Selenium Supplementation and Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) occurs in 5 to 10% of women. It is the most common cause of infertility in women. PCOS is typically described by the presence of common symptoms: mild obesity, irregular periods or absence of a period, and signs of excessive androgen such hirsutism and acne. Most PCOS patients will have multiple cysts in the ovaries. More research into the effects of selenium supplementation on PCOS is needed.

Polycystic ovary syndrome (abbreviated PCOS) is a hormonal disorder with a prevalence of 5 – 10% in women of reproductive age.

The exact cause of PCOS is unknown.
Symptoms of PCOS include irregular periods, increased levels of male hormone, and failure of the ovaries to function regularly.
Excess insulin production and low-grade inflammation are thought to have an effect on the development of PCOS [Mayo Clinic].

Selenium: Effect on Mental Health, Hormonal Profile, Inflammation, and Oxidative Stress in Patients with PCOS

In a randomized controlled trial enrolling 60 women aged 18 – 40 years, daily co-administration of a probiotic supplement and 200 micrograms of selenium for 12 weeks was associated with the following outcomes [Jamilian 2018]:

significant improvement in Beck Depression Inventory scores, general health questionnaire scores, and depression anxiety and stress scale scores compared with the placebo
significantly reduced total testosterone levels, hirsutism, high-sensitivity C-reactive protein levels (a bio-marker for inflammation), and malondialdehyde levels (a bio-marker for oxidative stress) as well as significantly increased total antioxidant capacity and total glutathione (GSH) levels compared with the placebo

The researchers concluded that the co-administration of probiotics and selenium for 12 weeks to women with PCOS had beneficial health effects.

Selenium: Effect on Metabolic Profile in Patients with PCOS

In a randomized controlled trial enrolling 70 women aged 18 – 40 years, daily supplementation with 200 micrograms of selenium for 8 weeks was associated with the following outcomes compared with placebo [Jamilian 2015]:

significantly decreased serum insulin levels
significantly decreased HOMA-IR insulin resistance levels and HOMA-B beta-cell function levels
significantly increased quantitative insulin sensitivity check index levels
significantly reduced serum triglyceride levels

The researchers concluded that selenium supplementation had beneficial effects on insulin metabolism parameters [Jamilian 2015].

Selenium: Effect on Inflammation and Oxidative Stress in Patients with PCOS

In a randomized controlled trial enrolling 64 women aged 18 – 40 years, daily administration of 200 micrograms of selenium for 8 weeks was associated with the following outcomes [Razavi 2016]:

higher pregnancy rates in the selenium group than in the placebo group
significantly decreased serum high sensitivity C-reactive protein levels (a bio-marker for inflammation)
significantly decreased plasma malondialdehyde levels (a bio-marker for oxidative stress)

The researchers concluded that the selenium supplementation of PCOS patients for 8 weeks had beneficial effects on reproductive outcomes, inflammation, and oxidative stress.

Selenium: Effect on Gene Expression Related to Insulin in Patients with PCOS

In a randomized controlled trial enrolling 40 infertile women, daily administration of 200 micrograms of selenium for 8 weeks was associated with the following outcomes [Zadeh Modarres 2018]:

Selenium supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ = important for the regulation of fatty acid storage and glucose metabolism) and glucose transporter 1 (GLUT-1 = important for glucose uptake needed to maintain cellular respiration) in the lymphocytes of women with PCOS who were candidates for IVF.
Selenium supplementation downregulated gene expression of low-density lipoprotein receptor (LDLR = important for making low-density lipoprotein receptors) in the lymphocytes of women with PCOS who were candidates for IVF.

Conclusion: Selenium Supplementation and PCOS

More research is needed into the effects of selenium deficiency and selenium supplementation on inflammation and oxidative stress in patients with PCOS. The studies summarized above represent a start.

Sources

Jamilian, M., Mansury, S., Bahmani, F., Heidar, Z., Amirani, E., & Asemi, Z. (2018). The effects of probiotic and selenium co-supplementation on parameters of mental health, hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome. Journal of Ovarian Research, 11(1), 80.

Jamilian, M., Razavi, M., Fakhrie Kashan, Z., Ghandi, Y., Bagherian, T., & Asemi, Z. (2015). Metabolic response to selenium supplementation in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clinical Endocrinology, 82(6), 885–891.

Mayo Clinic. (2019). Polycystic ovary syndrome (PCOS). Patient Care and Health Information. Retrieved from https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439

Razavi, M., Jamilian, M., Kashan, Z. F., Heidar, Z., Mohseni, M., Ghandi, Y. and Asemi, Z. (2016). Selenium Supplementation and the Effects on Reproductive Outcomes, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome. Hormone and Metabolic Research, 48(3), 185–190.

Zadeh Modarres, S., Heidar, Z., Foroozanfard, F., Rahmati, Z., Aghadavod, E., & Asemi, Z. (2018). The Effects of Selenium Supplementation on Gene Expression Related to Insulin and Lipid in Infertile Polycystic Ovary Syndrome Women Candidate for In Vitro Fertilization: a Randomized, Double-Blind, Placebo-Controlled Trial. Biological Trace Element Research, 183(2), 218–225.

The information provided in this review article is not intended as medical advice and should not be used as such.

Milestones in early selenium research

1817 Swedish chemist Jöns Jakob Berzelius discovers selenium

1957 Biochemist Klaus Schwarz shows that selenium in microscopic amounts has a vital importance for mammalian health

1969 Professor J.T. Rotruck discovers that selenium has a biochemical role as a component of the antioxidant enzyme glutathione peroxidase

1969 Professors R.J. Shamberger and D.V. Frost report a possible protective effect of selenium against cancer in humans

1973 Professor J.T. Rotruck identifies the enzyme glutathione peroxidase as a selenium-dependent protein

1977 Professor G.N. Schrauzer publishes cancer mortality correlation studies showing an inverse correlation between dietary intakes of selenium and cancer mortality in 27 countries

1988 Professor G.Q Yang summarizes the lessons learned about the selenium-related endemic diseases Keshan disease and Kashin-Beck disease and about the importance of adequate daily selenium intakes

1989 Professor G.G. Duthie publishes evidence for a role of selenium in the prevention of cardiovascular disease

1993 Researcher W.J. Blot publishes the results of the Nutrition Intervention Trials in Linxian, China, showing that supplementation with a combination of selenium and other antioxidants reduces the risk of cancer

1994 Professor G.N. Schrauzer publishes evidence that selenium is important in the maintenance and therapy of HIV-infected patients

1996 Professor Larry Clark publishes the results of a randomized controlled trial – the Nutritional Prevention of Cancer study -- that shows selenium's cancer-protective effects on colon cancer, lung cancer, and prostate cancer

1997 Professor G.F. Combs summarizes the evidence for the protective effects of selenium against cancer

1999 Professor J.E. Oldfield publishes his Selenium World Atlas, mapping areas of selenium deficiency around the world

2000 Researcher O.A. Levander publishes evidence showing an anti-viral effect of selenium

2002 Researcher R. Gärtner shows that supplementation with selenium reduces inflammation in patients with autoimmune thyroiditis

2002 Researcher Margaret Rayman presents the arguments for increasing selenium intakes to realize selenium’s antioxidant and anti-viral and anti-inflammatory effects as well as selenium’s enhancement of immune function and reproductive success.