The effect of vitamin D on vaginal atrophy in postmenopausal women Effect of 1-year, low-dose DHEA therapy on climacteric symptoms and female sexuality Vitamin D levels and menopause-related symptoms Vitamin D and calcium intake and risk of early menopause. Role of Vitamin D in urogenital health of geriatric participants Interaction between current vitamin D supplementation and menopausal hormone therapy use on breast cancer risk: evidence from the E3N cohort. Sunlight, hormone replacement status and colorectal cancer risk in postmenopausal women. Calcium and vitamin D supplementation do not influence menopause-related symptoms: Results of the Women's Health Initiative Trial. Effect of 1,25‐dihydroxy ‐ vitamin D3 in itself or combined with hormone treatment in preventing postmenopausal osteoporosis Serum 25(OH) Vitamin D and Risk of Breast Cancer: A Nested Case-Control Study from the French E3N Cohort Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Vitamin D intake and breast cancer risk in postmenopausal women: the Iowa Women’s Health Study [Changes in maturation index and vaginal dryness in postmenopausal women who use or not calcitriol]. Postmenopausal breast cancer risk and interactions between body mass index, menopausal hormone therapy use, and vitamin D supplementation: Evidence from the E3N cohort. BMI and season are associated with vitamin D deficiency in women with impaired fertility: a two-centre analysis Effect of treatment with dydrogesterone or calcium plus vitamin D on the severity of premenstrual syndrome. Pretreatment Serum Concentrations of 25-Hydroxyvitamin D and Breast Cancer Prognostic Characteristics: A Case-Control and a Case-Series Study
Background : Most of the women suffer from vaginal atrophy and dryness , and therefore , efficient and safe treatment is needed to improve vaginal lubrication . Vitamin D has several important functions which may be effective in proliferation and repair of the epithelial tissue . This study aim ed to evaluate the effect of vitamin D vaginal suppositories on maturation index , pH , and dryness in postmenopausal women . Material s and Methods : Women were enrolled in this double-blind clinical trial , in whom menopause occurred at least one year ago . Those women who had an abnormal Papanicolaou smear , had undergone hormonal treatment , or have had vaginal infection in the previous year were excluded . Forty-four women who found eligible were r and omized into two equal groups , the treatment and control groups , which received vitamin D and placebo vaginal suppository daily for 8 weeks , respectively . Vaginal pH and maturation value were measured at the beginning and end of the study . Pain , dryness , and paleness were assessed before treatment and at the end of the 2 , 4 , and 8 weeks of treatment . Results : In the treatment group , the number ( Mean ± SD ) of superficial cells increased ( 69.76 ± 12.4 ) and vaginal pH decreased ( 1.42 ± 0.67 ) significantly compared to the control group after 56 days . The mean pain significantly reduced after 8 weeks in the treatment group ( 1.23 ± 0.53 ) compared to the control group 1.95 ± 0.74 ( P < 0.001 ) . The mean of dryness and paleness reduced significantly in the treatment group versus control at 56 days . Conclusions : Vitamin D is effective in improving the maturation index and decreased the pH and dryness of the vaginal atrophy due to menopause ABSTRACT Background Sexual desire is affected by endocrine and psychosocial factors . Menopausal hormonal changes are relevant to the causes of sexual dysfunction during reproductive aging . Aim To evaluate the effects of different types of hormonal replacement therapy ( HRT ) on sexual function , frequency of sexual intercourse , and quality of relationship in early postmenopausal women . We recruited 48 healthy postmenopausal women aged 50–60 years ( mean age 54.5 ± 3.3 years ) . Women with climacteric symptoms were uniformly r and omized into three groups receiving either dehydroepi and rosterone ( DHEA 10 mg ) daily , or daily oral estradiol ( 1 mg ) plus dihydrogesterone ( 5 mg ) , or daily oral tibolone ( 2.5 mg ) for 12 months . Women who refused hormonal therapy were treated with oral vitamin D ( 400 IU ) . Efficacy was evaluated using the McCoy Female Sexuality Question naire before treatment and after 12 months . We evaluated the hormonal profile before treatment and after 3 , 6 and 12 months . Results The groups receiving DHEA or HRT reported a significant improvement in sexual function compared to baseline ( p < 0.001 and p < 0.01 , respectively ) using the McCoy total score . The quality of relationship was similar at baseline and after 3 , 6 and 12 months of treatment . There were significant increases in the numbers of episodes of sexual intercourse in the previous 4 weeks in women treated with DHEA , HRT and tibolone in comparison with the baseline value ( p < 0.01 , p < 0.05 , p < 0.01 , respectively ) . No changes in the McCoy score occurred in women receiving vitamin D. Conclusions Daily oral DHEA therapy at the dose of 10 mg , HRT and tibolone all provided a significant improvement in comparison with vitamin D  in sexual function and in frequency of sexual intercourse in early postmenopausal women Objective This study aims to determine whether vitamin D levels are associated with menopause-related  symptoms  in older women . Methods A r and omly selected subset of 1,407 women , among 26,104 potentially eligible participants of the Women ’s Health Initiative Calcium and Vitamin D trial of postmenopausal women aged 51 to 80 years , had 25-hydroxyvitamin D [ 25(OH)D ] levels measured at the Women ’s Health Initiative Calcium and Vitamin D trial baseline visit .  Information about menopause-related symptoms at baseline was obtained by question naire and included overall number of symptoms and composite measures of sleep disturbance , emotional well-being , and energy/fatigue , as well as individual symptoms . After exclusions for missing data , 530 women ( mean [ SD ] age , 66.2 [ 6.8 ] y ) were included in these analyses . Results Borderline significant associations between 25(OH)D levels and total number of menopausal symptoms were observed ( with P values ranging from 0.05 to 0.06 for fully adjusted models ) ; however , the effect was clinical ly insignificant and disappeared with correction for multiple testing . No associations between 25(OH)D levels and composite measures of sleep disturbance , emotional well-being , or energy/fatigue were observed ( P ’s > 0.10 for fully adjusted models ) . Conclusions There is no evidence for a clinical ly important association between serum 25(OH)D levels and menopause-related symptoms in postmenopausal women Background : Early menopause , defined as the cessation of ovarian function before the age of 45 y , affects ∼10 % of women and is associated with higher risk of cardiovascular disease , osteoporosis , and other conditions . Few modifiable risk factors for early menopause have been identified , but emerging data suggest that high vitamin D intake may reduce risk . Objective : We evaluated how intakes of vitamin D and calcium are associated with the incidence of early menopause  in the prospect i ve Nurses ' Health Study II ( NHS2 ) . Design : Intakes of vitamin D and calcium from foods and supplements were measured every 4 y with the use of a food-frequency question naire . Cases of incident early menopause were identified from all participants who were premenopausal at baseline in 1991 ; over 1.13 million person-years , 2041 women reported having natural menopause before the age of 45 y. We used Cox proportional hazards regression to evaluate relations between intakes of vitamin D and calcium  and incident early menopause while accounting for potential confounding factors . Results : After adjustment for age , smoking , and other factors , women with the highest intake of dietary vitamin D ( quintile median : 528 IU/d ) had a significant 17 % lower risk of early menopause than women with the lowest intake [ quintile median : 148 IU/d ; HR : 0.83 ( 95 % CI : 0.72 , 0.95 ) ; P-trend = 0.03 ] . Dietary calcium intake in the highest quintile ( median : 1246 mg/d ) compared with the lowest ( median : 556 mg/d ) was associated with a borderline significantly lower risk of early menopause ( HR : 0.87 ; 95 % CI : 0.76 , 1.00 ; P-trend = 0.03 ) . Associations were stronger for vitamin D and calcium from dairy sources than from nondairy dietary sources , whereas high supplement use was not associated with lower risk . Conclusions : Findings suggest that high intakes of dietary vitamin D and calcium may be modestly associated with a lower risk of early menopause . Further studies evaluating 25-hydroxyvitamin D concentrations , other dairy constituents , and early menopause are warranted Introduction : Role of Vitamin D is very well known for the functioning of many body organs . However , its role in the postmenopausal women in relation to various genitourinary disorders has been recognized recently . The main objective of this study was to evaluate role of Vitamin D in vaginal health , prolapse , bladder and bowel function , and bacterial vaginosis ( BV ) . Material s and Methods : This was a r and omized controlled study in which 200 geriatric female patients of 65–78 years of age divided into two groups comprising study and control group with 100 participants in each . Detailed obstetrical , gynecological , and clinical history was elicited . Detailed examination regarding the prolapse , urinary and bowel functions , and bacterial infections was done followed by follow-up of 3 and 6 months each . Chi-square and independent t-test used for data analysis . Results : Mean modified vaginal health index ( MVHI ) among patients with pelvic floor diseases was statistically significant with P = 0.0472 . There was a visible increasing trend in Vitamin D deficiency with increase in time since menopause ( P = 0.1193 ) . Patients with pelvic floor disease had mean Vitamin D statistically significant with P = 0.0462 . With increase in  Vitamin D levels , MVHI was found to be better . The association of mean Vitamin D levels among patients with urinary incontinence as compared to controls was significant with P = 0.0460 . Association of mean Vitamin D levels in patients with fecal incontinence and BV as compared to controls was not statistically significant with P = 0.6304 and 0.79 , respectively . Low Vitamin D levels were associated with high mean parathyroid hormone ( PTH ) levels statistically significant with P = 0.034 . MVHI was found to increase significantly with Vitamin D supplementation at 3 and 6 months ' follow-up . There was increase in Vitamin D and calcium levels and fall in serum PTH levels at 3 and 6 months . Conclusions : Vitamin D levels were associated with a decreased risk of pelvic floor disorders , improved MVHI in women in geriatric age group BACKGROUND Experimental studies suggest protective effects of vitamin D on breast carcinogenesis , particularly on estrogen receptor-positive tumors . Epidemiologic data are less conclusive . OBJECTIVE Our objective was to investigate the association between postmenopausal breast cancer risk and current or past vitamin D supplementation overall and according to the use of menopausal hormone therapy ( MHT ) . DESIGN Between 1995 and 2008 , 2482 invasive breast cancer cases were diagnosed among 57,403 postmenopausal women from the E3N prospect i ve cohort during 581,085 person-years .  Vitamin D supplementation was assessed from biennially self-administered question naires sent in 1995 , 2000 , 2002 , and 2005 and from medico-administrative data on drug reimbursements since 2004 . Multivariable HRs for primary invasive breast cancer and 95 % CIs were estimated by using Cox models . RESULTS A decreased postmenopausal breast cancer risk was associated with current ( HR : 0.82 ; 95 % CI : 0.69 , 0.97 ) but not past ( HR : 1.10 ; 95 % CI : 0.92 , 1.31 ) vitamin D supplementation ( P-homogeneity = 0.02 ) . The association with current vitamin D supplementation  differed according to MHT use : ever users ( HR : 0.74 ; 95 % CI : 0.60 , 0.90 ) and never users ( HR : 1.13 ; 95 % CI : 0.89 , 1.56 ) ; P-homogeneity = 0.02 . CONCLUSIONS In this observational study , current vitamin D supplementation , mostly taken daily and combined with calcium , was associated with a decreased postmenopausal breast cancer risk in MHT users . These findings should be confirmed before considering vitamin D supplementation to partly balance the MHT-associated increased breast cancer risk A re analysis of the Women 's Health Initiative ( WHI ) r and omized clinical trial found a significant interaction between supplementation with vitamin D/calcium and estrogen therapy and the risk of colorectal cancer risk , with reduced risks from supplementation limited to the placebo arms of the estrogen trials . To explore whether the vitamin D effects are modified by estrogen therapy , we report a largely cross-sectional , analysis of the association between sun exposure , which is an important vitamin D source , and colorectal cancer risk among postmenopausal women in the U.S. Radiologic Technologists study . Among 21,695 participants , there were a total of 108 cases . Sun exposure was based on time outdoors and on ambient ultraviolet radiation ( UV ) exposure based on residence linked to erythemal exposures derived from the Total Ozone Mapping Spectrometer data base . Although there was no relationship between outdoor time or ambient UV measure and colorectal cancer risk in current hormone replacement therapy ( HRT ) users , in never/past HRT users , there was an inverse association with higher ambient UV exposure , RR for highest vs. lowest tertile = 0.40 ; 95 % CI 017 , 0.93 ; p for trend = 0.04 . Non-significant lower risks were also associated with higher levels of outdoor time ( > or = 3.5 hr/week ) in never/past HRT users . The interaction between both indicators of sun exposure and HRT and CRC risk was not significant . These data , although exploratory , are consistent with evidence from the WHI suggesting a decrease in colorectal cancer risk may be associated with vitamin D exposure among postmenopausal women who are not taking HRT , but not among current HRT users BACKGROUND It is unknown whether supplementation with calcium and vitamin D has an impact on menopause-related symptoms . METHODS As part of the Women 's Health Initiative Calcium/Vitamin D Supplementation Trial ( CaD ) , women were r and omized at 40 clinical sites to  elemental calcium carbonate 1000 mg with vitamin D 400 IU daily or placebo . At the CaD baseline visit ( year 1 or year 2 ) and during a mean follow-up of 5.7 years , participants provided data on menopause-related symptoms via question naires . Generalized linear mixed effects techniques were used to address research questions . RESULTS After excluding participants with missing data ( N=2125 ) , we compared menopause-related symptoms at follow-up visits of 17,101 women r and omized to CaD with those of 17,056 women given the placebo .  Women in the CaD arm did not have a different number of symptoms at follow-up compared to women taking the placebo ( p=0.702 ) . Similarly , there was no difference between sleep disturbance , emotional well-being , or energy/fatigue at follow-up in those who were r and omized to CaD supplementation compared to those taking the placebo . CONCLUSIONS Our data suggest that supplementation with 1000 mg of calcium plus 400 IU of vitamin D does not influence menopause-related symptoms over an average of 5.7 years of follow-up among postmenopausal women with an average age of 64 at the WHI baseline visit Abstract . Eighty‐four normal women , 2.5‐5 years after their natural menopause , participated in a controlled double‐blind trial . The effect of various therapeutic regimens on postmenopausal bone mineral loss was measured by photonabsorptiometric determination of the bone mineral content of both forearms . The women were r and omized into four treatment groups : 1,25‐dihydroxycholecalciferol ( 1,25(OH)2D3 ) alone in a daily dose of 0.25 μg , oestrogens/gestagen alone or combined with 1,25(OH)2D3 , and placebo . The groups treated with oestrogens/gestagen ( without and with 1,25(OH)2D3 ) showed a similar increase in bone mineral content of about 1 % during one year of treatment . In contrast , both the placebo group and the 1,25(OH)2D3 group demonstrated a decrease of 1.9 % and 2.1 % , respectively , within the same period of time . While 1,25(OH)2D3 did not alter the rate of bone loss , it caused the characteristic and pronounced increase in urinary calcium excretion ( 15 % ) Background : High 25-hydroxyvitamin D [ 25(OH)D ] serum concentrations have been found to be associated with reduced breast cancer risk . However , few studies have further investigated this relationship according to menopausal status , nor have they taken into account factors known to influence vitamin D status , such as dietary and serum calcium , parathyroid hormone , and estradiol serum levels . Methods : We design ed a nested case-control study  within the French E3N cohort . Cases were women diagnosed with incident breast cancer ( n = 636 ) . Controls ( n = 1,272 ) were matched with  cases  on age , menopausal status at blood collection , age at menopause , and center and year of blood collection . Multivariate logistic regression models were established . Results : We found a decreased risk of breast cancer with increasing 25(OH ) vitamin D3 serum concentrations ( odds ratio , 0.73 ; 95 % confidence interval , 0.55 - 0.96 ; P trend = 0.02 ) among women in the highest tertile . We also observed a significant inverse association restricted to women under 53 years of age at blood sampling [ odds ratio ( T3 versus T1 ) , 0.60 ; 95 % confidence interval , 0.37 - 0.98 ; P trend = 0.04 ] . In premenopausal women , the risk was also decreased , although not significantly . Conclusion : Our findings support a decreased risk of breast cancer associated with high 25(OH ) vitamin D3 serum concentrations , especially in younger women , although we were unable to confirm a direct influence of age or menopausal status . Impact : R and omized intervention trials with vitamin D supplementation are required to confirm its benefits on breast cancer risk , but the maintenance of adequate vitamin D levels should be encouraged by public health policy . Cancer Epidemiol Biomarkers Prev ; 19(9 ) ; 2341–50 . © 2010 AACR OBJECTIVES To determine whether relative vitamin D deficiency during the winter months contributes to age-related bone loss  and whether rates of change in hard- and soft-tissue mass vary during the year . DESIGN Double-blind , placebo-controlled , 1-year trial in 249 women in which equal numbers of women were r and omized to either placebo or 400 IU of vitamin D daily . All women received 377 mg/d of supplemental calcium largely as calcium citrate malate . PATIENTS Healthy , ambulatory postmenopausal women with usual intakes of vitamin D of 100 IU/d . MEASUREMENTS Duplicate spine and whole-body scans were done by dual energy x-ray absorptiometry at 6-month intervals that were timed to periods when 25-hydroxyvitamin D levels were highest and lowest . Period 1 was June-July to December-January and period 2 was December-January to the next June-July . Serum parathyroid hormone and plasma 25-hydroxyvitamin D levels were measured during periods 1 and 2 . MAIN RESULTS In the placebo group , spinal bone mineral density increased in period 1 , decreased in period 2 , and sustained no net change . Women treated with vitamin D had a similar spinal increase in period 1 ( 1.46 % compared with 1.40 % in placebo ) , less loss in period 2 ( -0.54 % compared with -1.22 % , CI for the difference , 0.05 % to 1.31 % , P = 0.032 ) and a significant overall benefit ( 0.85 % compared with 0.15 % , CI for the difference , 0.03 % to 1.37 % , P = 0.04 ) . In period 2 , 25-hydroxyvitamin D levels were lower and parathyroid hormone levels were higher in the placebo than in the vitamin D group . Whole-body lean and fat tissue and bone mineral density varied during the year but did not change overall . CONCLUSIONS At latitude 42 degrees , healthy postmenopausal women with vitamin D intakes of 100 IU daily can significantly reduce late wintertime bone loss and improve net bone density of the spine over one year by increasing their intake of vitamin D to 500 IU daily . A long-term benefit of preventing vitamin D insufficiency in the winter seems likely although it remains to be shown . Observed changes in bone as well as in fat and lean tissue appear to be related to season Vitamin D , a prosteroid hormone with anti-proliferative and pro-differentiation activity , is thought to act as a cancer chemopreventive agent . This study evaluated the association between vitamin D intake and  breast cancer risk among women in a large prospect i ve cohort study . A total of 34,321 postmenopausal women who had completed a question naire that included diet and supplement use were followed for breast cancer incidence from 1986 to 2004 .  Adjusted relative risks ( RR ) for breast cancer were calculated for dietary , supplemental , and total vitamin D intake among all women . The adjusted RR of breast cancer for women consuming > 800 IU/day versus < 400 IU/day total vitamin D was 0.89 ( 95 % CI : 0.77–1.03 ) . RRs were stronger among women with negative than positive ER or PR status . The association of high vitamin D intake with breast cancer was strongest in the first 5 years after baseline dietary assessment ( RR = 0.66 ; 95 % CI : 0.46–0.94 compared with lowest-intake group ) , and diminished over time . Changes in  vitamin D intake over time might have contributed to the diminished association observed in later years . Vitamin D intake of > 800 IU/day appears to be associated with a small decrease in risk of breast cancer among postmenopausal women . Studies evaluating all sources of vitamin D , especially sun exposure , are needed to fully underst and the association between vitamin D and breast cancer risk BACKGROUND it is known that vitamin D increases the population of superficial cells , so the objective of the present work was to evaluate the effect in Mexican postmenopausal women who were using or not oral calcitriol .  METHODS postmenopausal women with vaginal dryness that received at r and om : calcium 500 mg orally every 24 h or calcitriol 0.25 μg every 24 h during two months . At the beginning of treatment and at two months a vaginal Pap smear was performed . The maturation index was determined and the estrogenic value was calculated . Vaginal dryness was evaluated using an analog visual scales and vaginal by the moistening of a pH test strip . Student 's t test was used for statistical analysis . RESULTS 23 postmenopausal women were studied and divided as follows : group I ( calcium ) = 11 women and group II ( calcitriol ) = 12 women . In the analyzed parameters only the average of superficial cells was significantly greater at the end of treatment in the calcitriol group . CONCLUSION calcitriol use increased the average of superficial cells in vaginal cytology , but did n't modify vaginal dryness Experimental studies suggest protective effects of vitamin D on breast carcinogenesis , but epidemiological evidence is not conclusive . Body mass index ( BMI ) has been shown to modulate the effect of supplementation on the vitamin D status , but its potential influence on the relationship with breast cancer risk has been little studied . We investigated a potential interaction between BMI and vitamin D supplementation  on breast cancer risk while considering an already reported interaction between vitamin D supplementation and menopausal hormone therapy ( MHT ) use . Vitamin D supplementation was prospect ively investigated in 57,403 postmenopausal women from the French E3N cohort including 2,482 incident breast cancer cases diagnosed between 1995 and 2008 .  Multivariable hazard ratios ( HR ) for primary invasive breast cancer and 95 % confidence intervals ( CI ) were estimated using Cox models . Among MHT ever users , vitamin D supplementation was associated with decreased breast cancer risk , similarly across BMI strata ( Phomogeneity = 0.83 ) . Among MHT never users , ever vitamin D supplementation was associated with increased postmenopausal breast cancer risk in women with baseline BMI < 25 kg/m(2 ) ( HR = 1.51 , 95 % CI : 1.13 , 2.02 ) , but not in women with higher BMI ( 0.98 , 95 % CI : 0.62 , 1.56 ) , Phomogeneity = 0.12 . In conclusion , our findings suggest that vitamin D supplementation may reduce the excess breast cancer risk in MHT users , but draw attention on a potential risk in postmenopausal women not exposed to high exogenous or endogenous hormones , i.e. non-overweight MHT-non users , especially in the present context of increasing vitamin D supplement use and decreasing MHT use Purpose Animal and human studies suggest that vitamin D regulates functions of the reproductive system . Vitamin D deficiency is prevalent in women of reproductive age . Vitamin D status has been associated with in vitro fertilisation outcome , features of polycystic ovarian syndrome ( PCOS ) and endometriosis . The aims of our study were to investigate the prevalence of vitamin D deficiency of infertile women living in central Germany , to identify risk factors for vitamin D deficiency and to specify seasonal variations of vitamin D status . Methods This was a retrospective cohort study at an academic tertiary care centre ( N = 113 ) and an Outpatient Centre for Reproductive Medicine ( N = 193 ) of women presenting for infertility treatment . The statistical evaluation was descriptive and explorative . Possible risk factors associated with an increased risk for vitamin D deficiency were assessed using multiple logistic regression models . Variables with p value less than 0.05 were further assessed in a multivariable logistic regression model . Results Overall , 98.2 % of patients at centre 1 and 81.3 % of women with impaired fertility at centre 2 had deficient or insufficient vitamin D levels . Overweight BMI and limited exposure to sun ( winter , spring and autumn trimester ) were associated with an increased risk of vitamin D deficiency . Vitamin D levels did not vary according to age or infertility associated disorders ( e.g. endometriosis , PCOS ) . Conclusion The rate of vitamin D deficiency among women with impaired fertility is alarming . Prospect i ve studies are pressingly needed to confirm a causal relationship and to investigate the potential therapeutic benefits of vitamin D supplementation in this population OBJECTIVE To compare the effects of dydrogesterone and calcium plus vitamin D in women with severe premenstrual syndrome ( PMS ) . METHOD In this r and omized , double-blind , placebo-controlled study , 180 Shiraz University students with PMS used question naires daily to rate their symptoms for 2 menstrual cycles . Then , the students were r and omly assigned to take a tablet containing either 5 mg of dydrogesterone , 500 mg of calcium plus 200 mg of vitamin D , or a placebo twice daily from the 15th to the 24th day of the cycle for 2 more cycles , and to use the same question naires during the intervention cycles . The collected data were then analyzed by repeated-measurement design and multilevel modeling tests . RESULT Treatment with dydrogesterone or calcium plus vitamin D  decreased symptom severity in a similar way ( by 4.64 % and 4.20 % , respectively ) and placebo was associated with a 3.42 % decrease . CONCLUSION Treatment with dydrogesterone or calcium plus vitamin D had a similar effect on symptom severity in women with PMS Background Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive . It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity . Methods and Findings In case-control and case-series analyses , we examined serum concentrations of 25-hydroxyvitamin D ( 25OHD )  in relation to breast cancer prognostic characteristics , including histologic grade , estrogen receptor ( ER ) , and molecular subtypes defined by ER , progesterone receptor ( PR ) and HER2 , among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008 . We found that breast cancer cases had significantly lower 25OHD concentrations than controls ( adjusted mean , 22.8 versus 26.2 ng/mL , p<0.001 ) . Among premenopausal women  , 25OHD concentrations were lower in those with high- versus low- grade tumors , and ER negative versus ER positive tumors ( p≤0.03 ) . Levels were lowest among women with triple-negative cancer ( 17.5 ng/mL ) , significantly different from those with luminal A cancer ( 24.5 ng/mL , p = 0.002 ) . In case-control analyses , premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer ( OR = 0.21 , 95 % CI = 0.08–0.53 ) than those with levels below the median ; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64 % lower odds of having triple-negative cancer ( OR = 0.36 , 95 % CI = 0.22–0.56 ) . The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses . Conclusion In our analyses , higher serum levels of 25OHD were associated with reduced risk of breast cancer , with associations strongest for high grade , ER negative or triple negative cancers in premenopausal women . With further confirmation in large prospect i ve studies , these findings could warrant vitamin D supplementation for reducing breast cancer risk , particularly those with poor prognostic characteristics among premenopausal women
Although the level of evidence for the effects of vitamin D on vaginal health is low in our study , we concluded that vitamin D may improve the vaginal health of women , especially during menopause
Menopause is associated with the onset of climacteric symptoms due to low estradiol levels , which may cause insufficient maturation of the vaginal mucosa .
Vitamin D may regulate the growth and differentiation of cells that are adversely affected due to low estradiol levels , thereby restoring vaginal health .
The objective of this systematic review , the first on this subject , was to investigate the effect of vitamin D on the  vaginal health of menopausal women .