Everything you need to know about vitamin D and menopause, including the causes and signs of vitamin D deficiency, the best types, how much to take and the symptoms it can help with.
Vitamin D is essential for good health during and after menopause. But lower levels of oestrogen at this time make your body less efficient at producing it and many menopausal women have a vitamin D deficiency.
Taking a vitamin D supplement can prevent this and may also help with a range of other menopause symptoms, such as weak bones or osteoporosis, vaginal dryness and low mood.
In this article, we’ll cover everything you need to know about vitamin D and menopause, including:
- why your body needs vitamin D
- the causes and signs of vitamin D deficiency
- the best types of vitamin D
- how it can help during menopause
- how much you should take
- whether you can use it alongside HRT
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What is vitamin D and why does your body need it?
Vitamin D, also known as calciferol, is essential for your overall health and wellbeing. It’s produced by your liver and kidneys when your skin is exposed to sunlight. Vitamin D is not naturally present in many foods, although you can get it from some oily fish like salmon and from mushrooms.
Vitamin D is involved in a range of key functions around your body. It maintains bones and muscles – including by helping you to absorb calcium – supports your immune system, reduces inflammation and keeps the nerves that carry messages from your brain healthy.
Scientists believe vitamin D may also impact how your body metabolises oestrogen. Changing levels of oestrogen are responsible for many of the most common symptoms of menopause.
Because it can be hard to get enough vitamin D from diet and sunshine alone, the NHS suggests taking a daily vitamin D supplement.
Menopause and vitamin D deficiency
During perimenopause – the years leading up to menopause – your levels of reproductive hormones like oestrogen begin to change. After menopause, when your periods have stopped, oestrogen settles at its lowest point.
Reduced levels of oestrogen make your skin and kidneys less efficient at producing certain forms of vitamin D, and your gut doesn’t absorb it as well. This may partly explain why vitamin D deficiency is very common among menopausal women.
After menopause, women with low vitamin D are significantly more likely to have problems with their bone health, such as osteoporosis and fractures.
As we’ll discuss later, getting enough vitamin D can reduce your risk of osteoporosis and help with a number of other menopause symptoms, including vaginal health issues and low mood.
What are the signs of low vitamin D?
For adults with low vitamin D, symptoms can sometimes be quite general and hard to pin down, such as:
- tiredness / fatigue
- aches and pains
- muscle weakness
- feeling generally unwell
People with very severe vitamin D deficiency can develop osteomalacia, a softening of the bones. Symptoms include a throbbing pain caused by touch, in areas like the chest, lower back, thighs, hips or pelvis, and increased weakness that could lead to trouble climbing stairs or getting up from a seated position.
Measurements of vitamin D deficiency
If your doctor thinks you could have a vitamin D deficiency, they will give you a blood test.
The form of vitamin D that circulates in your blood is known as 25-hydroxyvitamin D (25(OH)D) or calcitriol. The levels of calcitriol in your bloodstream are usually measured in one of two ways: in nanograms per millilitre (ng/mL) or in nanomoles per litre (nmol/L). A nmol/L is approximately 2.5 times a ng/mL.
There’s no definitive agreement on what levels constitute vitamin D deficiency, and lots of debate around the subject.
The Endocrine Society has suggested that anything below 20 ng/mL of calcitriol should be considered vitamin D deficiency.
However, the Institute of Medicine (now the National Academy of Medicine) says the right level will differ from person to person. It argues that 16 ng/mL is likely to be healthy for around half the population, with 12 ng/mL still a sufficient level for many.
Your doctor will consider both the results of your blood test and your symptoms when deciding whether you have a deficiency.
What's the best type of vitamin D for menopause?
When it comes to food and dietary supplements, vitamin D comes in two main forms, vitamin D2, also known as ergocalciferol, and vitamin D3, known as cholecalciferol.
Studies have shown that in single doses vitamin D3 is better than vitamin D2 at raising your levels of calcitriol, the form of vitamin D that circulates in your bloodstream. Vitamin D3 may also keep your levels higher for longer. However, if you take a daily supplement on a regular basis, there may be less difference between the effects of vitamin D2 and D3.
Although in food vitamin D2 comes from plant sources and vitamin D3 comes from animal sources, you can get vegetarian versions of both vitamin D2 and D3 supplements.
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How vitamin D could help with menopause symptoms
There’s evidence that a higher intake of vitamin D could help to tackle some of these common menopause symptoms.
Reduced bone density
Decreased oestrogen levels due to menopause mean you’re less efficient at absorbing calcium from your gut. This can lead to reduced bone density and eventually osteoporosis, where bones become weak and more likely to fracture.
One of the key functions of vitamin D is helping your body absorb calcium, so getting enough can keep bones strong and reduce the risk of osteoporosis.
One large-scale, long-term study involving postmenopausal women found that those with a higher intake of vitamin D had a significantly lower risk of hip fractures due to osteoporosis. Interestingly, the study also showed that intake of calcium itself had no effect on this risk.
Meanwhile, a review of clinical trials found that postmenopausal women who took a regular vitamin D supplement increased their bone density and reduced their risk of fracture.
Vaginal dryness
Another symptom of low oestrogen during perimenopause and after menopause is vaginal atrophy, a thinning of the walls of your vagina that leads to vaginal dryness. This can in turn cause soreness and itching, pain or discomfort during sex and an increased risk of infection.
Vitamin D is involved in regulating the growth of the different types of cells inside your vagina, including those that produce moisture and maintain a protective barrier.
One study involving postmenopausal women found that taking high-dose vitamin D supplements significantly improved several signs of vaginal atrophy after just 6 weeks.
Mood symptoms
Mood issues including low mood and depression are common symptoms of perimenopause and menopause.
Areas of your brain involved in processing emotions contain vitamin D receptors. Vitamin D is also integral to how your immune system responds to stress, as well as helping to regulate the mood hormone dopamine. People diagnosed with depression tend to have low levels of vitamin D.
In a study involving postmenopausal women, those with the highest intakes of vitamin D were less likely to have depressive symptoms than those with the lowest. They also had a 20% reduced risk of developing symptoms after 3 years.
Urinary tract infections
Low oestrogen during menopause can make the protective linings of your bladder and urinary tract more permeable and prone to bacterial infection.
Studies using infected tissues from postmenopausal women have shown that vitamin D increases the production of proteins that strengthen these linings.
However, more research is needed to demonstrate how these findings might translate to symptoms in women.
How much daily vitamin D should you take during menopause?
Vitamin D is usually measured by weight in micrograms – abbreviated to either mcg or μg – or as IUs (International Units).
IUs are based on how much of a substance it takes to produces a particular biological effect.
The NHS says a daily 10 mcg/μg (400 IU) vitamin D supplement is enough for the average person and recommends not taking more than 100 mcg/μg (4,000 IU) per day.
When it comes to treating vitamin D deficiency in menopausal women, experts have looked at the results of numerous studies to find the optimum dose.
Researchers writing in the journal Menopause Review concluded that daily doses of over 2,000 IU were needed to raise levels to 20 ng/mL in the course of a year.
How you take vitamin D is also relevant. Vitamin D is fat soluble, meaning it dissolves in fat rather than water. Although you can take vitamin D supplements on an empty stomach, you’ll absorb it more efficiently if you take it with food that contains some fat.
Can you take too much vitamin D?
Taking too much vitamin D in the form of supplements could cause a build-up of calcium in your body. Too much calcium is called hypercalcaemia and can actually weaken your bones, as well as damaging organs like your kidneys and heart.
According to the NHS, a regular daily dose of more than 100 mcg/μg or 4,000 IU could be harmful.
While you can’t get too much vitamin D from sunlight, it’s important to protect your skin with sunblock or clothing to reduce the risk of damage to your skin, and skin cancer.
Can you take vitamin D with HRT?
Hormone replacement therapy (HRT) replenishes reproductive hormones like oestrogen and progesterone lost during menopause. It’s an effective treatment for a range of common perimenopause and menopause symptoms.
If you’re on HRT, you can still take a vitamin D supplement. According to the Royal Osteoporosis Society, your doctor may prescribe them at the same time. The NHS says everyone should consider taking a vitamin D supplement, especially during the autumn and winter.
Summary
Vitamin D is an essential nutrient for strong bones, immune function and a healthy nervous system.
Lower levels of oestrogen during perimenopause and after menopause can make your body less efficient at producing and absorbing vitamin D and many menopausal women have a vitamin D deficiency.
Signs of vitamin D deficiency can include tiredness, aches and pain and feeling weak and unwell. A severe deficiency can lead to osteomalacia, a softening of the bones.
The main forms of vitamin D used by your body are vitamins D2 and D3. Vitamin D3 can increase and maintain the levels in your blood for longer.
Increasing your vitamin D intake could help with menopause symptoms including weak bones and osteoporosis, vaginal dryness and pain, and low mood and depression. There’s also some initial evidence that it could protect against urinary tract infections.
The NHS recommends that most people take a vitamin D supplement, especially during the darker autumn and winter months. Studies suggest that daily doses of over 50 mcg/μg (2,000 IU) are the most effective for tackling vitamin D deficiency in menopausal women.
Vitamin D3 is one of the ingredients in Better Night, an expert blend of herbal extracts and nutrients designed to improve anxiety, mood and sleep during perimenopause and after menopause.
Visit Better Night to find out more, and use the discount code WELCOME10 for 10% off your first order.