimmune, and decreased endometrial receptivity, we further explore the documented link between CD and infertility and investigate new information on NCGS. These findings are tentative and based on scant low-quality evidence, although some case reports and small clinical studies have indicated that avoiding gluten may help some people undergoing ART, especially those with immune-mediated diseases or infertility that cannot be explained. There is currently no robust prospective evidence confirming that gluten restriction improves infertility outcomes. Therefore, before gluten elimination is advised in this situation, more carefully planned extensive research is required to generate reliable scientific proof. Beyond traditional celiac disease, we suggest that gluten sensitivity might be an underappreciated factor in ART failure that merits more research. A gluten-free diet may serve as a low-risk supplementary option for appropriately selected patients, pending the results of more extensive controlled studies. Full article
(This article belongs to the Special Issue Nutritional Effects on Women’s Reproductive Health and Disease)
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Other

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16 pages, 2884 KiB  
Systematic Review
Efficacy of Zinc Supplementation in the Management of Primary Dysmenorrhea: A Systematic Review and Meta-Analysis
by Ting-Jui Hsu, Rong-Hong Hsieh, Chin-Huan Huang, Chih-Shou Chen, Wei-Yu Lin, Yun-Ching Huang, Jian-Hui Lin, Kuo-Tsai Huang, Yu-Liang Liu, Hui-Ming Tsai and Dong-Ru Ho
Nutrients 2024, 16(23), 4116; https://doi.org/10.3390/nu16234116 - 28 Nov 2024
Cited by 2 | Viewed by 4717
Abstract
Background/Objectives: Primary dysmenorrhea (PD) is a common condition affecting up to 90% of menstruating women, which often results in significant pain without an underlying pathology. Zinc, recognized for its anti-inflammatory and antioxidant effects through inhibiting prostaglandin production and superoxide dismutase 1 (SOD1) upregulation, [...] Read more.
Background/Objectives: Primary dysmenorrhea (PD) is a common condition affecting up to 90% of menstruating women, which often results in significant pain without an underlying pathology. Zinc, recognized for its anti-inflammatory and antioxidant effects through inhibiting prostaglandin production and superoxide dismutase 1 (SOD1) upregulation, alleviates menstrual pain by preventing uterine spasms and enhancing microcirculation in the endometrium, suggesting its potential as an alternative treatment for primary dysmenorrhea. The goal of this systematic review and meta-analysis was to assess the efficacy and safety of zinc supplementation in reducing pain severity among women with PD and to explore the influence of dosage and treatment duration. Methods: Following the PRISMA 2020 guidelines, we conducted an extensive search across databases such as PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar, up to May 2024. Randomized controlled trials assessing the effects of zinc supplementation on pain severity in women with PD were included. Pain severity was evaluated with established tools, such as the Visual Analog Scale (VAS). Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. Two reviewers independently performed the data extraction, and a random-effects model was used for meta-analysis. Meta-regressions were conducted to examine the influence of zinc dosage and treatment duration on pain reduction. Adverse events were also analyzed. Results: Six RCTs involving 739 participants met the inclusion criteria. Zinc supplementation significantly reduced pain severity compared to placebo (Hedges’s g = −1.541; 95% CI: −2.268 to −0.814; p < 0.001), representing a clinically meaningful reduction in pain. Meta-regression indicated that longer treatment durations (≥8 weeks) were associated with greater pain reduction (p = 0.003). While higher zinc doses provided additional pain relief, the incremental benefit per additional milligram was modest (regression coefficient = −0.02 per mg; p = 0.005). Adverse event rates did not differ significantly between the zinc and placebo groups (odds ratio = 2.54; 95% CI: 0.78 to 8.26; p = 0.122), suggesting good tolerability. Conclusions: Zinc supplementation is an effective and well-tolerated option for reducing pain severity in women with primary dysmenorrhea. Doses as low as 7 mg/day of elemental zinc are sufficient to achieve significant pain relief, with longer durations (≥8 weeks) enhancing efficacy. The favorable safety profile and ease of use support the consideration of zinc supplementation as a practical approach to managing primary dysmenorrhea. Full article
(This article belongs to the Special Issue Nutritional Effects on Women’s Reproductive Health and Disease)
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