The effects of postmenopausal Vitamin D treatment on vaginal atrophy
Introduction
Menopause in women is associated with the occurrence of climacteric symptoms like hot flushes, night sweats, palpitations, bladder problems, accelerated bone loss and vaginal discomfort. Low estradiol levels may lead to a deficient maturation of vaginal mucosa, so-called ‘vaginal atrophy’, a condition that is clinically presented by dryness, irritation and itch [1]. To compensate for declining levels of endogenous estrogens, women can be treated by exogenous estrogens. Clinical studies have demonstrated that estrogens are effective in relieving postmenopausal vaginal discomfort; they induce proliferation of vaginal epithelium [2].
Vitamin D and analogs have been used in the prevention and treatment of postmenopausal osteoporosis [3]. However, it has been shown that Vitamin D is also involved in the regulation of growth and differentiation of many cells. Especially, tissues lining stratified squamous epithelium, as present in the vagina, are under control of Vitamin D [4]. We hypothesise that Vitamin D in addition to estrogens may be involved in the regulation of growth and differentiation of vaginal epithelium. This would imply that Vitamin D when used for the prevention of postmenopausal osteoporosis could help in relieving postmenopausal vaginal discomfort. As far as we know, data regarding the effects of Vitamin D treatment (VDT) on vaginal atrophy is lacking in the literature. So, we decided to study the effects of VDT on vaginal atrophy.
Section snippets
Material method
From our database of women, who have been followed in our physical medicine and rehabilitation’s outpatient clinic during 5 years, we identified women with an intact uterus who had been postmenopausal for at least 1 year but <3 years. We selected the study and control group according to the following criteria: women who had been treated with calcitriol 0.500 μg per day (Rocatrol, Roche, Sweden) uninterruptedly for at least 1 year or women that had taken neither hormone replacement nor
Results
The mean age of the women in the VDT group was 50.2±4.0 (S.D.) years, whilst the mean age in the group without VDT was 49.7±4.6 years, thus similar in both groups (P>0.05). All subjects were in their postmenopausal period for at least 1 year, and the women in the VDT group were taking VDT for at least 1 year. Time elapsed since menopause was 30.7±6.8 months in the VDT group while it was 26.5±7.3 months in the group without treatment, similar in both groups (P>0.05). Demographic and baseline
Discussion
It was really very surprising that Vitamin D supplementations resulted in squamous maturation of the vaginal epithelium in our study. Vaginal atrophy was assessed by physical examination including vaginal pH, symptom scores and VMI.
To our knowledge there are no reports in literature about Vitamin D effects on the vagina. So, we hypothesise that there are Vitamin D receptors in vagina, like in other squamous epithelium, and that they are involved in the regulation of growth and differentiation
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