EMAS position statement: Vitamin D and menopausal health

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dc.authorid0000-0003-4067-7887
dc.contributor.authorAnagnostis, Panagiotis
dc.contributor.authorLivadas, Sarantis
dc.contributor.authorGoulis, Dimitrios G.
dc.contributor.authorBretz, Silvia
dc.contributor.authorCeausu, Iuliana
dc.contributor.authorDurmuşoğlu, Fatih
dc.contributor.authorErkkola, Risto
dc.contributor.authorFistonic, Ivan
dc.contributor.authorGambacciani, Marco
dc.contributor.authorGeukes, Marije
dc.contributor.authorHamoda, Haitham
dc.contributor.authorHartley, Caoimhe
dc.contributor.authorHirschberg, Angelica Lindén
dc.contributor.authorMeczekalski, Blazej
dc.contributor.authorMendoza, Nicolas
dc.contributor.authorMueck, Alfred
dc.contributor.authorSmetnik, Antonina
dc.contributor.authorStute, Petra
dc.contributor.authorvan Trotsenburg, Mick
dc.contributor.authorRees, Margaret
dc.contributor.authorLambrinoudaki, Irene
dc.date.accessioned2023-01-06T06:45:02Z
dc.date.available2023-01-06T06:45:02Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
dc.description.abstractIntroduction: There is increasing evidence that vitamin D has widespread tissue effects. In addition to osteoporosis, vitamin D deficiency has been associated with cardiovascular disease, diabetes, cancer, infections and neurodegenerative disease. However, the effect of vitamin D supplementation on non-skeletal outcomes requires clarification, especially in postmenopausal women. Aim: This position statement provides an evidence-based overview of the role of vitamin D in the health of postmenopausal women based on observational and interventional studies. Materials and methods: Literature review and consensus of expert opinion. Results and conclusions: Vitamin D status is determined by measuring serum 25-hydroxyvitamin D levels. Concentrations <20 ng/ml (<50 nmol/l) and <10 ng/ml (<25 nmol/l) are considered to constitute vitamin D deficiency and severe deficiency, respectively. Observational data suggest an association between vitamin D deficiency and adverse health outcomes in postmenopausal women, although they cannot establish causality. The evidence from randomized controlled trials concerning vitamin D supplementation is not robust, since many studies did not consider whether people were deficient at baseline. Moreover, high heterogeneity exists in terms of the population studied, vitamin D dosage, calcium co-administration and duration of intervention. Concerning skeletal health, vitamin D deficiency is associated with low bone mass and an increased risk of fractures. Vitamin D supplementation at maintenance doses of 800–2000 IU/day (20–50 ?g/day), after repletion of vitamin D status with higher weekly or daily doses, may be of benefit only when co-administered with calcium (1000–1200 mg/day), especially in the elderly populations and those with severe vitamin D deficiency. Concerning cardiovascular disease, vitamin D deficiency is associated with an increased prevalence of cardiovascular risk factors, mainly metabolic syndrome, type 2 diabetes mellitus and dyslipidemia. Vitamin D deficiency, especially its severe form, is associated with an increased risk of cardiovascular events (coronary heart disease, stroke, mortality), independently of traditional risk factors. Vitamin D supplementation may have a modestly beneficial effect on lipid profile and glucose homeostasis, especially in obese individuals or those ?60 years old and at doses of ?2000 IU/day (?50 ?g/day). However, it has no effect on the incidence of cardiovascular events. Concerning cancer, vitamin D deficiency is associated with increased incidence of and mortality from several types of cancer, such as colorectal, lung and breast cancer. However, the data on other types of gynecological cancer are inconsistent. Vitamin D supplementation has no effect on cancer incidence, although a modest reduction in cancer-related mortality has been observed. Concerning infections, vitamin D deficiency has been associated with acute respiratory tract infections, including coronavirus disease 2019 (COVID-19). Vitamin D supplementation may decrease the risk of acute respiratory tract infections and the severity of COVID-19 (not the risk of infection). Concerning menopausal symptomatology, vitamin D deficiency may have a negative impact on some aspects, such as sleep disturbances, depression, sexual function and joint pains. However, vitamin D supplementation has no effect on these, except for vulvovaginal atrophy, at relatively high doses, i.e., 40,000–60,000 IU/week (1000–1500 IU/week) orally or 1000 IU/day (25 ?g/day) as a vaginal suppository.
dc.identifier.citationAnagnostis, P., Livadas, S., Goulis, D. G., Bretz, S., Ceausu, I., Durmuşoğlu, F. ... Lambrinoudaki, I. (2023). EMAS position statement: Vitamin D and menopausal health. Maturitas, 169, 2-9. https://dx.doi.org/10.1016/j.maturitas.2022.12.006
dc.identifier.doi10.1016/j.maturitas.2022.12.006
dc.identifier.endpage9
dc.identifier.issn0378-5122
dc.identifier.issn1873-4111
dc.identifier.pmid36566517
dc.identifier.scopus2-s2.0-85144802051
dc.identifier.scopusqualityQ1
dc.identifier.startpage2
dc.identifier.urihttps://dx.doi.org/10.1016/j.maturitas.2022.12.006
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10250
dc.identifier.volume169
dc.identifier.wos000914182100001en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorDurmuşoğlu, Fatih
dc.language.isoen
dc.publisherElsevier Ireland Ltd
dc.relation.ispartofMaturitasen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectCancer
dc.subjectCardiovascular Disease
dc.subjectCOVID-19
dc.subjectMenopause
dc.subjectPostmenopausal Women
dc.subjectVasomotor Symptomatology
dc.subjectVitamin D
dc.titleEMAS position statement: Vitamin D and menopausal health
dc.typeArticle

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