Early menopause and infertility can be caused by a deficiency of vitamin D, vitamin E, and selenium

When a woman’s ovaries fail to function normally and menopause occurs before the age of 40, the condition is referred to as premature ovarian insufficiency (POI). The accompanying hormonal imbalances cause symptoms such as menstrual irregularities and infertility. Mood swings, fragile mucous membranes, osteoporosis, and other complications may also occur. According to a review article published in Health Science Reports, widespread deficiencies in vitamin D, vitamin E, and selenium appear to increase the risk of premature ovarian insufficiency, whereas supplementation with these nutrients may improve ovarian function and hormonal balance.

Premature ovarian insufficiency (POI) is defined as a failure of normal ovarian function before the age of 40. The condition is characterized by menstrual irregularities, such as infrequent periods with intervals longer than three months (oligomenorrhea) or a complete cessation of menstruation (amenorrhea). A range of hormonal imbalances is also observed, including elevated levels of follicle-stimulating hormone (FSH) and decreased anti-Müllerian hormone (AMH), which is an indicator of the remaining egg reserve in the ovaries. Estrogen deficiency caused by POI can negatively affect the cardiovascular system, bones, mucous membranes, cognitive functions, and mood. Additionally, the risk of accelerated aging, certain cancers, and early death is increased. It is also believed that an underlying progesterone deficiency may play an even greater role than estrogen deficiency.
POI affects approximately one percent of women worldwide and can occur spontaneously or as a result of medical treatments. Recent studies have highlighted that oxidative stress may play a key role in the development of POI. Oxidative stress arises when harmful free radicals exceed the protective capacity of antioxidants. While free radicals are naturally produced during metabolic processes, oxidative stress occurs when they become uncontrolled and can attack ovarian follicles -the small sacs that contain and mature an egg. Research suggests that ovaries and follicles can be protected by various antioxidants, which counteract damage caused by free radicals and oxidative stress.
The researchers behind the review article analyzed a number of studies from Web of Science, PubMed, Scopus, and other databases. These studies included a total of 521 women under 40 years of age, either diagnosed with POI or serving as control groups. Overall, all studies showed a correlation between blood levels of vitamin D, vitamin E, and selenium and several markers of ovarian function. Based on this, the researchers concluded that deficiencies in these nutrients increase the risk of developing POI. Conversely, supplementation with vitamin D, vitamin E, and selenium may raise AMH levels and reduce FSH levels, indicating a higher number of healthy eggs in the ovaries and improved hormonal balance. The researchers say that this knowledge and relevant supplementation could have significant potential in the prevention and treatment of POI.
The authors also elaborate on the roles of vitamin D, vitamin E, and selenium in female fertility and the prevention of oxidative stress, as outlined below.

The role of vitamin D in female fertility

Active vitamin D functions as a steroid hormone and regulates many of our genes through different on-off switches. Most of the body’s cells and organs have vitamin D receptors, including the pituitary gland, ovaries, and endometrium, all of which are important for female fertility. Vitamin D also regulates granulosa cells - the hormone-producing cells surrounding an immature egg in the ovary. Additionally, vitamin D plays a role in the regulation of other steroid hormones (estrogen, testosterone, cortisol, and progesterone) and in controlling chronic inflammation, which increases the risk of oxidative stress.
A lack of sunlight during summer, heavy use of sunscreen, dark skin, overweight, and insufficient vitamin D supplementation during the winter months or year-round are major causes of widespread vitamin D deficiency.

The role of vitamin E in female fertility

Vitamin E serves as the primary antioxidant, protecting ovaries and follicles from damage caused by free radicals and oxidative stress. While several mechanisms of vitamin E are still not fully understood, its ability to protect cell membranes, DNA, and other cellular components is crucial. Vitamin E is also important for optimal selenium function, as the two nutrients work in close collaboration.
Good dietary sources of vitamin E include olive oil, avocado, nuts, seeds, eggs, and full-fat dairy products. However, low-fat diets and poor fat absorption increase the risk of vitamin E deficiency.

The role of selenium in female fertility

Selenium is a component of 25–30 selenium-dependent proteins, several of which function as potent antioxidants. Selenium has been seen to accumulate in healthy follicles during maturation, while it is absent in small or degenerated follicles. Studies have shown that blood selenium levels are lower in women with POI compared to fertile women. Selenium deficiency also appears to increase the risk of elevated FSH, which is a hallmark of POI.
In Europe, selenium-deficient soil is the primary cause of selenium deficiency, as it affects the entire food chain.

References:

Faridh Pargar et al. Association of Deficiency in Vitamin D, Vitamin E, and selenium Levelt With Premature Ovarian Insufficiency: A Systematic Review. Health Science Reports. 2025

Anette og Jens-Ole Paulin. Naturlig Hormonterapi – opgør med østrogenmyten. Vingholm 2019