Assessment of Gonadal Hormones levels in Iron Deficient Females of Reproductive Age

Background Iron deficiency is a common malnutritional disorder with a wide variety of systemic clinical outcomes, including endocrine dysfunction. This study is a randomized descriptive study that, primarily, aimed to investigate that impacts of iron deficiency on the serum levels of gonadal hormones levels among females on reproductive age. To achieve so, a total of one hundred and twenty-three Female were included and were categorized by the menstrual phase based on obtained information form included subjects. Furthermore, based on their serum iron levels, subjects were subcategorized into iron sufficient (IS) and iron deficient (ID) females. Serum levels of iron, ferritin, Follicle-stimulating factor (FSH), Luteinizing hormone (LH), Progesterone, and estrogen were measured. Results No remarkable change in serum hormones levels during the follicular phase. During midcycle phase, ID subjects had significantly lower LH (17.49 ± 1.14 vs. 45.22 ± 6.31 IU/L, P < 0.001) and higher progesterone (11.2 ± 3.5 nmol/L vs. 1.95 ± 0.4 nmol/L, P < 0.05). Though it was statistically insignificant, the average serum estrogen among ID subjects was 128.4 ± 14.9 IU/L as compared to 202.4 ± 52.5 IU/L among IS females, P = 0.212. Serum LH and progesterone were significantly associated with serum iron levels (0.581, P < 0.005 and − 0.481, P < 0.05, respectively). Among ID females on luteal phase, significantly higher serum levels of estrogen (170.6 ± 9.5 pg/mL vs. 121.1 ± 13.1 pg/mL, P < 0.005) and progesterone (43.9 ± 3.3 nmol/L vs. 28.0 ± 4.1 nmol/L, P < 0.01). Furthermore, they were significantly associated with serum iron (-0.421, P < 0.05 and − 0.400, P < 0.05, respectively). Conclusion our data offers initial insights into the dysregulatory impacts of iron deficiency on the dynamic balance of gonadal hormones via the disruption of the hypothalamic-pituitary-gonadal-axis. Considering the positive feedback interaction, the main findings are the reduced levels of LH and estrogen below the optimal levels, during the luteal phase, in the context of iron deficiency. The reported impaired or delayed LH surge during the midcycle may reveal clinical impacts of iron deficiency on fertility and ability to conceive among females on reproductive age. Further investigation is required to validate our findings on a larger sample size and multiple time-points measurements throughout the menstrual phases of study subjects.