Vitamin D and Genitourinary Disorders in Menopausal Women
Vitamin D and Genitourinary Disorders in Menopausal Women
Vitamin D is, as I prattle on about incessantly, the cure for pretty much everything. Or at the very least it is required to be at optimal levels in the body before just about anything can be cured, along with whatever additional treatments are necessary. This is why, as discussed in the “Megadosing Vitamin D” newsletters, one U.S. Intensive Care Unit injects patients with 500,000 IU of vitamin D when they first show up with life-threatening conditions: because these doctors know that all healing will require firstly that we have sufficient stores of vitamin D. So, it should come as no surprise that vitamin D is showing potential in playing a role in treating various genitourinary disorders in postmenopausal women.
A variety of studies have found supplementing patients with vitamin D has had a positive effect on a collection of symptoms referred to as genitourinary syndrome of menopause (GSM).
This makes a lot of sense because many of the changes that occur during menopause make a woman susceptible to vitamin D deficiency, due to a variety of factors. “These factors include changes in body composition, advancing age, racial disparities, limited exposure to sunlight, inadequate dietary intake of vitamin D, and increased adiposity.” Of course I have been suggesting a triad of nutrients to help rebuild the mucous membranes in the body for decades, as per my blog How 3 Nutrients Can Heal Most Ailments, so I’m not surprised that even vitamin D on its own can do much to repair the lining of the urogenital organs.
This appears to be due to the fact that vitamin D receptors (VDRs) are present in the surface layers of the mucous membranes lining these organ systems. VDRs are dependent on estrogen and are sensitive to changes in vitamin D levels, and these VDRs “are involved in regulating the development, differentiation, and protection of the epithelium of the urinary tract and the vagina”.
Menopausal Symptoms
The advent of menopause brings on “many physiological and cellular changes in the external genitalia and urogenital tissues, including the vaginal epithelium, pelvic floor muscles, and urinary tract”.
With the decline in hormones that occurs at this point in a woman’s life comes a loss of the collagen found in the connective tissues of the bladder, urethra and vagina, syptoms of which manifest as increased frequency and urgency of urination, and dysuria (“the sensation of pain and/or burning, stinging, or itching of the urethra associated with urination”). Another result of this loss of collagen and thinning of the mucosal lining is a condition known as dyspareunia, “defined as persistent or recurrent genital pain that occurs just before, during or after sex”.
As well, changes can occur in the vaginal flora, including a reduction in (good) lactobacillus bacteria, which leads to a rise in vaginal pH. Symptoms that follow include irritation, itching and vaginal dryness, and even worse since once the woman’s bacterial defenses are down there is potential for an overgrowth of bad bacteria. This can result in urinary tract and/or vaginal infections. Unfortunately, due to the intimate nature of many of these symptoms, women will often not report them to their medical professional due to embarrassment. So, while international surveys indicate that these symptoms are highly prevalent, many women nonetheless suffer in silence.
Fortunately, there is now a body of research supporting the idea that these potentially devastating symptoms of GSM can be relieved by supplementing with vitamin D.
Vitamin D and Estrogen
The aforementioned vitamin D receptors “play a role in regulating the development, differentiation, and protection of the urinary tract and vaginal epithelium, with vitamin D promoting barrier integrity, upregulating genes encoding epithelial cell junction proteins, and stimulating vaginal epithelium proliferation”.
By now most women are aware that the urogenital tissues rely on estrogen to maintain functionality, and thus many of the symptoms described above have been simply linked to the decline in estrogen that accompanies menopause.
Certainly estrogen as a vasoactive hormone promotes blood flow to the urogenital areas, required for maintaining vaginal lubrication. Estrogen receptors also stimulate new cell growth in the lining of the vulvovaginal tissues, working to maintain the mucous membrane. And the reduction in estrogen levels contributes to not only a decline in collagen but also in elastin and hyaluronic acid (a tissue lubricant) in the urogenital tissues.
Well, interestingly, it appears that oral estogen therapy increases the synthesis of vitamin D in the kidneys of postmenopausal women, and “increases the free and total calcitriol as well as vitamin D binding protein (DBP)”.
Thus, there is clearly a relationship between vitamin D and estrogen. And, given the dangers of taking estrogen hormone replacement therapy, it may be wise to approach these health issues we are discussing with the use of vitamin D rather than turning immediately to a prescription for estrogen.
(As a side note, using natural progesterone cream is a safer and more effective way to get the body to increase estrogen production. As is a product like our AdrenalStart which can raise DHEA levels, allowing the body to produce a safe amount of estrogen. Many female customers have told us that AdrenalStart has been phenomenal in dealing with menopausal symptoms.)
OAB and UTIs
The prevalence of urinary tract infections (UTIs) in postmenopausal women is in part due to the thinning of the protective mucous membranes that we have discussed, but as well there is a relationship between estrogen and friendly flora in the vagina.
“Previous work has shown that the vaginal microbiome decreases in Lactobacillus predominance and becomes more diverse following menopause. It has also been shown that estrogen therapy restores Lactobacillus-dominance in the vagina, and that topical estrogen is associated with OAB (overactive bladder) symptom improvement.” (Source)
Estrogen deficiency also contributes to UTIs in postmenopausal women, however the solution for that and the above mentioned OAB is the use of a vaginal estogen cream. Which as discussed, comes with inherent dangers. But, since “pathogens from the gut can travel into the vagina and contribute to vaginal dysbiosis, taking care of the gut will likely improve vaginal health”. (Source)
So, just regularly taking a good prebiotic, like Lactospore, or hydrolyzed guar gum, as well as eating fermented foods, can help prevent dysbiosis in the gut which could migrate to the vagina.
However, when dealing with vaginitis or UTIs one might consider using acidophilus suppositories as an alternative treatment, or even our Lactospore product. “One study gave two vaginal tablets daily, 150 million spores of bacillus coagulans per tab, which treated non-specific vaginitis, improved vaginal pH, and provided complete relief in 91% of patients (44 women, 6 postmenopausal).” (Source)
This is the end of Part One. In Part Two we will continue our examination of the relationship between genitourinary ailments and vitamin D, covering the subjects of sex drive, the vaginal microbiome and pelvic floor dysfunction.